An industry rises to the occasion

What has palm oil got to do with condoms?  Surprise! Surprise! It's in the lubricant and spermicide.

BOOST FOR MALAYSIAN RUBBER: Three decades after HIV/AIDS reared its ugly head, millions are still dying from it. Dec 1 -- World AIDS Day -- is a stark reminder of that horrifying fact. Without an effective vaccine or cure, Malaysian condoms have become the best defence in most parts of the world against the epidemic and other equally fatal, sexually-transmitted diseases, write Tan Choe Choe and Ooi Tee Ching

The world's biggest condom maker has factories in Malaysia and Thailand. Supplying up to 15 per cent of the world's current market, Karex Industries Sdn Bhd's manufacturing facilities hardly have a day to stand still. And the company is working at turning its factories wholly automated to roll out more rubber at a much faster rate.

Unknown to many, since 2009, Malaysia has emerged as the world's largest supplier of condoms, meeting 20 per cent of the world's condom demand of 20 billion pieces a year.

With 15 per cent of the market share in Karex's grip alone, the privately-owned Malaysian company churns out some three billion condoms that are distributed around the world a year.

Last year, the Malaysian Rubber Export Promotion Council's data showed condom manufacturers here exported 4.37 billion pieces, valued at around RM285 million. This year, the value of condom shipments is expected to surpass RM300 million. Sales remain robust as this form of birth control is widely used in the prevention of sexually-transmitted diseases (STDs), especially HIV/AIDS.

An effective vaccine or cure for this terrible illness has yet to be found three decades after it was first uncovered.

An American gay man called Timothy Brown, who received a bone marrow transplant in 2007 to treat a type of blood cancer while he was a student in Germany, is the only person who seems to have been cured of the illness as the transplant appears to have kicked the HIV virus out of his system.

Previously referred to as the "Berlin Patient" to protect his identity as a HIV-positive man, he has since shrugged aside the cloak of anonymity to show the world that five years after his transplant, he remains free of the virus, despite having long given up his anti-viral drugs.

Brown's case is a beacon of hope for many terminally ill HIV-patients, though it is still not clear how he has fought off the infection. 

But it has spurred renewed optimism in the medical community as scientists continue their search for a viable, effective cure or vaccine. Until that is found, the humble rubber condom remains the best bet at preventing HIV infection.

Karex's managing director Goh Miah Kiat also estimates that 40 to 50 per cent of the current global consumption of condoms is for the prevention of HIV/AIDS and STDs, a trend that his own company closely reflects.

Indeed, Karex, which opened for business in 1988, emerged as the No. 1 supplier of condoms globally because of the company's foresight to focus on this market segment, which is competitive as the customers are generally government health and family planning agencies, non-governmental organisations (NGOs) and multilateral bodies like the United Nations.

"A lot of people didn't look into this market segment because of the low profit margin, but we saw it as a potential. We looked into it, and we expanded our production accordingly. So today, we have the capacity that a lot of our competitors do not have."

For Nulatex Sdn Bhd, a relative newcomer in the high-entry-barrier industry of condom manufacturing, the increasing awareness of the efficacy and reliability of condoms in the fight against the HIV/AIDS epidemic has proven to be a huge boon.

"It has driven our rather steady growth over the years, what with ongoing HIV/AIDS awareness campaigns around the world.  But even so, it depends on religious and cultural acceptance. It is unlike gloves for healthcare, where the demand for that rubber will shoot up when there's an illness outbreak.

"For condoms, there are no sudden push factors -- it has always been used for STDs prevention, family planning, and personal hygiene -- issues that have always been around," said its managing director, Chan Cha Lin.

From about 200 million condoms per year in 2007, Nulatex's production capacity has gone up to 360 million a year. "If you look at our order quantity, the biggest part of our sales is from the sale of regular condoms, which are used primarily in the prevention of HIV/AIDS and assurance of personal hygiene."

The company has been selling a lot of its rubber to the African continent as well as China through various social marketing projects and NGO-initiated HIV/AIDS prevention programmes.

No. 1 worldwide, but not popular at home
THE  condom is regarded by the National Community and Family Development Board or Lembaga Penduduk dan Pembangunan Keluarga Negara (LPPKN) as an ideal family planning tool, since it forms an actual, physical barrier to prevent sperm and egg from meeting.

With correct and consistent use, figures show that male and female condoms provide 98 per cent and 95 per cent effectiveness, respectively.

As an actual physical barrier to the exchange of bodily fluids, condoms are also ideal in the prevention of STDs, something which other methods of family planning cannot do.

In recent years, the pattern of HIV/AIDS infection in the country has slowly but clearly been moving away from what is now regarded as the "traditional" transmission patterns; infection is no longer occurring exclusively among needle-sharing drug addicts, passed on from sex workers to their clients and vice versa, or only among men who have sex with men.

Instead, alarm bells are ringing among health practitioners and policy-makers as a new pattern of infection has emerged -- increasingly, the disease is being passed on from husbands to wives -- drug addicts who have spouses and those who visit sex workers are not necessarily single males.

The majority of men who have sex with men in Malaysia, too, are actually married and lead seemingly normal, conforming lives on the surface.

Yet, no matter their proclivities and notwithstanding that Malaysia is the No. 1 condom supplier in the world, Malaysian men are not fond of using them. Local condom consumption is estimated at just 80 million pieces a year.

According to the Malaysian Population and Family Survey 2004 conducted by LPPKN, the condom is used only half as frequently as birth-control pills as a form of contraception, at 7.4 per cent versus 14 per cent.

The emergence of other long-term or more permanent methods of contraceptives may also have overcome the usage of condoms among some quarters. “We have been using condoms in the country since the 1960s and today it is still not the most popular method of family planning. Birth control pills remains the preferred choice because of the ease of use," said LPPKN chairperson Tan Sri Napsiah Omar.

There is also the reality that it is almost taboo -- religiously and culturally -- to be caught with a packet of rubber; to the point that such precaution is regarded as indicative of immoral behaviour.

Condom manufacturer Goh Miah Kiat feels, however, that it is an unnecessary taboo. Young adults should be provided some form of protection, he said. As it stands, the Health Ministry has itself reported that it is seeing an increasing number of pregnancies among adolescents aged 10 to 19 years (from 3.1 per cent in 2010 to 4.1 per cent last year).

Speaking to the New Sunday Times on the sidelines of the World Population Day 2012 celebrations by LPPKN a few months ago, Napsiah (far right in the photo) expressed concern that about seven or eight children were born to unmarried teenage mothers every day. 

"Many of them don't even know how a baby is conceived."

In an email interview later, LPPKN said: "From a public health perspective, prevention is more important (and) primary prevention of unintended pregnancy in adolescents involves the delay in the initiation of sexual activities until psycho-social maturity, or marriage, depending on the religious or cultural perspective.

"Secondary prevention is the use of safer sex practices by those who are sexually active, and who do not plan on abstaining from sexual activities."

This would most certainly include the use of condoms, even though the federal agency admits that awareness of condom usage is still low in Malaysia, despite its advantages. "Condoms do not require a visit to a health professional or a prescription. They're sold in drugstores and family planning clinics.

"Given the fact that Malaysia is currently the major latex condom manufacturer in the world, it is an added reason why wider usage of condoms should be encouraged locally," it added.

Hotter demand at sports meets

THIS  year's London Olympics chalked up a new record for the highest number of free condoms handed out in the Games Village -- 150,000 -- and has been cheekily regarded as the "raunchiest games ever".

Previously during the Beijing Olympics, 100,000 condoms were supplied. The Athens Olympics in 2004 prepared 130,000 condoms for the athletes.

The Sydney Games in 2000 originally allocated 70,000 pieces, but had to pump in an extra 20,000 very quickly.

Goh Miah Kiat of Karex doesn't really see a direct correlation between major sports meets and sales of condoms. But Malaysian condom export figures, provided by the Malaysian Rubber Export Promotion Council, indicate that in the last five years, whenever a major sports meet pops up, there is always a sudden spurt in condom sales from the previous year. 

For example, we exported 55 per cent more condoms in 2008 compared with 2007. In 2010, which is the World Cup year, our sales jumped 33 per cent more from before; this year, sales are expected to surpass US$100 million (RM303 million), still a jump of at least 10 per cent from last year.

"We don't have customers in the United Kingdom but based on our World Cup experience in Africa, there were a lot more enquiries from interested buyers, and many wanted to custom make some condoms with fun ideas to commemorate the sporting event," said Chan Cha Lin of Nulatex.

One of the most common enquiries that they received was to customise condoms with the design and colours of a country's flag. 

"Say if you were a Brazil supporter, you would probably buy a condom designed in the colours of that country's flag."

And he thinks it's only logical that when there's an influx of tourists in one spot for a sporting event, there will be an increase in "extra-curricular activities".