Behind the nondescript facade of a drop-in centre in Addis Abeba, a quiet struggle unfolds nightly. Among those seeking refuge is a 25-year-old sex worker, driven by financial hardship from waitress to the streets. The centre, offering essential services like showers, meals, and STI tests, also provides a crucial lifeline: condoms. Yet, a severe shortage looms, leaving women to fend for themselves in a perilous gamble with their health. The bi-weekly allotment of eight condom packets from Population Services International (PSI) Ethiopia barely scratches the surface of their needs.

Ironically, this scarcity persists despite Ethiopia’s soaring HIV infection rates and dwindling funds from international donors. The Ethiopian Pharmaceutical Supply Services (EPSS) and NGOs like DKT International and PSI Ethiopia scramble to cover an annual demand of 250 million condoms but only manage to provide about 100 million. Free condom distributions, once common in universities and public spaces, are now a rarity. Health centres have cut down their giveaways drastically, capping them at three packs per person, under the pretext of preventing resale.

Health officials blame the restrictions on alleged abuse. The heads of the pharmaceutical supply services at the Addis Abeba Health Bureau insist the caps are necessary to curb resale. However, health centre managers tell a different tale of overwhelming reliance on donor support as government supplies fall drastically short. They recount receiving a fraction of requested supplies from EPSS, with donors stepping in to fill the gap. Yet, the restrictions remain, ostensibly to ensure wider access.

The Ministry of Health acknowledges the supply shock post-COVID-19, justifying its focus on high-risk groups like sex workers and adolescent girls. Those in charge of HIV prevention argue that strategic prioritisation is essential amid declining global funding. The targeted approach, however, leaves institutions like Addis Abeba Science & Technology University in the lurch, exacerbating sexually transmitted infections (STI) and unwanted pregnancy cases among students. A public health officer at the University lamented the rising demand for condoms he cannot meet.