About 80 days into the U.S.-Iran war, while much of the world struggles with oil supplies, India is confronting a different crisis: a widening condom shortage. Health activists warn the supply disruption could worsen HIV/AIDS risks in the world’s most populous country.

Disruptions in maritime trade through the Strait of Hormuz have strained supplies of petrochemicals and industrial lubricants used in condom manufacturing. The crisis has increased production costs across the sector and pushed retail prices sharply higher.

India’s condom manufacturing industry is valued at nearly $1 billion. 

Production depends heavily on silicone oil and ammonia. Silicone oil, a key lubricant used in manufacturing, is in short supply. Ammonia, which stabilizes raw latex, is expected to see price increases of 40-50 percent. Rising packaging costs have added further pressure. Some manufacturers and retailers have reported condom prices increasing by as much as 50 percent.

India is home to an estimated 2.5 million people living with HIV, the world’s second-largest population of HIV-positive people, according to a 2024 report. The Health Ministry’s India HIV Estimation 2025 technical report said 5.4 percent of HIV cases in 2024-2025 were linked to transmission between men who have sex with men.

In 2024, India recorded an estimated 64,470 new HIV infections and 32,160 AIDS-related deaths nationwide. The figures marked declines of 48.69 percent and 81.42 percent, respectively, compared with 2010.

Ankit Bhuptani, an LGBTQ activist in India, told the Washington Blade that the country has made significant progress in reducing HIV infections over the past two decades. But, he said, that progress depended heavily on affordable condoms, targeted outreach programs and on-the-ground work by NGOs serving MSM and transgender people.

“Pull one thread and the whole thing loosens. What worries me about this particular shortage is that it arrives at exactly the moment when India’s LGBTQ community was beginning to access healthcare more openly after the Section 377 reading down,” said Bhuptani. “Young queer Indians in tier-two cities were just starting to trust government health systems enough to engage with them. A price spike that prices them out, or a shortage that sends them to substandard alternatives, could set that trust back by years.”

The Indian Supreme Court in 2018 struck down Section 377, a colonial-era law that criminalized consensual same-sex sexual relations.

In March, the Commerce and Industry Ministry acknowledged the difficulties faced by Indian exporters due to disruptions caused by the war in West Asia and launched a roughly $51.5 million Resilience and Logistics Intervention for Export Facilitation, or RELIEF, program. It provides credit insurance support for exporters whose shipments have been stranded because of the conflict.

“Price elasticity in sexual health products is brutal. When a condom pack goes from 20 rupees to 40, usage drops. It’s that simple,” said Bhuptani. “And when usage drops in populations with higher baseline HIV exposure, you don’t see the consequences for two or three years. Then the numbers arrive and everyone acts surprised.”

The situation has been further aggravated by the structure of India’s condom market, which operates on a high-volume, low-margin model designed to keep products affordable for a population of more than 1.4 billion people. Industry analysts say that model is now under growing pressure from rising raw material and shipping costs.

Reports in Indian media said supply constraints and price volatility involving PVC foil, aluminium foil, and packaging materials have disrupted production and complicated order fulfilment across parts of the condom manufacturing sector.

“Supply chain vulnerability assessments almost never include sexual health commodities. They should. India imports roughly 86 percent of its anhydrous ammonia from West Asian countries including Saudi Arabia, Qatar, and Oman, with that ammonia being essential for stabilizing the natural rubber latex used in domestic condom production,” said Bhuptani. “That is a documented strategic dependency that was never flagged as a risk. The Iran war converted it from a latent vulnerability into an active supply shock in a matter of weeks.”

The National AIDS Control Organization, or NACO, which oversees India’s HIV/AIDS programs, during the 2026-2027 fiscal year received an allocation of about $249 million, up from roughly $238 million the previous year. By comparison, the U.S. approved a $6 billion funding package in 2026 for global HIV/AIDS programs, according to the United Nations.

“The gay and trans community in India report high perceived HIV risk and adopted PrEP through non-profit and private channels, with cost and access remaining consistent concerns,” said Bhuptani. “The community organizations managing that risk perception are now operating in a tighter supply environment while simultaneously absorbing the downstream effects of USAID funding cuts. Health workers seeing increased anxiety among community members are observing the predictable consequence of removing redundancy from a system that had very little to begin with.”

The Washington Blade reached out to Indian condom manufacturer Manforce several times, but the company declined to comment.

Harish Iyer, an LGBTQ and equal rights activist in India, told the Blade that this is the time when the government needs to step in. Condoms, Iyer said, are not about pleasure, but about life.

“Not just in terms of HIV, it is also a source of contraception in a nation which is heavily populated. So, if there is a crisis in the condom industry, it has an adverse effect on the LGBTQ community,” said Iyer. “And eventually it has a compounding effect on the economy as well. Because if the cases of HIV wrecks to rise, if the population was to explode, it is going to have a straining effect on the economy as well. So, I think it is time that the government steps in, and condoms should be recorded as a necessity commodity rather than making it feel like any kind of commodity that some (privileged people) can afford.”

Iyer told the Blade that the government should provide condoms free of cost. 

He pointed to the Nirodh Scheme, India’s long-running family planning and safe sex program launched by the government in 1968. Condoms, Iyer said, are a necessity, not a luxury product. He urged the government to classify them as essential items and either remove the Goods and Services Tax or reduce it to a minimum.

The Nirodh Scheme was launched by the Health and Family Welfare Ministry to promote contraception and prevent the spread of sexually transmitted infections, including HIV, through the nationwide distribution of subsidized and free condoms.

A new health agreement between the U.S. and the Philippines has raised questions among HIV/AIDS service providers.

A joint declaration signed by the U.S. and the Philippines on April 7 sets out a plan for closer health cooperation, aimed at transitioning the Philippines toward greater autonomy and “self-reliance” in its health systems, according to a State Department statement released.

In practice, “self-reliance” in health systems refers to a country’s ability to fund, manage, and deliver care without heavy dependence on external donors. In the Philippines, programs serving LGBTQ people — particularly those focused on HIV prevention, testing and treatment — have relied in part on international funding and technical support, including from the U.S., according to UNAIDS. 

The Philippine Department of Health has led the national response to the pandemic.

The joint declaration of intent was signed under the Trump-Vance administration’s “America First Global Health Strategy.” The State Department said the agreement would involve co-funding of mutually agreed global health objectives under bilateral health cooperation between the U.S. and the Philippines in the near future.

The declaration also outlines areas of cooperation beyond financing: workforce development, health information systems, and emergency preparedness. The State Department said the framework is intended to strengthen coordination between U.S. and Philippine institutions while supporting the Philippines’ capacity to manage public health challenges independently over time. The statement does not specifically address LGBTQ health.

Similar agreements in other regions have drawn scrutiny from LGBTQ advocacy groups. 

In Africa, community organizations have warned that a shift from donor-funded, community-led health programs to government-to-government frameworks could affect access for marginalized populations, including LGBTQ people. The Washington Blade found that such changes may reduce reliance on specialized clinics that have historically provided stigma-free care, raising concerns about discrimination, privacy, and continuity of services.

Desi Andrew Ching, president of HIV & AIDS Support House in the Philippines, said the partnership presents a significant opportunity, but added that, like any large-scale international agreement, its success for the LGBTQ community will depend on how it is implemented on the ground.

“On one hand, it’s a positive move. Increased cooperation on health systems can lead to better technical support and potentially more resources for HIV/AIDS prevention and mental health — areas that deeply impact our community,” Ching told the Blade. “If the government and civil society work closely together, we could see some real progress.”

Ching said community concerns often center on where those resources ultimately go. Ching added there is a risk funds could remain within “usual” government-aligned channels or traditional implementers that may not have the trust or reach of grassroots LGBTQ organizations.

The Philippines is facing one of the fastest-growing HIV epidemics in the Asia-Pacific region, with UNAIDS statistics indicating new infections increased by about 543 percent between 2010 and 2023.

The epidemic is concentrated among key populations, particularly men who have sex with men and transgender women who account for a vast majority of new infections. A 2023 analysis found that key populations represented about 92 percent of new HIV cases in the country, underscoring the disproportionate impact on LGBTQ communities. At the same time, stigma, limited access to testing and gaps in healthcare delivery continue to shape outcomes for these groups.

Ching said that for the partnership to be effective, support would need to be closely targeted to reach those most at risk, including individuals who often avoid government facilities because of stigma and fear of judgment. 

“If the partnership prioritizes ‘community-led’ monitoring and direct support to local organizations, it will be a game-changer. If it stays at the top tier of administration, we might just see the same results as before,” Ching said.

Community-led organizations have been central to the Philippines’ HIV response, particularly in reaching LGBTQ populations often underserved by formal healthcare systems. UNAIDS notes groups such as LoveYourself have expanded testing and treatment access through community-based clinics and online outreach, including during the COVID-19 pandemic, when movement restrictions limited access to government facilities.

“To be honest, in these high-level agreements, ‘guarantees’ are hard to come by on paper. The real safeguards lie in the mechanics of implementation,” said Ching. “From the community’s perspective, we believe the best way to prevent services from being diluted is through direct involvement in the planning phase. We would like to see the funding groups and government stakeholders sitting at the same table as the community to game out the specific work plans. It should not be a top-down approach; it needs to be co-designed.”

Ching said oversight would be a critical layer of protection, adding that a dedicated point of contact, such as a U.S Agency for International Development technical lead or a similar monitor, would be needed to track how funds are used.

USAID officially shut down on July 1, 2025, after the Trump-Vance administration dismantled it.

Ching added community-led monitoring would also be necessary in addition to government oversight. He said safety and trust cannot be guaranteed by policy alone but must be built through experience, noting that community-led organizations have consistently reached the most marginalized populations. 

“Safety and trust aren’t things you can just write into a policy; they have to be built through experience,” Ching said, adding that community-based sites are often seen as more accessible and safer because they are “for us, by us.” 

He said the partnership should direct substantial support to grassroots organizations that have demonstrated an ability to overcome stigma, while strengthening coordination with government clinics. The most effective approach, he added, would combine government infrastructure with community-led delivery, allowing trusted local groups to serve as the primary point of access.

’We want a seat at the table’

According to a report by the World Health Organization on the Philippines, prevention efforts account for only about 6 percent of total HIV spending, despite a sharp rise in cases. The report said the gap has been compounded by a recent pause in U.S. funding, which has delayed the development and implementation of prevention programs and community-led responses.

Asked whether community-led LGBTQ organizations would be funded and included in implementation or sidelined under a government-led approach, Ching said that remained the central question for the community, adding that no detailed plan has yet been made public.

“But we have to be realistic about the politics — both within the government and even within civil society — that can sometimes slow things down,” said Ching. “A good baseline to look at is the UNAIDS 30-80-60 targets. These milestones are specifically designed to put community-led responses at the center of the HIV fight. If we’re being honest, as a country, we are still finding our footing in meeting those specific targets. There is a very real risk of being sidelined if the execution defaults to a standard ‘government-only’ approach.”

The UNAIDS set global targets to guide the HIV response, most notably the “95-95-95” goals for 2025. 

The framework calls for 95 percent of people living with HIV to know their status, 95 percent of those diagnosed to receive sustained treatment and 95 percent of those on treatment to achieve viral suppression. The targets were designed to reduce transmission and improve health outcomes, while also highlighting gaps in access to testing, treatment, and prevention services.

“We view this new partnership with the U.S. as a chance to course-correct. If the intention is to end AIDS as a public health threat, the data shows it simply cannot be done without the community in the driver’s seat for service delivery,” said Ching. “Our hope is that the implementation isn’t just government-led, but government-enabled. We want a seat at the table not just for the sake of being there, but to ensure the resources are actually hitting the ground where they matter most. We’re looking for a partnership that honors those 2025 milestones by making community-led organizations formal, funded partners in this roadmap.”

The Sri Lankan government has withdrawn its support for an initiative that encourages LGBTQ tourists to visit the country.

The Sri Lanka Tourism Development Authority last September partnered with Equal Ground, an LGBTQ rights group, on the initiative.

The Daily Mirror, a Sri Lankan newspaper, reported Sri Lanka Development Authority Chair Buddhika Hewawasam in a letter to Equal Ground Executive Director Rosanna Flamer-Caldera said his agency recognizes “the potential of this project to diversify our tourism markets and position Sri Lanka as a safe, inclusive, and welcoming destination for all travelers.”

Cardinal Malcolm Ranjith, the archbishop of Colombo, along other prominent Christian and Buddhist leaders criticized the initiative. Attorney General Parinda Ranasinghe on Feb. 10 indicated the Sri Lanka Tourism Development Authority had rescinded its support for the campaign.

Flamer-Caldera on April 10 acknowledged the criticism over the initiative but added “the fact that the letter has been rescinded doesn’t make any difference.”

“We’re still doing work with the tourism industry who have basically opened up to us and are willing participants in the project,” said Flamer-Caldera. “They realize the potential of the boost to our tourism industry as well as boosting our economy.”

Sections 365 and 365A of Sri Lanka’s colonial-era penal code criminalizes consensual same-sex sexual relations.

The U.N. Committee on the Elimination of Discrimination Against Women in 2022 ruled the criminalization law violated Flamer-Caldera’s rights. The Sri Lankan Supreme Court in 2023 said a bill that would decriminalize homosexuality is constitutional.

Transgender people in Sri Lanka since 2016 have been able to request a Gender Recognition Certificate that allows them to legally change their name and gender on ID cards. Flamer-Caldera noted to the Blade that LGBTQ rights opponents have challenged the Gender Recognition Certificate in the Supreme Court.