Zika epidemic underscores gaps in access to emergency contraception

On February 18th, 2016, the WHO recommended that access to emergency contraception needs to be part of the response to the Zika epidemic. Yet in Latin America and the Caribbean, access to emergency contraceptives is challenging in a number of settings. The World Health Organization’s guidance on Prevention of potential sexual transmission of Zika virus includes the statement that “Women who have had unprotected sex and do not wish to become pregnant because of concern with infection with Zika virus should also have ready access to emergency contraceptive services and counselling.”

We agree that women – all women, in all settings – need access to a range of contraceptive methods, including condoms. Unfortunately, access to EC is not a given in Latin America and the Caribbean. Several of the countries most affected by Zika (including Costa Rica, Haiti and Honduras) have no EC product registered or available through mainstream health services. In Costa Rica, EC has never been approved; in Honduras, an absolute ban on emergency contraception was enacted in 2009 and confirmed by the Supreme Court in 2012; in Haiti, contraceptive manufacturers and distributors have been reluctant to invest in the market given the difficult conditions. Although a black market for EC may exist in these countries, it is not certain that such products would be of adequate quality, nor are they expected to be affordable.

In Latin American countries where EC is more readily available, other barriers may prevent women from easily accessing this essential second chance form of contraception: it may not be available in the public sector (as in Guatemala), a prescription may be required (as in Peru), or there may be age restrictions preventing younger women from accessing it (as in Chile).  For more country-by-country information, please see our EC access database (and send us updates please!). For news coverage, see the article in the New York Times.

Contraception is only one factor in what should be a multifaceted and multisectoral response to Zika. The WHO’s recommendation “for women’s ready access to emergency contraceptive services and counseling” highlights the continuing need for attention to emergency contraception access for all women. Unfortunately, for too many women in the Zika-affected countries in Latin America and the Caribbean, access to emergency contraception remains a challenge.