India Women Fighting Birth Control Injections

by Ranjit Devraj

Leaders of well-known women's groups met Health Minister C.P. Thakur last night to demand the withdrawal of birth control injections, which they say are already been approved for use in the country's most populous state, Uttar Pradesh.

Women's rights activists say this contraceptive method has harmful side-effects and allege it is being introduced in the birth control program under pressure from multilateral lenders. They have also urged the government not to let in birth control drugs under the liberalized policy for pharmaceutical import.

Some 42 million women in India are estimated to be in need of protection against unwanted pregnancies. Providing contraception services to these women is one of the key goals of the half century-old birth control program.

"In their bid to meet population targets under World Bank tutelage...authorities have relaxed drug regulations in order to expedite introduction of long-active, invasive and hazardous contraceptives into this country," said Brinda Karat of the communist party affiliate, All-India Democratic Women's Association (AIDWA).

According to Karat, a well-known women's rights campaigner, the re-introduction of the injectable Depo-Provera and other "synthetic, steroidal female hormones" as contraceptives, is a "big victory" for U.S. transnational drug companies.

Women's groups allege that the foreign drug companies are pushing the contraceptive injections without getting these certified for safety through an independent assessment.

They accuse the government of allowing transnational drug companies to carry out their own safety assessment of the contraceptive injections, even though the government has fine medical research facilities of its own.

Depo-Provera is administered once every three months, but can block contraception for a year or more after the last injection. What is more worrying is that the drug is suspected to have many side-effects, including interfering with the reproductive health of progeny, say those opposing its use in the country.

According to independent medical expert C. Satymala, who has studied Depo-Provera use, the drug has serious harmful side-effects. "The drug has been indicted for causing premature menopause, atrophy of the ovaries, sterility death from spontaneous blood clots, susceptibility to HIV-infection, Down's Syndrome in offspring and cervical cancer," she said.

Saytamala accuses the drug's manufacturer of concealing these side-effects and misleading Indian health authorities to obtain clearance to market the contraceptive in the country.

Though Depo-Provera was cleared for use in India seven years ago, women's rights activists had successfully stalled its introduction in the birth control program by appealing to the country's apex court. The Supreme Court ordered a stay on the drug's use on the grounds that there was insufficient research on its suitability for Indian conditions.

Those campaigning against the contraceptive injections also say that these are not suitable for India because the country lacks a proper public health care delivery system. The long-acting contraceptives require proper counselling and follow-up, which is not possible with India's poorly managed and ill-equipped health delivery services, they say.

Public health expert Mohan Rao, who teaches at the Center for Social Medicine and Community Health at New Delhi's Jawaharlal Nehru University, sees contradictions in the government's birth control policies.

This year, India announced a new National Population Policy, which speaks of a "target-free and non-disincentive regime" in birth control.

But the federal government has allowed several states to negotiate direct funding for birth control from international agencies, which have laid down conditions that go against the national policy, he said.

Women's rights campaigner Karat said that the national birth control program is using coercion to reach its targets, which she said amounts to "punishing the poor for their poverty."

Thus western Maharashtra state announced that it would cut subsidized food quotas for children of the poor with large families. The governments of Uttar Pradesh, central Madhya Pradesh and western Rajasthan states have also linked availability of benefits under government schemes to family size.

The adjoining states of Delhi and Haryana have enacted laws to bar from local body elections, candidates with more than two children.