THE REBECCA PROJECT FOR HUMAN RIGHTS
Health Safety and Dignity for Vulnerable Families
Ending the Use of Depo Provera – The World’s Most Dangerous Contraceptive
The Rebecca Project for Human Rights commends Israel for its decision to terminate the use of Depo Provera on Africans. On January 28, 2013, Israel admitted that they coerced African women to use Depo Provera without consent and full understanding of harm. Israel has now acted ethically and instructed doctors not to renew Depo Provera prescriptions without full disclosure and consent, thus fundamentally ending its use on Africans and immigrants. In spite of the international trends, it is uncertain that USAID and U.S. Foundations will follow suit to respect the reproductive rights of low-income women and communities of color within the United States, Africa and Latin America.
Harm
Over the past thirty years, Depo Provera, an injectable carcinogenic contraceptive, has been targeted at vulnerable lowincome women. Albeit cheap and effective at preventing pregnancies, Depo Provera carries deadly side effects.
According to the 2004 Pfizer/FDA Black Box Warning, women who use Depo Provera may suffer significant bone mineral density loss and bone loss is greater with increasing duration of use and research has not proven this reversible.
Apart from excessive weight gain, excessive bleeding and strokes admitted by Pfizer; scientific research have also confirmed that women who use Depo Provera have double the risk of developing breast cancer. Depo Provera has an unintended consequence of increasing a woman’s susceptibility to HIV/AIDS seven-fold, due to the fact that the high dose of progesterone in Depo Provera induces thinning of the vaginal epithelium, which also contributes to miscarriages and sterility. Additionally, statistics indicate that women infected with HIV who use Depo Provera put HIV-negative partners at a greater risk of contracting the virus. Birth control providers that serve low-income women and girls, for example Planned-Parenthood, characteristically eschew informing patients about FDA Depo Provera warnings. Ethically they should be mandated to post the FDA’s Depo Provera warnings on websites and not mislead and misinform families about dangerous side effects. According to Dr. Betsy Hartmann and Jael Silliman who are women’s rights advocates and worked with the Committee on Women, Population, & the Environment (CWPE), women in the United States are often coerced to taking Depo Provera to prevent future births.
Over the last three decades, Depo Provera is documented as the world’s most dangerous contraceptive, and physicians seldomly administered this drug to White or affluent women and girls in the U.S. or Europe. Minority communities in the United States have high HIV/AIDS infection and transmission rates. In 2009, according to the CDC, African Americans comprised 14% of the US population, but accounted for 44% of all new HIV infections– African-American women have the highest per capita usage of Depo Provera in the United States followed by Latinas. Latinos accounted for 20% of new HIV infections, while representing 16% of the total US population. In 2010, some 280,000 South Africans died of HIV/AIDS. Approximately 42% to 47% of all deaths among South Africans have been HIV/AIDS related. However, South Africa and its neighboring countries continue to have the highest use of Depo Provera, which is funded by the United States via USAID. Most European countries have effectively banned or curbed the use of Depo Provera.
Seminal Depo Provera Experiment
The African continent has been a theater for unregulated, unethical human experimentation and turpitudinous malpractice. In a seminal reproductive “family planning” experiment, discussed in the Rebecca Project’s 2011 whitepaper The Outsourcing of Tuskegee, researchers experimented with Depo Provera on approximately 9,000 impoverished women in Navrongo, Ghana. Population Council researchers deliberately withheld providing informed consent to women and families that they were human subjects in this Navrongo Experiment designed by Dr. James Phillips, and this included not giving them detailed information on the dangerous side effects of Depo Provera. Population Council researchers also fabricated false research data for desired outcomes.
Recommendations
The Rebecca Project for Human Rights and the Dignity of Women’s Health Coalition (a Clergy coalition), advocates to implement mandatory consent requirements before Depo Provera is administered in the United States, Africa and Latin America. It is our recommendation that birth control providers, before administering Depo Provera, shall inform women verbally and in writing, with signed Informed Consent, that: 1) Depo Provera significantly reduces bone mineral density, 2) Depo Provera doubles the risk of breast cancer, 3) Depo Provera increasing a woman’s susceptibility to HIV/AIDS seven-fold, due to the fact that the high dose of progesterone in Depo Provera induces thinning of the vaginal epithelium; therefore, condoms should be used during every sexual encounter, 4) Depo Provera causes blood clots and strokes, and 5) Depo Provera contributes to miscarriages and sterility. Finally, we recommend that Federal funding is terminated in order to end inherent coercion associated with birth control providers who serve low-income women—there are safer contraceptives funded under Medicaid.
Impact of Rebecca Project’s Advocacy
In early 2010, The Rebecca Project began working on non-consensual research initially focusing on unethical Depo Provera research after it received detailed information about Depo Provera and the Navrongo Experiment from a doctor at Johns Hopkins University. On September 23, 2011, this work culminated in the publication of “The Outsourcing of Tuskegee: Non-Consensual Research in Africa,” which was launched at Congressman Conyers’ Judiciary Braintrust at the Congressional Black Caucus (CBC) Conference. The CBC Unethical Human Research panel was moderated by Laura Murphy, Director, ACLU (Washington DC Legislative Office). After our launch, copies of our report were mailed to every doctor, researcher, university and foundation mentioned in our report. Report was also mailed to USAID, Health, Judiciary and Human Rights Committees in Congress. Finally, we mailed report to 38 African Embassies, and included Haiti, Jamaica, Ecuador, El Salvador, Honduras, Peru, and Thailand.
1) Following the presentation of our report at the CBC conference our efforts we recognized. According to Keenan Keller (Senior Counsel for Congressman John Conyers), Peter Donaldson, the President of the Population Council and Patricia Vaughn, his General Counsel, came to Washington to discuss our report. During the meeting, Mr. Donaldson stated that he welcomed our report saying, “Anyone who denies what is explained in our report is suspect” (notes taken from conversation with Mr. Keller). Mr. Donaldson further detailed to Mr. Keller that improvements need to be made in research regions of Africa and stated that he would like to work toward that goal. Mr. Donaldson also agreed during this meeting that the GAO should study the Navrongo Experiment to improve oversight and to ensure compliance of grantees with World Health Organization guidelines.
2) On January 28, 2013, Israel admitted that they coerced African women to use Depo Provera without consent and full understanding of harm, and instructed doctors not to renew Depo Provera prescriptions without full disclosure and consent. Canada, India, Australia, France, Germany, Spain, Switzerland, United Kingdom and all EU countries have either banned or effectively restricted Depo Provera’s use with strict Informed Consent policies. However, because of the power dynamic between African countries and USAID and US Foundations, African leaders cannot refuse Depo Provera when it is intricately tied to much needed foreign aid for health that included family planning.
3) Organized a panel discussion hosted by Georgetown Law’s Committee on Human Rights – Ethically Impossible: A Panel Discussion on Non-Consensual Medical Research in Guatemala, Africa and the United States. Examining the use of Depo Provera on vulnerable populations and medical research conducted across the globe by U.S. physicians and corporation without informed consent.
4) Educating Congress about harm and the need for hearings. Rebecca Project is in discussions with the House Subcommittee on Africa, Global Health, Global Human Rights and International Organizations present Chairman is Congressman Chris Smith, R-NJ.
Special thanks to Agnes J. for sending us the info.
