04/04/2013 10:22 pm ET Updated Jun 04, 2013

Bill and Melinda, Sex and the Condom Conundrum

Last week, Bill and Melinda Gates and their Foundation announced (to much Internet chatter) their latest Grand Challenge in Global Health. The call was to create "a next generation condom that significantly preserves or enhances pleasure." The declaration went viral, and for good reason: The man who transformed the world with technology is now aiming to do so with condoms.

The challenge is not trivial. The Foundation has targeted what I call the great condom conundrum. On the one hand, condoms really work and most people know it. Ask any health professional, anywhere, and they will tell you access to condoms today remains one of the most proven tools to lower rates of unwanted pregnancy, STDs and HIV transmission, especially in developing countries where problems become epidemics.

If you're going to have sex, there is little else that still protects you like a condom.

Yet getting people to use condoms remains a struggle in all corners of the globe. Cultural barriers are big, local and complex. The Grand Challenge focuses on increasing "pleasure," which is great. But even more pressing than feeling good -- and lesser known -- is the global condom shortage, especially in developing countries. There are simply not enough condoms being made and delivered to people who need them most.

Enter the Gateses, and the tantalizing proposition of a new technology. It's exciting, for sure. The project's promise fits a narrative of our time -- apply technology to realize great social change. I hope the challenge will crack the paradox of condoms. The world would be a better place.

Yet when it comes to encouraging condom use here in the U.S. and in developing countries, from my seat the problem appears a bit more complicated than the thickness of the latex. If we can't increase supply and make the condom an easy choice for people to reach for in the most intimate of moments -- whether you live in New York, London or on the streets of developing nation's city -- change will likely not be fast.

Consider the anecdotes from two countries: The first, Haiti, one of the poorest nations on earth. Even with all the aid and attention the country has received in recent years, a 2012 Euromonitor International report estimated the condom shortage to be more than 30 million a year, a nearly 40 percent shortfall to overall demand. Talk to people in Port-au-Prince about condoms, and there is a product disconnect. Available brands are packaged in foreign languages. Most condoms delivered by well-intentioned aid workers are typically cheap and poorly made -- and the Haitians know it. There is, in short, little respect for the consumer.

Then, consider this from the United States: Condoms have become so widely distributed, encouraged and successfully marketed in the past 25 or so years (a story too long to detail here), the product has become a commodity. The result: A 2010 Indiana University study revealed that nearly 80 percent of today's young people between 14 and 17 used a condom in recent sexual activity (Interestingly, on the other end of the age spectrum, STDs are a growing issue for dating Baby Boomers).

To be sure, for all its simplicity in use, the saga of the condom and its role in the world is profoundly complex. But one point is clear: The access to good condoms along with the respect for people and their culture probably trumps promises of high-tech prophylactics... for now. Done well, over time, the impact can be large and lasting. That is, until the arrival of Condom 3.0.

Jim Moscou is the CEO of the Sir Richard's Condom Company, a distributor of chemical-free condoms and where for every condom purchased, one is contributed to a developing country. In 2011, working with Haitian artists and health workers, Sir Richard's developed the first condom brand in Haitian Creole under the label KORE, which means "I've got your back". KORE condoms are being made available for free at Partners In Health clinics and others across Haiti today.