In a case of damned if you
do, damned if you don’t, the Indian government is taking a lot of heat
for its recent ban on the drug quinacrine. Originally developed as an
anti-malarial agent, the drug had been used for the last 20 years to chemically
sterilize women in India.
Led by protests from women’s
rights activists in India, the government banned the drug last year. Almost
all international family planning agencies oppose the use of quinacrine
and, as used in India, the drug has rather severe side effects.
The sterilization procedure
requires a quinacrine tablet to be inserted in the uterus where it causes
severe scars on the fallopian tubes that prevent pregnancy. Aside from
the intense pain, the procedure can cause abnormal menstrual bleeding,
backaches, fever, abdominal pain and headaches. Additionally, some studies
have suggested an association between quinacrine and some forms of cancer.
In addition, the use of quinacrine
became tinged with North-South politics. The drug was sold to Indian doctors
at no charge by a couple of individuals in the United States convinced
that India is overpopulated. The drug is not approved for use to induce
sterilization in the United States and many critics charged the exporting
of the drug was just more neo-imperialism.
So, given all these issues,
why would women and their doctors possibly want to continue to use quinacrine?
Because the drug has a couple big advantages over alternatives. Although
the procedure is painful, it doesn’t require women to stop working. More
importantly, it is a lot easier for women to keep the procedure secret
from husbands who might object. And, of course, the low cost makes it
affordable even for very poor women.
In many ways, the issue is
which of several bad choices women should have. “If the drug causes
cancer, I don’t want to promote it,” surgeon J.K. Jain told the Associated
Press, “But pregnancy itself is a killer. If the drug has so much
potential to improve the lives of women in the reproductive age, it should
be allowed.”
At least give women the choice
to make that decision for themselves.
Source:
India wrestles with ethics of sterilization drug. Hema Shukla, Associated Press, January 11, 1999.