Create a Better Condom, Win a Million Dollars

On Friday, the Bill and Melinda Gates Foundation announced a new challenge in the group's Grand Challenges for Global Health: $100,000 to develop a next-generation condom, which can be increased to one million dollars depending upon the project.

Historically, the Bill and Melinda Gates Foundation has sought out innovative and inexpensive fixes for some pretty basic technologies. The condom is a fair candidate; they're used by over 750 million people a year worldwide, and is the simplest, most widely available contraception technique. Obviously, the healthcare costs of unintended pregnancy and STIs are enormous.

The call to action on the Grand Challenges page cites reduced sensation as a key reason that individuals opt out of condom usage. Creating a condom that feels better—or even enhances a sexual experience—could increase usage, which would directly reduce the burden of HIV, other STIs, and unwanted pregnancies on individuals and governments around the world. A condom that men and women (the competition is seeking innovative designs for the female condom as well) actually want to wear could revolutionize how many people live.

Though there is speculation that rudimentary condoms were used in antiquity, the first well-documented use of condoms appears in a text titled De Morbo Gallico by16th century Italian physician Gabriele Falloppio, of Fallopian tube fame. He recommended a device of his own invention—a chemical-soaked sheath to be wrapped around the glans of the penis then tied on with a ribbon—in order to prevent the spread of syphilis, or as it was then known, the “French Disease.” Sounds festive.

Prior to the 15th century, other “just the tip” condoms were used in Asia, though they were typically only available to the upper classes. In China they were likely made of oiled silk or animal intestine. In Japan, they were made from tortoise shell or animal horn–which sounds pretty terrible for a woman.

Animal skin, bladder, and intestine condoms, along with chemical-treated linen ones, were the mainstays until the discovery of vulcanized rubber in the mid-1800s. Originally, doctors needed to measure each man’s glans to achieve the correct fit for a glans-only rubber condom, but rubber companies quickly realized it was easier to just create long tube condoms that didn’t require a doctor’s touch. It was at this point that most condoms made the shift to the full-length, one-size-fits-most variety we know today.

The invention of latex occurred in 1920, and this has been the material of choice for the last century or so. With all the recent leaps in materials science, the creation of new fabrics and substrates with amazing properties, maybe it’s time that the condom got an upgrade. The thinner the condom can be while still remaining effective, the most likely men and women are to feel it doesn’t encumber their experience.

Apparently, there’s a World’s Best Condoms annual competition, which essentially is a list compiled by an “Official Condom Testing Pool" made up of 250 regular customers of Condom Depot who were asked to review 40 varieties of condoms. I can’t speak to the legitimacy or rigor of this experimental model, but the results were nevertheless interesting.

In 2012, the winner was Crown Skinless Skin Condoms, a variety manufactured by Japanese company Okamoto. They were the thinnest condoms by far, ringing in at a mind-blowing 0.00185 inches, or around 47 microns, thick. By comparison, Durex Her Sensation condoms are 0.027 inches thick, or about 15 times thicker.  Making this ultra-thin condom the norm might encourage more people to use them.

Condom companies have tried enticing customers with sensation-enhancing gels and lubes within their product, and they’ve met with slight success. While it may help a brand stand out in a crowded condom aisle, "fire and ice” gel or whatever else isn't driving people around the world to adopt condom usage en masse. (Perhaps there’s a way to treat condoms with gel that would increase blood flow to the penis. I imagine that would be a draw to users.)

Perhaps we could radically reimage the fit of the female condom, creating something that was less cumbersome and more appealing to use. Currently, most women have never used a female condom and most don’t even know how. Empowering women to use prophylactics themselves is a wise goal.

For the past 500 years, humans have been on the lookout for a reliable means of preventing unwanted pregnancy as well as disease. Design and comfort have certainly moved forward, but maybe it’s time for another revolutionary leap similar to the transition from intestines to rubber.

That's what the Gates Foundation challenge is designed to do: make condoms easier to use, more pleasurable, and less intrusive, in the hopes that more people will put them to use. The more appealing we make safe sex, the more lives can be saved and improved.

@kellybourdet