17 July 2012

Africa: Women to Gain Access to Innovative Contraception

Photo: Tami Hultman/AllAfrica
Melinda Gates promoting family planning in London.

London — Up to three million women in Sub-Saharan Africa and South Asia could soon benefit from a simplified, more accessible contraceptive injection, it was announced at the Family Planning Summit, in London last week (11 July).

The partnership behind the new injection comprises the UK Department for International Development (DFID), the US Agency for International Development, the Bill & Melinda Gates Foundation, pharmaceutical company Pfizer, and the international health non-governmental organisation PATH (the Program for Appropriate Technology in Health).

This public-private partnership, established in July ahead of the summit, plans to produce 12 million doses of the contraceptive between 2013 and 2016.

The drug, Depo-SubQ Provera 104, is a version of the well-established intramuscular Depo-Provera contraceptive injection - a synthetic form of the female hormone progesterone, which is injected in the buttock or upper arm muscle.

Imanol Echevarria, a senior director at Pfizer, said that although Depo-Provera has proved to be a popular contraceptive - the injection lasts three months and is generally well tolerated - its delivery has always presented challenges.

"We can get the product to a rural health centre fairly easily, but getting it to remote villages - that 'last mile' - is a challenge: the injection comes in a small glass vial, it is heavy, fragile and must be administered by a qualified nurse," he said.

New packaging will allow the contraceptive to be delivered by less skilled health workers, thus potentially reaching more women.

The active compound is the same, but the drug is packaged in an injection system called Uniject, a prefilled, disposable plastic bubble, administered subcutaneously - a health worker simply squeezes the bubble to inject the contraception under the skin.

Uniject was initially developed by PATH for use with vaccines, but feedback from the field lead to the broadening of its application for use in antibiotic and contraception delivery as well.

For women in remote parts of the developing world, this could mean the end of a return trip to the health clinic every three months - sometimes a day's walk or more.

Partners are also developing innovative educational materials for health workers, including a mobile phone application and an instructive animation, to enable more efficient administration of the drug.

The project's joint funding arrangement means that the contraceptive will be available at affordable - although still undisclosed - prices, the partnership announced.

A number of countries have expressed interest in licensing the product, including Senegal.

Awa Marie Coll-Seck, Senegal's former health minister and PATH board member, announced at the summit that Senegal plans to roll out the contraceptive, as part of the country's commitment to "making family planning a top priority".

Coll-Seck said that the Senegalese government planned to more than double the country's coverage of contraceptives (the percentage of women who are practising - or whose sexual partners are practising - any form of contraception) from 12 to 27 per cent by 2015.

According to the partnership, other countries keen to adopt the drug include Burkina Faso, the Democratic Republic of Congo, Ethiopia, Kenya, Liberia, Nigeria and Uganda.

However, any adoption is subject to regulatory approval. A partnership meeting in October will finalise details of the roll out.

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