While in the thick of an assignment a few weeks ago, I just barely managed to keep up with email and other information that crosses my desk on a daily basis. However, I remembered scanning a post in one of the science, technology, engineering, and math (STEM) newsletters about three new Grand Challenges from the Bill and Melinda Gates Foundation.
The Grand Challenges are a family of grant programs sponsored by the Gates Foundation that foster innovation to solve key global health and development problems. Three new Exploration Challenges have been added:
· Bringing Together Human and Animal Health for New Solutions (the One Health Concept)
· Increasing Interoperability of Social Good Data
· Developing the Next Generation of Condom
With tired eyes, I re-read the three new challenges above, knowing full well that it was the last one that I was most curious about. After reading the post again, I said, “Yeah! That is what it says.” Over the next few days I would hear about the challenge to develop a better condom thru various news outlets including social media. There were several news commentators who also questioned if there might be a possible error in the information provided? or wanted to know exactly what the Gates Foundation was thinking when they came up with this one? Or at least like me some said, “Is there a typo in the wording?”
So now I am thinking, “I haven’t done grant work in a while.” Is this one that I should consider pursuing given my educational background as a chemical engineer, MBA graduate, and my knack for problem solving. It also led me to ask “What is the history and evolution of the condom?”. Turns out this question has been asked a number of times. A quick web search revealed numerous articles and documents on the topic.
Some interesting historical notes about the development of the condom include:
· Bladders, animal membranes, sheaths and salve-coated cloths have been used for similar purposes since the beginning of recorded history. [Ref 1]
· The first speculation of condom use comes out of Ancient Egypt, when some historians think that men used linen as a sexual barrier. However, there is no scientific evidence to support this claim, and the incidence of sexually transmitted infections in Egypt was low. [Ref 2]
· Fast forward to the sixteenth century, when anatomist and physician Gabriele Falloppio is the first man to describe the condom, unequivocally, in written texts. He even performed clinical trials, in which he claims his linen sheaths protected 1,100 men in Italy from contracting syphilis. [Ref 2]
· Significant rise in the popularity of the condom is tied to the epidemic of syphilis. Syphilis was transforming European society. It was a disease that not only impacted your well-being (you eventually did die from syphilis), but it was also passed along to sexual partners, and unborn children. [Ref 2]
· In 1839, Charles Goodyear discovered a method to process rubber to make it more durable and elastic regardless of temperature. The rubber vulcanization process was patented by Goodyear in 1844 [Ref 1, 3], that would eventually lead to the invention of latex years later.
· First rubber condom produced in 1855. [Ref 3]
· Latex, rubber suspended in water, was invented in 1920. Latex condoms required less labor to produce, eliminated the use of gasoline and benzene and thereby a fire hazard associated with the previous process, performed better, and were stronger, thinner, and had a shelf life of five years compared to three months for rubber. [Ref 3]
· Onset of H.I.V. and AIDS in the 1980s created another crisis in which advertisements and educational materials invoked death and disease, just as the warnings about sexual diseases did in earlier centuries. [Ref 1, 3] Condom use for safe sex was promoted heavily during this period.
Now onto the leading question: Why is the Gates Foundation interested in developing a better condom? A few questions that have been asked by the foundation on this topic are: What is one of the oldest medical devices in existence? What is the most effective method of preventing sexual transmission of HIV? What medical product is so simple that it can easily be manufactured by the millions and costs just pennies? The answer to all three is the same – the condom. This modest device is one of the most effective tools in our armature against HIV infection. It also prevents unintended pregnancies! When used consistently and correctly, condoms are extremely effective at preventing HIV infection and unplanned pregnancy.
Foundation employees Papa Salif Sow and Stephen Ward write in their article: Reinventing The Condom [Ref 4], “But if condoms are so marvelous, why are we seeking ideas for the Next Generation of Condoms in our current Round of Grand Challenge Explorations?” The success and impact of any public health tool hinges on that tool being used consistently and correctly by those who need it. Vaccines sitting on shelves don’t prevent disease. New tuberculosis drug regimens won’t help if patients stop taking them halfway through the necessary days. Likewise, the potential value of condoms is limited by inconsistent use.
The Challenge (as issued from the Gates Foundation): Condoms have been in use for about 400 years yet they have undergone very little technological improvement in the past 50 years. The primary improvement has been the use of latex as the primary material and quality control measures that allow for quality testing of each individual condom. Given the advances in material science and an improved understanding of neurobiology, new concept designs with new materials can be prototyped and tested quickly. Large-scale human clinical trials are not required. Manufacturing capacity, marketing, and distribution channels are already in place.
From reviewing a few of the historical facts above, latex condoms were introduced in 1920 and still dominate today’s market in sales. Other materials that have been introduced are polyurethane in 1994 and polyisoprene in 2008 [Ref 3, 5]. As a possible applicant, I note that this project has merit, and an effective solution requires some thought. One thing that was specifically spelled out in the problem statement is that one of the major drawbacks to more consistent condom use is the perception of decreased pleasure and sensation when the device is used as compared to when it is not. This creates a trade-off that many men find unacceptable.
The Foundation is seeking an enhanced design to the current products in the market place that enhance pleasure. If so, would such a product lead to substantial benefits for global health, both in terms of reducing the incidence of unplanned pregnancies and in prevention of infection with HIV or other STIs?
As I ponder this grand challenge, at the forefront of my thinking is that the enhanced or new product must have all of its 19th and 20th century attributes: safe non-prescription birth control, protect against sexually transmitted diseases, does not require interaction of a health care worker, user controlled and user applied, easily transportable, and affordable. The 21st century improvement must enhance sensation and pleasure, and if possible, also be applicable to the female condom market.
Should I choose to submit a proposal, I already know one that I may be competing with was designed by Jörg Sprave, co-founder of video editing hardware company MacroSystem AG. Sprave proposes a slingshot condom gun that could make the device easier to apply. According to Sprave, “Nothing fascinates male human beings more than guns and sex, so when we combine both, you must see the huge potential this has.” [Ref 6]
I have to admit that my concept is more conventional, however, his video of the proposed design generated over three (3) million views in only four (4) days. Look whose laughing now.
Ready. Set. Go!
1. Unrolled, Unbridled and Unabashed: Exhibition Review | ‘Rubbers: The Life, History & Struggle of the Condom’, by Edward Rothstein, published in the New York Times, February 4, 2010
2. Condom History Mirrors Society’s Changing Views, Condom History Mirrors Changing Societal Attitudes & Modern Human Sexuality (VIDEO and transcript), Cara SantaMaria, November 7, 2012 http://www.huffingtonpost.com/2012/11/07/condom-history_n_2059497.html
3. Wikipedia, www.wikipedia.org
4. “Reinventing the Condom”, Papa Salif and Stephen Ward, March 18, 2013, in Impatient Optimists, a newsletter of the Gates Foundation, www.gatesfoundation.org
5. Modern Medicine: What materials have been used to make condoms? (Answered by Planet Green), http://curiosity.discovery.com/question/what-materials-used-make-condoms
6. “Weaponized Condoms for Bill and Melinda Gates Foundation”, Michael del Castillo, Upstart Business Journal Technology & Innovation Editor, April 12, 2013, http://upstart.bizjournals.com/entrepreneurs/hot-shots/2013/04/12/macrosystem-ag-and-bill-gates-for-condom.html