The European Consortium for Emergency Contraception (ECEC) recently made available the electronic version of the EC wheel on their website. The wheel, a counseling tool for health providers, including pharmacists, aims to strengthen the quality of EC counseling and promote women’s choice in post-coital contraception.
The EC wheel is based on WHO and the UK Faculty of Sexual and Reproductive Healthcare recommendations for EC use. The methods included are the copper IUD and levonorgestrel and ulipristal acetate EC pills. Recommendations are provided based on which method is preferable to use in a number of circumstances. Clarifications and brief recommendations on additional protection after EC use and QuickStart are included on the back of the wheel.
For more information, see the Partner Publications section of our website or visit ECEC’s website.
In February 2017, ICEC’s Senior Technical Officer Melissa Garcia attended the stakeholders’ workshop in Abuja, hosted by the Federal Ministry of Health, to develop a National Guideline for EC in Nigeria. In this video interview conducted by the Association for Reproductive and Family Health, Melissa explains this process and why it is a particularly opportune moment for EC in Nigeria. In Nigeria, EC pills have been available for over 20 years in the private and social marketing sectors, and they will soon become available in the public sector for the first time.
Together for Girls, along with partners PAHO, WHO, UN Women, Women Deliver, Save the Children USA, Care International, Child Helpline International, Jhpiego, SafeTrek, BD, and Cummins & Partners have developed new Every Hour Matters campaign resources.
The Every Hour Matters campaign aims to increase awareness about the critical importance of quickly accessing post-rape care. The resources are available here in English, Spanish, French, and Swahili. Included among the resources is “Every Hour Matters After Rape,” an infographic on emergency contraception and post-exposure prophylaxis; “A Call for Post-Rape Care;” “What National Leaders Need to Know about Post-Rape Care;” “Key Considerations for Creating a National Post-Rape Care Campaign;” and “Resources for Post-Rape Care.” Please visit the Partner Publications section of our website for more information in English, and click here for the resources in French.
Melissa Garcia of ICEC and Sarah Rich of the Women’s Refugee Commission co-authored a blog post on the Sexual Violence Research Initiative’s website about EC and post-rape care, which can be read here. EC has particularly critical relevance for post-rape care since it can reduce the risk of pregnancy following unprotected sex, including forced sex, but it is not systematically provided to survivors, which violates their human rights. The blog piece discusses the most crucial barriers to EC access for sexual violence survivors, including policy, legal, and regulatory barriers; facility protocols and provider biases; and women’s low level of knowledge of EC and delayed care-seeking. As these barriers are often exacerbated in crisis settings, the blog piece calls for new approaches for ensuring that survivors receive EC.
In August 2016, Stuart Derbyshire published an article in Conscience Magazine entitled “Does Big Pharma Believe in Autonomy?” In it, Derbyshire argues that pericoital contraception, contraception that women take just before or just after sex, could help dramatically decrease the rate of unintended pregnancies, but that pharmaceutical companies seem hesitant to fill this need because of moral implications. Specifically, pericoital contraception will facilitate women’s sexual autonomy, which is not welcome because such autonomy includes the possibility of unplanned sex.
In response to Derbyshire’s article, Elizabeth Westley and Elizabeth Raymond wrote a letter to the editor, entitled “Pericoital Contraception and the Market” and published in December 2016, in which they state that Derbyshire’s argument that “big pharma” is keeping EC pills out of the hands of women who want to use it as a regular method because of moral control is too simplistic. They argue that pharmaceutical companies are not investing in pericoital contraception because of markets, not morality. There are a number of challenges that pharmaceutical companies would have to overcome before the routine use of EC can become widespread, such as approval by a stringent regulatory authority and expensive clinical trials proving efficacy and safety. The authors do make the point, though, that in the absence of a dedicated pericoital pill, manufacturers and drug stores are starting to sell EC in multipacks, which encourages advance planning and makes it easier for women to use them more than once, destigmatizes repeat or routine use of emergency contraception, and may offer a price that allows some women to use this pill several times a month.
The Brazilian Health Institute has recently published an e-Book about EC. While the book, called “Panorama da Contracepção de Emergência no Brasil” [Overview of Emergency Contraception in Brazil], touches on global issues relating to EC as well as issues specific to Latin America, its primary focus is on EC access issues in Brazil. The topics explored in the book are wide-ranging and include the knowledge and use of EC among adolescents in Brazil, EC and sexual violence, Brazilian pharmacists’ views on EC, and how EC is being portrayed in the Brazilian press. The first chapter, titled “A Global Assessment of Emergency Contraception Accessibility,” was written by Elizabeth Westley and Jamie Bass of ICEC and Cristina Puig of ECEC.
The book is in Portuguese, except for the first chapter, which is in English. The book can be viewed here, as well as on our Partner Publications page.
The British Pregnancy Advisory Service (bpas) recently launched a campaign in the UK calling for LNG EC to be made available directly on pharmacy shelves at an affordable price. Currently in the UK, women can only obtain EC from behind the pharmacy counter after a consultation with a pharmacist, and LNG EC costs up to £30, which is more than anywhere else in Europe with the exception of Ireland. bpas’s campaign is calling for EC to be reclassified as a General Sales List medication so that it can be placed on pharmacy shelves for women to buy without a consultation. The organization is also calling for all those involved in the pricing of EC to consider how they can provide women with a much more affordable product.
To launch the campaign, bpas created a tongue-in-cheek video highlighting that for some women in the UK it would be cheaper to fly to France to buy EC than purchase it in their local community. Click here
to see the video, and for more information on the campaign, please visit http://www.justsaynon.org.uk/
The Johns Hopkins Center for Communication Programs and ICEC, working closely with the National Reproductive Health Program, recently developed a leaflet on EC for health providers, community-based distribution agents, and pharmacists in the Democratic Republic of the Congo (DRC) to use when counseling their patients or clients. Knowledge and use of EC is very low in the DRC and the goal of this leaflet, which was produced in French, Swahili, Lingala, and Kikongo, is to bring an increased awareness and understanding of EC to the populations who most need it.
In 2009, the provision of EC pills in public health facilities was banned by the Constitutional Court. Despite having more than 16 EC brands on the market, the public health system has not provided EC during all these years, not even in cases of rape, creating a clear inequality among women who can and cannot afford to buy EC and limiting the post-coital contraceptive choices for the lower-income population.
The troubled history of EC in Peru is well explained in the short film (in Spanish) “AOE: Bendita pildora” (“EC – Holy pill”).
In 2014, the Peruvian NGOs PROMSEX, DEMUS and Paz y Esperanza, and the Center for Reproductive Rights filed a lawsuit against the Ministry of Health based on the case of “Maria,” a young women who was denied EC in a public hospital after being raped. The case has also been brought up to the InterAmerican Commission of Human Rights, where it is awaiting to be seen.
However, this past August, and while the case is waiting to be heard at a local court, a judge order that EC pills be procured and provided in public health units, as a precautionary measure. This move prompted a heated public debate and, once again, those opposing the measure used the language on the FDA label for LNG products to claim that EC can interfere with implantation.
The trial is supposed to be held soon, but thanks to the precautionary measure, women who cannot afford EC can already receive it for free through the public health network.
A new blog post, authored by Elizabeth Westley and Melissa Garcia, details ICEC’s recent strategy to increase awareness of EC by promoting EC-related storylines in “entertainment for education” media projects. These projects, which are produced by our partners Population Media Center and ONG RAES and include engaging television and radio soap operas, provide innovative and unique opportunities to reach wide audiences in the countries where ICEC has focused work (Democratic Republic of the Congo, Senegal, and Nigeria). Click here to read more.