By Rebecca Oas, Ph.D and Lisa Correnti | August 11, 2016
WASHINGTON DC, August 12 (C-Fam) A new study suggests the World Health Organization, Gates Foundation, USAID and other wealthy donors knowingly downplayed increased risk of HIV from contraception they distribute to women in developing countries. Mounting evidence has forced the global health establishment to reluctantly admit its concern.
Feminist and conservative groups alike have warned of the link between HIV and the injectable contraceptive Depo Provera (DMPA). But the World Health Organization (WHO) and the sexual and reproductive health establishment repeatedly rebuffed concern, especially in the lead up to their 2012 push for donors at their massive family planning conference in London.
“Ignoring the body of evidence put before them prior to the scale-up was hurtful to Africans, and grossly negligent,” said Kwame Fosu, a human rights defender among the first to report on the dangerous side effects. Fosu said he sent numerous correspondences to all responsible parties on the documented side effects that include irreversible bone density loss, and double-risk of breast cancer.
Shortly before the July 2012 launch of the massive FP2020 global family planning initiative led by the Gates Foundation WHO released a statement that essentially declared Depo Provera safe.
Guttmacher researcher and lead author of the new analysis Chelsea Polis, worked for the U.S. foreign aid division when it produced a “watered down” report which influenced WHO’s position that Depo Provera was safe, according to Fosu. This happened despite two decades’ evidence showing the HIV-Depo Provera risk.
Following the rollout of FP2020 a special partnership with the pharmaceutical company Pfizer was announced doubling Depo Provera production, including through a new self-injectable version of the drug called Sayana Press.
This collaborative effort included USAID, European governments, United Nations Population Fund (UNFPA), PATH, FHI 360 and International Planned Parenthood Federation (IPPF)—now receiving many millions to distribute and administer the shot.
The Guttmacher Institute press release announcing the new review study carefully avoided alarmism over the HIV-DMPA link and appears as a general review of the association of hormonal birth control methods and HIV.
It reports “a reassuring lack of increased risk” for users of contraceptives other than Depo Provera and “underscores [the] differences between methods” while admitting the “new and increasingly concerning evidence on DMPA.”
Fosu expressed frustration that politics continues to trump the best interests of poor women.
“We should be less concerned with damage control and more focused on the growing global public health threat Depo-Provera has caused due to millions of women now using it,” he told the Friday Fax. “A complete policy reversal is needed by all involved.”
The Gates Foundation and the U.S. government are the two largest funders of the WHO and will have a large say in future policy decisions.
Even if WHO changes its guidance, the press release suggests WHO is already working hard to contain the fallout. In particular, the new report emphasizes that a similar link is not seen with non-DMPA injectable contraceptive NET-EN or other non-injectable methods. However, like DMPA, Norethisterone Enanthate (Net En) is a synthetic progestin hormonal contraceptive, therefore significantly increases the risk of breast cancer.
Polis previously said that continued use of Depo Provera would be “a public health benefit” unless it more than doubled the risk of HIV transmission.
https://c-fam.org/friday_fax/cover-evidence-contraceptive-hiv-link/