By Nina Hasen, Vice President, HIV and Tuberculosis, PSI
Earlier this year, a provocative article in the New York Times asked: “Are face masks the new condoms?” We at PSI are novices when it comes to preventing infections of the new coronavirus, SARS COV-2, but we’re old pros when it comes to preventing infections of HIV, the virus that causes AIDS, and we know that the two viruses are similar in important ways:
- You can be infected and not know it: in the case of SARS COV-2, some people who get the virus and transmit may never know they had it.
- You share the virus through bodily fluids: condoms can protect the wearer from spreading or acquiring HIV infection by creating a barrier. Face masks also create a barrier that prevents droplets that are exhaled, sneezed or coughed by an infected person from being expelled as far into the air as they would be without a face mask.
- Neither condoms nor face masks are perfect, but both make risky behaviors safer.
Of course, there are also important differences between face masks and condoms. We know that face masks are likely much less effective at protecting us from viruses than condoms. And depending upon both the material used to make the mask, how well it fits and how well the wearer uses it, a face mask may block anywhere from 30 to 95 percent of viruses.
Compounding this is that face masks tend to provide less protection for the wearer than they do for the people around her. While a condom protects a man and his sexual partner equally from HIV transmission, a face mask won’t do much for the wearer unless others around her wear a mask, too.
Given these critical constraints, should we really embrace the face mask—especially the non-medical face mask—with all its caveats? And should we be spending precious global health dollars on this new intervention in the developing world?
Here is where that third similarity to HIV is so important. The reality is that in many of the poorest parts of the world, avoiding other people (just like abstaining from all sex) is unrealistic. In densely populated slums, packed public transport and crowded streets, maintaining the World Health Organization’s recommendation to stay at least one meter away from each other is simply impossible.
We need to offer easy, practical ways for people in low and middle-income countries to protect each other—and, in so doing, themselves. The face mask isn’t perfect, but it can be much better than nothing. If we can get most people in very crowded settings in the developing world to wear one most of the time, then hundreds of thousands of SARS COV-2 infections can be prevented along with deadly cases of COVID-19.
Over the last 50 years, PSI has prevented millions of HIV infections by helping some of the world’s most vulnerable people to use condoms. We achieved those results through building robust systems of supply, demand and healthy behaviors. Realizing the prevention benefits of face masks can happen quickly if we apply that know-how. Here’s how we’re ready to help:
- Building a healthy market to ensure a steady supply: for large numbers of people to use masks in the developing world, there needs to be a ready and cheap supply. Ideally, this supply is locally produced, which will strengthen local economies, create jobs and avoid dependence on fragile global supply chains. PSI will build on our long experience in local economies to get domestic mask markets off to a strong start while also ensuring that consumers are getting good quality, long-lasting products.
- Creating lasting, informed demand: masks won’t work if people don’t use them consistently and correctly. Our decades of experience teaching consumers in the developing world to use everything from water purification to bed nets to condoms make us an ideal partner to help achieve this goal. We’ll work with governments and donors to design smart communication and education campaigns built on deep consumer insight, that create both knowledge and motivation to use, care for and dispose of face masks correctly.
- Support the enabling environment: the use of face masks can only play an effective role if policymakers, regulators and administrators work together. For many years, PSI has been working with governments at every level to support the introduction of health products.
We believe face masks could be the key to preventing thousands of COVID-19 infections and deaths in countries whose fragile health systems need protection. We are ready to realize this goal, but we need your support to put our skills to work. If you’re interested in learning more about how PSI can help prevent COVID-19 in the developing world, please click here.