A report by non-governmental coalition Oxfam International slams policymakers for not promoting female condoms as part of their HIV/AIDS and family planning programs, despite evidence that many women worldwide prefer them to male condoms, Toronto’s Globe and Mail reports.

According to the report, titled “Failing Women, Withholding Protection,” 3 billion male condoms are sold worldwide each year compared to 26 million female condoms, with a ratio of 423:1.

Experts attribute this disparity to the relatively high cost of a female condom, a lubricated polyurethane sheath that is inserted into the vagina before intercourse, which is 18 times that of male condoms.

The report recommends that an additional $20 million investment in developing female condoms would bring two new models to market, which should sharply lower prices.

“This is a 15-year scandal born of ignorance and inertia,” said Oxfam’s honorary president Mary Robinson. “We now know that millions of women might have been spared HIV, unwanted pregnancies and empowered themselves in the process if they had access to this simple method.”