Some 20 years ago in the Philippines, DKT International launched an advertisement for strawberry-scented Trust condoms. An archbishop of the Catholic Church, a man incongruously named Cardinal Sin, quickly condemned the ad as an illicit promotion of sex.
In 1997, when I was working in Ethiopia on a family planning project, we introduced a second brand of condom, called "Sensation," to the marketplace. The blue package featured a Caucasian couple embracing on a beach in their swimwear. Ministry of Health officials summoned me to their offices and ordered me to stop all promotion and sales, questioning why Ethiopia, or any country, would need more than one condom brand (the government was still heavily influenced by Socialist approaches to the economy). My first instinct was to ask them why any man would need more than one shirt.
In July of 2013, a condom commercial in Pakistan broke new ground by gently suggesting that the use of Josh condoms had enabled a homely man to marry a supermodel. After 10 days on air, the ad was pulled by the regulatory authorities, which deemed the ad indecent.
While some public health advocates might suggest that a more nuanced approach to condom promotion would have been better, I disagree. Why? In all three instances, some very positive public health outcomes emerged -- especially for consumers.
In the Philippines, the controversy resulted in record sales of strawberry condoms, an aroma which has proven to be the most popular among condom purchasers all over the world. Because of the brouhaha, consumers wanted to see what the fuss was about (strawberry both masks the scent of latex and adds a romantic and titillating atmosphere to the sex act). Trust condoms are now the most popular brand in this country of 92 million and more than six other condoms with aromas and even real flavors have since been introduced to the marketplace.
In Ethiopia, in line with the government's request, we produced no more Sensation condoms and halted promotions. However, we continued to press our case with Ministry officials and, after two years, were able to relaunch Sensation condoms and even a third brand. Sensation condoms now sell 30 million pieces a year and come in eight flavors, offering more choice to Ethiopian men and women.
In Pakistan, the recent controversy (which also included concerns -- again -- about the strawberry scent) has provided opportunities to bring the conversation about family planning out of the bedroom and into the open (condoms account for nearly a third of modern family-planning use in Pakistan). The ad ban catalyzed widespread discussion, including in Pakistan Today, Al Jazeera and the GlobalPost, with arguments on all sides. And while the dust is only just settling on the public's uproar, my guess is that breaking some of these taboos will prove important to addressing the root causes behind the very low contraceptive use rates in Pakistan, and increase condom use.
These controversies stem in part from cultural taboos and universal nervousness about sex. Condoms, more than other family planning products, are closely aligned with sensuality and non-procreative sex. This may be due to the fact that condoms are so closely associated with the sex act itself. Or perhaps because condoms are an over-the-counter, direct-to-consumer product, they don't require conceptual and practical buy-in from a medical establishment that necessitates a heightened veneer of respectability. Whatever the case, condom ads have often been advertised using sensual themes (humor and macho backdrops are also typical).
Family planning programs, by contrast, have generally kept their promotions asexual, choosing to show happy families, responsible fathers, and mothers who are healthy and cheerful. The adults in these ads look content and prosperous -- but not particularly sexy.
I think we're missing an opportunity here. The reason that people use contraceptives is to enjoy having sex without fear of pregnancy. Forty years ago when modern methods such as oral contraceptives and IUDs were introduced, this was a radical idea. Is it still? Family planning programs fail to capitalize on the primary motivation of men and women to take up family planning in the first place. Mayone Stycos noted this incongruence in his 1977 article, "Desexing Birth Control," and suggested that the family planning movement "recast communications in terms of sexual liberation rather than of sexual control" and that we change slogans like "love carefully" to "love without care."
A sexy family planning ad is long overdue. Imagine the following script: a lingerie-clad wife entices her husband to the bedroom after putting the kids to bed. Candelight. Mood music. And cut to the women looking over her husband's shoulder and holding up her pack of pills. She says, "Tonight, he's all mine. I don't have to worry because we use family planning." Fade to black.
Will this create controversy? Probably. But if experience from the condom category is any proxy, the result will be a generation of new husbands rushing to buy oral contraceptives for their wives. This will result in fewer pregnancies and a myriad of associated benefits such as reduced maternal deaths. And of course, more people will be enjoying healthier, more pleasurable sex lives, a positive for all concerned. The impact of increased family planning will be especially significant in developing countries.
The family planning community should be willing to take some reasonable risks when it comes to acknowledging the pleasure motivation in birth control. We know that this kind of sexy advertising works to sell pretty much everything else in the world. Why not with family planning, one of the most empowering and powerful forces for good and pleasure in the world? This is an idea whose time has come. The question is, who will be brave enough to give it a try?