[e-drug] USA trying to block abortion pills in new WHO EML?

["E-Drug" <e-drug@healthnet.org>]

E-DRUG: USA trying to block abortion pills in new WHO EML?
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[The WHO Expert committee on essential medicines met in Geneva 7-11 March 2005 for the first time after 2 years (the 2004 meeting was postponed). Normally the Expert Committee makes a new WHO Essential Medicines list available in 48-72 hours. This time this didn’t happen. It is now one month since the meeting, and the WHO website page about the committee (see www.who.int/medicines/organization/par/edl/expcom14/expcom05agenda.shtml) remains silent, and only lists the agenda and the supporting documents.
 
Rumours in WHO indicate that the Director-General’s office has been put under pressure by the USA because of the recommendations of the Expert Committee on abortion drugs (mifepristone combined with misoprostol) and a replacement therapy for heroine dependence (methadone).

Formally the Expert Committee only makes recommendations, and the WHO DG has the right to change them. However, this is a rare event, and would undermine the position of the WHO Expert Committee on Essential Medicines. The delay is also affecting the 51 other decisions that the Expert Committee was to make. 

Attached a Guardian article about the evolving story, copied as fair use. What do e-druggers think?
All evidence is still available on the WHO website. Remarkably there were no comments on the technical proposal for misoprostol & mifeprostone. However, on methadone there was a serious debate on WHO's website. All files are still available at www.who.int/medicines/organization/par/edl/expcom14/expcom05agenda.shtml
WB]

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US accused of trying to block abortion pills 

Sarah Boseley, health editor
Thursday April 21, 2005
The Guardian 

The US government is trying to block the World Health Organisation from endorsing two abortion pills which could save the lives of some of the 68,000 women who die from unsafe practices in poor countries every year. 
The WHO wants to put the pills on its essential medicines list, which constitutes official advice to all governments on the basic drugs their doctors should have available. 

Last month, an expert committee met to consider a number of new drugs for inclusion on the list. They approved for the first time two pills, to be used in combination for the termination of early pregnancy, called mifepristone and misoprostol. In poor countries where abortion is legal, doctors currently have no alternative to surgery. 

The Guardian understands that the US department of health and human services has been lobbying the director general's office at the WHO to block approval of the pills, in line with President George Bush's neoconservative stance on abortion. 
While the availability of pills might make abortion easier and could increase the number choosing it, the experts want them listed to reduce the deaths and damage caused by surgery. Every year, 19 million women have unsafe abortions - 18.5 million of those take place in developing countries. An estimated 68,000 women die as a result of botched or unhygienic surgery, while many others suffer long-term damage, including sterility. 

The WHO's own department of reproductive health proposed the addition of the abortion pills to the list. 

In a review of the drugs for the committee, a Brazilian professor of pharmacology, Lenita Wannmacher, wrote: "There is great concern about the effectiveness and safety of surgical methods that may be less effective and may increase the risk of infection, uterine perforation, cervical laceration, incomplete evacuation, haemorrhage, miscarriage, future sterility and even death." 

The risk of death from abortion in developing countries is 100 times higher than in countries such as the UK, where mifepristone has been licensed since 1991. The pills were licensed in the US in 2000. 

The WHO committee, which included two British and two US experts, recommended unanimously that the pills go on the essential medicines list. But although the director general's approval is usually a formality and the changes are published within days, more than a month has now passed. 

On March 23, the director general's office wrote to committee members asking if they had considered a warning that mifepristone can, in rare cases, carry a risk of serious bacterial infections, sepsis and bleeding. The committee members replied that all side-effects had been considered, adding that the risks of infection and bleeding from surgery in poor countries were far greater. 

One committee member told the Guardian that all the evidence on the risks and benefits of the pills had been on the WHO website for months. 

A spokeswoman for the WHO director general's office said there had been delays because "we had some questions and sought clarification." 

Asked whether there had been any contact between the US department of health and human services and the director general's office, she said: "I can't answer that. I just don't know." She said a decision would be made within days.