POPULATION: Group Seeks Ruling on New Sterilisation Drug

By Thalif Deen Reprint | | Print |

Thalif Deen

UNITED NATIONS, Mar 30 1999 (IPS) - Population planning experts want the World Health Organisation (WHO) and the US Food and Drug Administration to determine whether a controversial new drug can be safely used as a method of family planning in the world’s poorer nations.

The Washington-based Population Institute says that if quinacrine hydrochloride is proved to be both safe and effective, it could be one of the cheapest female sterilisation agents in the market – costing only about 15 cents.

“With our planet’s human numbers expected to reach six billion later this year – and 97 percent of that growth occurring in the developing world – it is obvious that there is an urgent need for economical, safe and effective contraceptives,” says Werner Fornos, president of the Institute.

Fornos told WHO Director-General Gro Harlem Brundtland and FDA Commissioner Jane Henney that successful clinical studies on the drug would have a significant bearing on family planning services provided to developing nations.

Since both WHO and FDA expressed safety concerns, the Institute formally requested both institutions “to resolve once and for all” questions relating to the sterilisation agent.

If quinacrine hydrochloride is given a clean bill of health, “we would have a low-cost, non-surgical sterilisation method – with no operating room, no anesthesia, no expensive equipment – that is long term and does not require lengthy training,” Fornos added.

“But if scientific evidence shows that quinacrine is dangerous, ineffective, or both, then there is a responsibility and an obligation to prevent its use.”

According to the Institute, the drug was used as an anti- malarial agent in the 1930s, and administered orally to millions of US soldiers and sailors serving in the South Pacific during the Second World War.

A Chilean researcher, Jaime Zipper, first used quinacrine for sterilisation in the early 1970s, and claims to have sterilised about 4,000 women with no deleterious effects. The drug has also been tested on some 1,800 Vietnamese women.

To sterilise women, pellets of the drug are inserted into the uterus near the fallopian tubes. The chemical dissolves, burns the tubes’ lining, and blockage from the resulting scar tissue prevents pregnancy, according to the Institute.

Failure rate of the drug has been variously estimated at between one in 10 and one in 20.

Fornos said that if appropiate testing concludes that the sterilisation agent is both safe and effective, “it could go a long way toward ensuring that population stabilisation will be achieved in time to save our planet from perhaps irreparable environmental damage and millions of people from hunger, malnutrition, disease and unnecessary infant, child and maternal mortality.”

Jack Lippes, Professor of Gynecology and Obstetrics at the State University of New York, said that more than three million US servicemen took quinacrine to prevent malaria and other parasitic diseases.

“They took 100 milligrams daily for years. Since the end of the great war and with more than a 50 year follow-up, no clusters of cancer have been attributed to quinacrine,” he said.

Lippes said that an estimated 100 million people have taken quinacrine and no serious side effects have been reported. To this day, he said, the drug is used to treat several diseases, including lupus and rheumatoid arthritis, with no reports of significant harm.

He said that “a well designed and carefully administered American study would answer any questions the doubters may have.”

Among the issues under discussion at a weeklong meeting on population is contraception and fertility rates. The meeting, which is scheduled to end Thursday, is reviewing the successes and failures in implementing a Plan of Action adopted at the 1994 International Conference on Population and Development (ICPD) in Cairo.

Robin Chandler Duke, of Population Action International, told reporters last week that about 60 percent of the world’s fertile couples had access to family planning services and the use of contraception today, compared with 10 percent at the inception of the UN Population Fund (UNFPA) 30 years ago.

She said it was essential to eliminate the more than 500,000 preventable maternal deaths occurring every year, and to advocate education and meaningful employment opportunities for women and girls.

In a report released last week, the United Nations said that over the past five years, there have been increases in contraceptive use in all regions of the world.

The average level of contraceptive use is estimated at 70 percent in rich countries and about 55 percent in poorer nations. Between 1988 and 1998, prevalence rose from 27 to 39 percent in Kenya, from 32 to 49 percent in Bangladesh, and from 36 to 46 percent in the Philippines.

“However, despite the sustained rise in contraceptive use, effective control over fertility has eluded a sizeable number of couples,” the report said.

The gap between stated desires to prevent or delay a birth and the actual use of contraception to achieve those goals is considerable in many countries, and the full range of modern family planning methods still remains unavailable to large numbers of couples worldwide, the study noted.