Rights advocate demands full disclosure of U.S.-Liberia health compact implementation plan
Congo Town, Monrovia, Liberia - April 6, 2026: The Liberian government's recent decision to restrict the sale and use of abortion pills has sparked strong backlash from institutions and human rights advocates, who argue that the move threatens women's health and contradicts national commitments to reduce maternal mortality.
The Ministry of Health has issued a new policy tightening controls on the sale and use of Misoprostol, commonly known as Cytotec.
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The drug is a synthetic prostaglandin used to prevent stomach ulcers caused by nonsteroidal anti-inflammatory drugs (NSAIDs) and is widely used in obstetrics and gynecology for medical abortions, often in combination with mifepristone, as well as for miscarriage management and labor induction.
Medical practitioners explain that Misoprostol works by reducing stomach acid and inducing uterine contractions. When used to terminate early pregnancies, it causes bleeding and cramping that helps empty the uterus.
The medication is listed by the World Health Organization as an essential medicine, though experts note that it has higher failure rates when used alone compared to the combined mifepristone-misoprostol regimen.
Announcing the new regulation on April 3, 2026, the government said the widespread and unregulated sale and use of Misoprostol had become alarming.
In a statement, the Ministry of Health, in collaboration with the Liberia Medicines and Health Products Regulatory Authority (LMHRA), the Liberia Pharmacy Board (LPB), and the Liberia Medical and Dental Council (LMDC), emphasized that the drug must only be sold upon presentation of a valid prescription from a licensed physician or authorized prescriber under Liberian law.
The directive further warned that Misoprostol should be dispensed only under the direct supervision of a licensed pharmacist or authorized dispensing professional and exclusively within appropriately licensed facilities.
However, the policy has drawn sharp criticism from institutions, including the Liberia Sexual Reproductive Health and Rights Champions (SRHR-Champion Liberia), led by human rights advocate Titus B. Pakalah.
In a public statement, Pakalah described the government's action as a violation of Liberia's health policy and a breach of its commitment to protect the health and well-being of women and girls under the National Action Plan aimed at reducing maternal deaths.
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"We express grave concern over the Ministry of Health's directive tightening access to Misoprostol, particularly in light of the ongoing U.S.-Liberia health compact and the government's own commitments under its 365-Day National Action Plan to address maternal mortality," Pakalah said. He called for the full public disclosure of the U.S.-Liberia health compact implementation plan, including any policy changes affecting access to medicines and reproductive health services.
Pakalah argued that the new restrictions directly contradict national health priorities and warned that limiting access to Misoprostol would not stop its use but instead drive women toward unsafe practices. Human rights advocates also noted that the policy comes at a time when the government has pledged urgent action to reduce maternal mortality.
According to Pakalah, restricting access to essential medicines undermines that goal and weakens public trust in the government's reform agenda for inclusive development.
"The impact of this restriction will be most severe for women and girls in rural communities, where access to licensed providers and regulated facilities is limited," he said. "For many, Misoprostol is the only realistic option. Increasing barriers and risks are pushing them into unsafe conditions with potentially fatal consequences."
