Health Horizons

Origami Condom Inventor Says Tests Look “Very Promising”

Updating the design of condoms could change healthcare.

Awareness advocates dressed as condoms walk on International Condom Day, in Lima, Peru. (AP Photo/Martin Mejia)

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“It’s because I had these four in one year,” Theresa Efua told me through a translator. “That’s why there are so many.” It was late evening in a village in Ghana, and my friend Joyce was helping me talk to a woman who lived in the courtyard building I occupied that summer. Efua was describing her fertility in terms of defeat.

She had eight living children, including two sets of twins born in the same 12-month period — first identical boys, then fraternal girls, one of whom was disabled. She’d had another baby since the four twins were born. She made no bones about not wanting so many kids. Uneducated and informally self-employed as a market vendor, she sometimes went hungry for so long I found her in a glassy-eyed stupor. “If my problems were solved, I’d thank God,” she said, unable to identify any other source of potential help.

What stood between Efua and adequate birth control was money, and the participation of her husband, a manual laborer who interspersed his paying work and household help with occasional drunkenness and domestic violence. More broadly, her problems arose largely from the penury into which she’d been born. “Their attempts to escape poverty were long bets that failed,” global health expert Paul Farmer concluded about several impoverished women he described in his 1996 book Women, Poverty, and AIDS. For Efua, the failure came in the form of unwanted pregnancies — but she wasn’t safe from HIV or other STDs either.

On some level, solutions are simple: Condoms can avert both pregnancy and AIDS. But will a new condom design help women like Efua?

Two years ago, the Gates Foundation presented a Grand Challenge, one of a series of requests for grant proposals intended to stimulate development of solutions to global health problems. This one asked for an update of the condom, a device that hasn’t changed in over a century. The project specified the new product should be easy to put on, accessible worldwide — and so pleasant to wear that men would prefer it to current condoms — or better yet, to no condom at all.

Danny Resnic, an American who’d contracted HIV in 1993 in an interaction involving a broken condom, says his device, the Origami Condom, might fulfill that tall order.

The Origami Condom has garnered attention from conservatives who mock the name, but Resnic explains it just signifies “a condom that unfolds,” which expands like an accordion and is looser and faster to apply than today’s rolled condoms. It also replaces latex with silicone; the company claims these features make use more pleasurable for the male wearer.

(Credit: Origami Condom)

Marketing research found that U.S. consumers would expect to pay as much as $7 per Origami condom — a fact that might attest to customer satisfaction or to the perceived strangeness of the product. Resnic says the real price will be nowhere near that high. “We don’t have a price point yet, but they’re going to be competitively priced” to female condoms, which are listed on Amazon for less than $5.

However, Efua might earn only $5 a week. In developing world countries, condoms have sometimes been cheap or free — a subsidy designed to encourage consistent use. Will the new condom be accessible in places where people like Efua can reach it?

Resnic says the product will be distributed via “organizations like USAID and the World Health Organization,” but makes clear it’s simply too soon in the development process for the details to be worked out.

The time frame to get there isn’t defined just yet either. The condoms are currently being tested in South Africa by a cohort of 28 couples (heterosexual and gay). While Resnic says it “looks very promising,” he can offer no preliminary results — nor any outcomes of previous tests. Next is “a phase II clinical trial of 1,000 uses of the device” as part of FDA approval for what is technically a “medical device.”

In short, the new condom is in roughly the same place that other condoms and similar products were before the Gates Foundation issued its Grand Challenge: “While potentially transformational, most of these products are high risk, years away from being available, and their path through development, regulatory approval, and delivery remains unclear.”

Efua, who is illiterate, has never used a computer, and does not have a phone, presumably remains unaware of these details. But it’s easy to envision her as she was on a summer evening a few years ago during our conversation in the courtyard of her house. I imagine if I told her about cheap, accessible technology to prevent future pregnancies, she’d be interested.

But with an unspoken understanding of Paul Farmer’s claim that “gender inequality calls into question the utility of condoms in settings in which women’s ability to insist on ‘safe sex’ is undermined by a host of less easily confronted forces,” she’d continue the life she’s always had, surrounded by growing children, worried about today’s meals, and inured to the help so delayed in coming.

The “Health Horizons: Innovation and the Informal Economy” column is made possible with the support of the Rockefeller Foundation.

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M. Sophia Newman is a freelance writer and an editor with a substantial background in global health and health research. She wrote Next City's Health Horizons column from 2015 to 2016 and has reported from Bangladesh, India, Nepal, Kenya, Ghana, South Africa, and the United States on a wide range of topics. See more at​

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