during intercourse turn off some potential users, as does the visibility of the outer ring which remains outside the vagina. Regulatory issues have also limited interest in manufacturing female condoms. In the United States, the FDA historically categorized female condoms as Class III medical devices, a category with more stringent requirements than Class II, which includes external condoms. Following proposals to reclassify female condoms, the FDA announced in 2018 that single-use female condoms would now be known as single-use internal condoms, and moved to Class II. In November 2005, the World YWCA called on national health ministries and international donors to commit to purchasing 180 million female condoms for global distribution in 2006, stating that "Female condoms remain the only tool for HIV prevention that women can initiate and control," but that they remain virtually inaccessible to women in the developing world due to their high cost of 72¢ per piece. If 180 million female condoms were ordered, the price of a single female condom was projected to decline to 22¢. In 2005, 12 million female condoms were distributed to women in the developing world. By comparison, between 6 and 9 billion male condoms were distributed that year. Awareness and access Recently, a number of initiatives have been undertaken by international and intergovernmental organizations to expand access to the female condom. In 2012, the United Nations Commission for Lifesaving Commodities for Women and Children (UNCoLSC) endorsed female condoms as one of its 13 Life-Saving Commodities, catalyzing inter-organizational efforts to overcome several commodity-specific barriers currently inhibiting women in the developing world from benefiting from this product. Price has been one of the key obstacles in expanding access to female condoms on an international level. Female condoms cost, on average, US$2–4, depending on local market factors. At the 2012 Family Planning Summit in London, the Female Health Company pledged to increase access to the FC2 female condom for the world's poorest countries and announced a prospective pricing arrangement based on aggregate purchases and 5 percent free goods based on the prior year's purchases, together with a multiyear agreement to provide $14 million in training and education by FHC over the next six years. The Cupid female condoms have been sold in Kyrgyz Republic through UNFPA for their public distribution system. The Woman's Condom has been sold to the public sector in China. Globally, it is acknowledged that further price reductions are necessary