Harmful Contraceptive Tests on E Indian Women

Accusing their governments of turning a blind eye, health activists and women's groups in the two South Asian nations are calling for a halt to trials of the sterilization drug quinacrine, which they allege are being pushed by right-wing groups in the United States.

Quinacrine, used as an anti-malarial drug in World War II, is a potent chemical poison, say medical experts. It can cause irreversible sterilization, and even its contraceptive value is doubtful, they say.

But the "Q method," which used quinacrine pellets, is illegal in India and has no medical sanction in Bangladesh. The Indian Council of Medical Research (ICMR) abandoned quinacrine trials five years ago when four out of eight women participating became pregnant.

The World Health Organization (WHO) also opposes quinacrine trials without proper toxicological studies of the drug. Quinacrine is a known mutagen, capable of causing changes in the cells and could even cause cancer, say medical experts.

The Q method involves inserting seven small (36 milligrams) quinacrine pellets into the uterus with a device akin to the copper-T inserter. The drug bonds with the uterus tissue DNA and produces severe scarring and inflammation. It blocks the junction of the uterus with the fallopian tubes, preventing sperm entry.

But experts say the scars may not achieve proper closure, unlike tubectomy. The method is likely to make pregnancies fatal, they say.

And unlike tubectomy, quinacrine sterilization is irreversible. A young woman who has undergone it and later wants to have a baby, cannot do so.

Since it needs no surgery, no anaesthetic, no real follow-up and costs only one dollar in each case, it is easy to use the method indiscriminately, say health activists.

The film makers interviewed three such women. None was told of quinacrine's risks or side-effects, a clear breach of elementary medical trial ethics and a violation of the principle of informed consent. Two of the women said they suffered side effects, including swelling of feet, severe abdominal pain, and depression. One of them, a mother of four, became pregnant and had to undergo a surgical abortion.

In trials in Bangladesh, quinacrine failed to prevent conception in 14 percent of cases, an unacceptably high rate for a method of contraception.

Health activists allege the drug is being promoted by the zealous population- control- at- any- cost international lobby, which was behind the trials of harmful contraceptives like Depo Provora and Norplant in developing nations.

They say quinacrine is being supplied to Indian doctors by U.S. right-wing lobbies. The Quinacrine used in the trials by the Lady Hardinge doctor was donated by such groups. Activists say that the U.S. Agency for International Development (USAID) has also funded quinacrine supplies to India.

Women's groups and activists say that such trials of controversial drugs can be avoided if there are clear cut rules on medical trials and these are properly implemented. They want the government to set up a national commission which should also include women's groups, patients associations and academics, to spell out rules for contraceptive trials and penalties for their breach.

The Q method was pioneered by Jaime Zipper of Chile. Its main promoters are said to be two U.S.-based doctors, Elton Kessel and Stephen Mumford, who advocate mass use of the drug in the developing world even before necessary toxicological studies are completed.

Such trials can take as long as 20 years and cost millions of dollars.