When we think of saints and superheroes, advertisers aren’t exactly top of mind. But in a crisis like the Zika pandemic, Mad men (and Mad women) may have the power to save thousands of families from lifelong suffering precisely because they’re so practiced at getting our attention and selling stuff they associate, in just the right way, with sex.

Libertarian entrepreneur Phil Harvey is a pioneer of social marketing—not social media but the application of Madison Avenue’s skill set and commercial infrastructure to solve social problems by selling needed goods at subsidized rates through ordinary retail channels.

Harvey has spent much of his life focused on the problem of badly timed or unwanted pregnancy. He got his start trying to reduce hunger in rural India and realizing that the number of hungry children kept growing unless parents had means to manage their fertility. If the solution was going to be “more permanent and more real,” it needed to include family planning, and couples needed to know their options. He pivoted. Forty years later he is board chair and former CEO of DKT International, one of two nonprofits that he founded. DKT has sold tens of millions of condoms around the world, preventing HIV and unwanted pregnancy by making safe sex hot.

Harvey spoke with me from his Washington D.C. home about Zika and how marketers might make a difference.

Tarico: Latin Americans are panicking. Governments have told women to delay pregnancy until the Zika pandemic has either swept through or been brought under control. But that’s not exactly helpful for women who may lack the power to refuse sex or otherwise prevent pregnancy. So, delaying pregnancies is going to involve men and modern contraceptives. How do we make that happen?

Harvey: Social marketing of contraceptives rests on mass media advertising and ubiquitous point of purchase. That means getting appealing, branded products at affordable prices into every little store and kiosk in which fast moving consumer goods are normally available. We’ve been doing that for 20 years in Brazil with an enormous variety of condoms –flavors, colors, aromas. Those products might be available in 40,000 or 50,000 different outlets.

Social marketing can drive demand for products like these or it can promote pro-social ideas and behavior change—for example like advertising against smoking.

Tarico: I like to tell myself that advertising doesn’t really affect me. But I have to believe that the market isn’t stupid, at least in the narrow sense of companies knowing what affects sales and profits. When it comes to social marketing, how do you measure what works?

Harvey: Ads generally bring about increases, but it’s hard to know which of TV spots or a big musical event or a series of magazine ads (all things we are doing in Latin America) —made the difference. People in the industry like to say, “We know that at least half of ad budget is wasted, we just don’t know which half.” We do know for sure that advertising works. We spent 20 million on pure advertising last year. In some countries a half million dollars goes a long way.

Tarico: So what is your reach in the Zika plague areas?

Harvey: In Brazil in 2015 we sold 110 million condoms through our proprietary branded products,  Prudence and a dozen others. The commercial market would be 2 ½-3 times that. The government is also giving away condoms. In 2014, the Brazilian market was almost a billion condoms. Half was government giveaways.

Tarico: If the government is giving away condoms, why the need for social marketing? Also, don’t giveaways erode the market in the long run by interrupting demand and sales or making it impossible for businesses to compete with free products?

Harvey: At times government giveaways can actually increase the commercial market by stimulating interest in a product. For example, when the Brazilian government was promoting condoms for HIV/AIDS they did interesting sexy advertising; and that stimulated the commercial market. At other times it can become competitive. In Brazil, DKT competes more with commercial brands, because government condoms tend to be thought of as inferior because they are not well packaged. But even with both government and profit-driven companies in the game, social marketing still improves lives. By increasing competition, we drive down the price as well as driving up availability of appealing products.

Tarico: How about other contraceptives? Condoms are a heck of a lot better than nothing, but they require diligence and mutuality, which is why they have a 1 in 6 annual pregnancy rate. By contrast, “get it and forget it” IUDs and implants drop the pregnancy rate below 1 in 500. They don’t take constant vigilance and don’t fail just because people are tired or drunk or make a mistake. They put females in charge of our own fertility and have some bonus health benefits. As a mom of two daughters that combination makes me a big fan.

Harvey: DKT Brazil does just condoms, not pills or long acting methods. But pills are available in every drug store. In El Salvador, PSI has a program for IUDs. But IUDs are expensive, as is insertion. So the most simple and immediate and cost effective way to improve lives is one of several brands of condoms. PSI social marketing sold 2.5 m condoms in 2014. A good many IUDs were also sold in 2014. One of the things that the Salvadorian government could do is get on mass media and tell people about the availability of good contraceptives and where to get them.

Tarico: In some traditional cultures, men see a woman’s pregnancy—or lots of offspring–an indicator of their own virility and status. If we have to rely on men to prevent an epidemic of babies is that going to work?

Harvey: The total fertility rate in Latin America is just over two children per woman, by contrast with almost six in 1960. It’s reasonable to assume that men as well as women are taking part in the decisions that have led to low fertility. Seventy-five percent of all couples in Brazil are using some modern method of birth control.

Tarico: Condoms can be 98 percent effective if used perfectly and with perfect consistency. But humans aren’t perfect, which is why we get such a high pregnancy rate—from human inconsistency and error. If you were creating a marketing campaign aimed at men, to get them to be even more careful right now, how would you go at that?  

Harvey: My best guess would be to focus on the message that getting your wife or girlfriend pregnant right now could lead to serious problems. I don’t think men want to sire defective babies. It shouldn’t be too hard to remind them that they can prevent that. I think that would be powerful but I would want to try it out. I would conduct focus groups, mindful that we are messaging in a new context.

Tarico: Even here in the U.S, where 98 percent of sexually experienced females have used a modern contraceptive at some point, and with a birthrate just above replacement, half of pregnancies are not intentional, and I understand that the rate is even higher in Latin America. That seems like a lot of potential for babies microcephalic, brain damaged babies.

Harvey: Well, a very substantial are not intended at the time they occur, but that doesn’t necessarily represent a contraceptive failure in people who really don’t want to get pregnant. A lot of young women in poor communities absolutely want to become mothers, and aren’t as focused on when. They’re ambivalent or unsure or indifferent about getting pregnant sooner rather than later. If I were a woman in Brazil, I would be moving from I don’t know to I really don’t want to get pregnant right now. The idea of a baby with birth defects is well understood and devastating. In the U.S. it’s a minor risk right now, but that could change.

Tarico: Will DKT be shifting priorities in response to Zika?

Harvey: Carnival is just beginning in Rio, and DKT Brazil will be giving out 300,000 condoms over the course of the week. In keeping with the spirit of Carnival, they will include Fire, a warming condom, Ice, which tingles, and Neon, which glows in the dark. The United Nations has called for greater contraceptive access as part of the Zika emergency response, and we are preparing to distribute an extra 200,000 condoms as part of the effort. The Brazil team, led by our Country Director Daniel Marun, is filming 3-minute videos on Zika prevention featuring a popular sexual health educator, Dr. Jairo Bouer. You’ll be able to find them on our YouTube channel.  

Tarico: Thank you for taking time for this conversation—and for all of the wellbeing you have brought into the world during the last forty years! Readers are probably ready to check out your sexy commercials. I noticed that one has over 6 million clicks! But any final comment?

Harvey: The Zika virus is a new ball game. The business that we have been in for the last 40 years is “If you don’t want to get pregnant, here’s how” or “Did you know it’s possible to only get pregnant if you want to – to space or limit your children.” We’ve worked where a majority of women didn’t even know it was possible to have sex without getting pregnant and in societies where women knew about contraceptives but didn’t have access. 

This situation calls for a very different social marketing approach. It’s tricky business for government to say don’t get pregnant right now because that carries a lot of freight. So what’s important is getting the facts out there so that people can make up their own minds. Parenthood is the center of life for a lot of young women in poor communities, so you have to address young women on doing it for their kids. So you have to talk about it as parenting from the beginning, from even before a baby is conceived. This is a new game.