Boosting condom use through clever marketing

In military-ruled Myanmar, condoms were virtually invisible and rarely used just a decade ago. But Population Services International (PSI), a US-based NGO, has managed to break through the social resistance to using, and talking about, condoms, thanks to a clever and culturally specific marketing campaign, starring a sun-hat wearing chameleon. Chameleons - or pothinyo in Burmese - are common animals in this southeast Asian country. It is traditional for young boys who see the chameleon to play a game in which they chant, "pothinyo, nod your head if you want a girl," then to watch and wait to see if the reptile moves its head. When PSI launched a high profile advertising campaign for its subsidised "Aphaw" brand of condoms four years ago, it used the marketing icon of a chameleon, wearing a traditional Burmese man's sunhat. Giant billboard images and magazine adverts with the new PSI mascot were accompanied with the slogan "Pothinyo, nod your head if you want an aphaw," a variation of the chant in the original game. The campaign was a major hit among Burmese - all the more so because PSI's local brand name "Aphaw", which means 'trusted companion', rhymed with the word for young girl, 'apiyo', used in the original chant. To Guy Stallworthy, PSI's country director based in the capital, Rangoon, the advertising campaign demonstrated how culturally sensitive advertising can help overcome deep resistance and taboos against condoms, one of the key weapons in Asia's battle against HIV/AIDS. The government estimates almost 340,000 people in Myanmar were living with HIV/AIDS at the end of 2003. UNAIDS puts the figure at more than 600,000. The virus is primarily spread through sexual transmission, accounting for two out of three infections. Intravenous drug use accounts for most of the rest, with a small percentage being due to unsafe blood and mother-to-child transmission. Condom sales, a mere 2.6 million in 1996, hit 40 million in 2005, reflecting a major increase in public awareness about HIV/AIDS and how condoms can prevent the spread of the virus. While condoms are one of the country's fastest-growing consumer items, 82 percent of those living in urban areas recognise PSI's Pothinnyo and nearly all of them link it to HIV/AIDS. "Our product is a little stigmatised and humour defuses the situation," Stallworthy said. "We also didn't want to simply import MTV-style Western advertising. We want to respect Myanmar culture and capitalise on this. This is something that is uniquely Myanmar - it only works here." PSI began working in Myanmar a decade ago, despite criticism from pro-democracy groups that their presence could help prop up the repressive military regime. The military, which has ruled the country since 1962, had refused to hand power over after the National League for Democracy, led by Nobel Peace prize winner, Aung San Suu Kyi, won a landslide victory in national elections in 1990. Despite the intense debate over providing aid to Myanmar – and the relatively low level of funding available, PSI felt that the country's AIDS epidemic demanded a response – a response that could not afford to wait for political change. Myanmar, crippled by both long-term economic mismanagement and Western sanctions - including a US ban on imports from the country – has one of south east Asia's most serious HIV/AIDS epidemics, with up to 2.2 percent of adults infected, according to the UN. PSI's condoms, which today account for 75 percent of Burma's total condom market, are heavily subsidised to make them affordable to the cash-strapped population. But aside from offering price subsidies, the organisation operates like a fast-moving consumer goods company, using market distribution channels, such as small retailers and its own advertising, to promote condom use. Marketing condoms was initially a delicate proposition, since the military regime considered condom possession evidence of prostitution, and it was worried that advertising them would encourage promiscuity. But the 'trusted companion' brand name, and the packaging – featuring a romantic image of a silhouetted couple at sunset under a palm tree – were deemed acceptable for this conservative country. Marketing and distribution were also major hurdles. With most international donors unwilling to support aid work in Myanmar through the late 1990s, PSI had almost no resources for advertising and local shopkeepers were wary of openly selling the potentially incriminating items. Burma's military had not yet acknowledged HIV as a major threat to its 52 million people either. But all that changed in 2001, when a top general publicly acknowledged that the country had a big AIDS problem, and Western donors began giving money to control the epidemic. Buoyed by fresh funds, PSI began advertising on billboards and in privately owned news journals and magazines. As condoms were more visible in the media, shopkeepers grew more relaxed about displaying them. "Both the government and the culture have shifted enormously in nine years; what is possible has changed dramatically," said Stallworthy. "People have had access to information about condoms and HIV/AIDS from many different directions. Our growth has been driven by our ability to use newspapers, magazines and mass TV to get the message out." Today, PSI considers the rising condom sales graph as a vindication of their controversial decision to set up shop in Myanmar a decade ago, though the market still has further room to grow. Condom use in the country is still just 0.8 per capita per year, but PSI hopes to bring it closer to the estimated 1.6 to 2.1 per person per year average in neighbouring Thailand and Cambodia, which are considered to have successfully controlled their own AIDS epidemics.