no to injectables

NO TO INJECTABLES! NO TO COERCIVE POPULATION POLICIES!

The Health Minister has recently announced plans to initiate trials for a hazardous injectable contraceptive for women called Net-En. We condemn this decision as the trial signifies the perpetuation of anti-poor, anti-women attitudes while implementing the new population policy.

No to injectable contraceptives!

Net-En is a depot preparation of a drug with progesterone-like activity and it can be given to women of reproductive age once every two months as a spacing method.

1. The common and disturbing side effects of Net-En are severe disturbances to the menstrual cycle - from frequent bleeding to no bleeding, mental depression, loss of bone density - causing increased susceptibility to fractures, increased frequency of abnormal blood clotting, weight gain etc.

2. The major problems that may have long term consequences are failure to regain fertility, risk of developing cancer and loss of bone density. A similar profile of side effects exists for other long acting injectable contraceptives such as Depo Provera and Norplant.

3. Though Depo Provera and Net-en have been available for social marketing for many years, a Delhi-based survey of private gynaecologists reveals that the majority of them do not recommend injectable contraceptives for two reasons: one, the extensive counselling required and two, the number of side effects encountered by women.

4. Recommendations of the Drug Technical Advisory Board in 1995 and a Supreme Court ruling of 1999 strongly advise against use of injectable contraceptives on large scale in an unsupervised manner. The recent decision of the Ministry of Health and Family Welfare to conduct trials on Net-En in many hospitals across the country is thus ethically violative of these guidelines.

5. The Indian contraceptive market can provide 40 million potential users for these contraceptives and hence multinational pharmaceutical companies have a major interest in these trials. The plan to initiate these trials for Net-En clearly follows the agenda of the manufacturers of Net-En and Depo Provera.

6. Given the appalling state of the health care system in the country and the existing health profile of Indian women, there is no justification for introducing these harmful contraceptives.

This decision must be seen in the context of population policies of the States which are anti-poor, anti-dalit, anti-adivasis and anti-minorities, and, above all, anti-women.

No to coercive population policies!

The National Population Policy (NPP) is committed to "voluntary and informed choice" and the "target free approach" in administering family planning services. However, policies of the governments of Uttar Pradesh, Madhya Pradesh, Rajasthan, Maharashtra and Andhra Pradesh violate the letter and spirit of the NPP.

1. There is no "population bomb". The birth rate is declining naturally in large parts of the country. There is no need for incentives and disincentives in a family welfare package.

2. There is a large and unmet need for health and family planning services. To propose punitive measures in this context is clearly irrational.

3. If population stabilisation is the goal, removing disparity in infant mortality rates in various states needs priority attention.

4. The disincentives proposed are anti-poor, anti-dalit, anti-adivasis and anti-minorities. Rather than working towards elimination of social and economic causes for disparity, the government is attempting to eliminate existing opportunities for these populations.

5. A two-child norm would bar these populations from contesting elections and deprive them from availing welfare measures.

6. The disincentives are also anti-women as they make a mockery of the "choice" that women do not have in their lives - from deciding about the number of children to contesting elections. They may provide an impetus to sex-selective abortions and female feticide, worsening the already deplorable sex ratio in the country.

7. Coercive population policies will further damage the credibility of a weak and under-funded health care system.

8. The proposals violate several Directive Principles of the Constitution of India as well as several international Covenants that India is signatory to, including the Rights of the Child and India's commitments at the ICPD in Cairo.