Monday, November 17, 2014
In developing countries "the risk for maternal death during childbirth can be as high as 1 in 15". One might expect this horrifying statistic to be used as an argument for adequate and safe maternal healthcare. Instead, it is being used to sell Depo Provera hormonal contraceptive for Pfizer, administered via a device claimed to be 'innovative'.
The device in question, the 'Sayana Press', may reduce the risks of needles and syringes being reused, and (hopefully) of single doses being split between two people. But calling something 'innovative' does not guarantee its safety, and the hope is that the drug can also be self-administered, in addition to being administered by community based health teams.
However, Depo Provera has been found to double the risk of HIV negative women being infected with the virus through sex with an infected partner, and double the risk of HIV positive women transmitting it to a HIV negative sexual partner. In the case of Depo Provera, population control, reducing the number of births in developing countries, is being prioritized over protecting women from being infected with and with transmitting HIV.
The citation above from one of PATH's blogs starts off talking about the long walk some women have to 'access' contraception, the long queue they have to wait in, the use of a smaller needle, etc. But dressing this up as an exercise in 'enabling' women or genuine service provision is pure humbug.
The Don't Get Stuck with HIV Collective is in favor of access to healthcare, especially reproductive healthcare, as long as that healthcare is safe. Depo Provera is not safe. The World Health Organization has accepted that it is not safe, but has decided that reducing birth is more important than safety, and even than reducing HIV transmission.
The blog goes on about reaching women in remote areas. Women in remote areas are far less likely to be infected with HIV than women in urban areas, or women living close to major roads, health facilities and other modern amenities. But the use of Depo Provera may be the very factor that increases risk under such circumstances.
'Getting health services out to people' is only desirable when those health services are safe. True, many women want to limit the size of their families, presumably many men do, too. But giving people options must include knowledge about healthcare safety and awareness about non-sexual risks from unsafe healthcare, dangerous pharmaceutical products like Depo Provera, and even the many vested interests that various parties in the population control bruderbond may prefer to keep to themselves.
Insidious use of words like 'innovative', 'community', 'village' and the like are great when raising funds or carrying out PR activities, but it doesn't get away from the fact that, in the case of a dangerous drug like Depo Provera, it is not the method of delivery that presents the increased risk of HIV transmission, but the drug itself.
Healthcare is a human right, and an inherently good thing; but unsafe healthcare is the complete opposite of what people in developing countries with serious HIV (also hepatitis, TB, ebola, MRSA, etc) epidemics need. Depo Provera has been found to be unsafe. Creating demand for it, therefore, is not in the interest of people living in poor countries; it only benefits Pfizer, and the many organizations and institutions that have been attracted to the potential funding it represents.