The Emergency Contraception Newsletter

Spring 2002

Vol. 7, No. 1 

ABOUT THIS NEWSLETTER:

 

This newsletter is prepared and distributed as a voluntary activity on behalf of the American Society for Emergency Contraception and the international Consortium for Emergency Contraception. It is distributed electronically twice each year to anyone wishing to receive it. To contribute a news item, please send it to AmSocEC@aol.com, to Tara Shochet (shochet@princeton.edu), or to Charlotte Ellertson (cellertson@popcouncil.org.mx). We reserve the right to check and edit items as appropriate. To add or remove your name from the newsletter circulation list, please write to AmSocEC@aol.com. More information about ASEC and the Consortium is located at the end of this newsletter.

PRODUCT NEWS

Plan B expands pharmacy directory, applies for behind-the-counter status in Canada, wins packaging award, approved for extended shelf life

 

Over the past three months, Plan B's distributors added several thousand more pharmacies to the Plan B web-based pharmacy directory (www.go2planb.com). The big increase was the result of a major promotion campaign designed to improve availability at retail pharmacies across the country. A majority of U.S. pharmacies still don't carry any dedicated product for emergency contraception. On March 6, an application to take Plan B off prescription in Canada was submitted to Health Canada. The application has been granted priority review status, and approval for “behind-the-counter” sales could come by late fall of 2002. The additional studies needed to support an application for over-the-counter in the United States were completed in early May and the application to the FDA should be ready for submission later this summer. In May, Plan B was named one of three drug “Packages of the Year” by the Healthcare Compliance Packaging Council, an industry trade group. The HCPC found the unusual Plan B package to be highly user friendly and well-designed for optimal safety and efficacy. Finally, recent FDA approval of a 36-month expiration dating period will allow clinics and pharmacies to keep a larger stock of Plan B and also facilitates advanced prescribing. 

Contact: 

Sharon L. Camp, PhD

Women's Capital Corporation

1990 M Street, NW, Suite 250

Washington, DC 20036

USA

Tel: 202-969-8438

Fax: 202-969-8439

Email: scamp@go2planb.com

PREVEN approved for 48 month shelf life

 

The expiration dating for PREVEN® Emergency Contraceptive Pills has been extended to 48 months. The longer shelf life helps to facilitate women of reproductive age keeping PREVEN® on hand, so that it is available if an emergency contraceptive need arises.  When EC's are taken shortly after unprotected sex, maximum efficacy is achieved. 

Contact: 

Dawn M. Carone

Product Manager

Gynétics, Inc.

3371 Route One, Suite 200

Lawrenceville, NJ 08648

USA

Tel: 609-919-1931 ext. 100

Fax: 609-919-9409

Email: dcarone@gynetics.com

NorLevo to be available directly from a pharmacist in Finland and Switzerland, continues global expansion

 

NorLevo, the dedicated levonorgestrel emergency contraceptive product marketed by HRA Pharma, is now available directly from a pharmacist in Finland, and will soon be in Switzerland, without the need for a clinician's prescription. Continuing its expansion around the globe, NorLevo has recently been approved as a prescription drug in Morocco, Singapore, Taiwan, El Salvador, Peru, and the Dominican Republic

Contact: 

André Ulmann

HRA Pharma

19, rue Frédérick Lemaitre

75020 Paris

FRANCE

Tel: 33-1-40-33-1130

Fax: 33-1-40-33-1231

Email: infohra@hra-pharma.com

COUNTRY UPDATES

High Court in United Kingdom rejects assertion that ECPs are abortifacient

 

In the United Kingdom, the judicial challenge by the Society for the Protection of the Unborn Child claiming that emergency contraceptive pills contravened the Offenses against the Person Act of 1861 was rejected by the High Court. They claimed that EC was an early method of abortion and as such should be subject to the legislation governing abortion. The judgment handed down on 18 April focused on the scientific meanings of the terms "pregnancy," "miscarriage," and "abortion." After taking evidence from several medical experts in the field, the judge argued: "Up until the attachment stage, the embryo is not attached in any way to the woman herself." He added: "Current medical definitions given in medical dictionaries support the view that pregnancy begins once the blastocyst has implanted in the endometrium and more particularly, that miscarriage is the termination of such a post implantation pregnancy." In terms of how emergency contraception works, he pointed out that once an embryo had implanted, or had begun to implant, "the morning after pill cannot act to cause it to de-implant." Although it is still possible to take it to the House of Lords, medical providers in the UK are very relieved to be able to legally prescribe ECPs and for women over 16 years to be able to buy them from pharmacies without a prescription. 

Contact: 

Anne Webb

Abacus Centre for Contraception and Reproductive Health

40-46 Dale Street

Liverpool L2 5SF

UNITED KINGDOM

Email: awebb@westkirby1.freeserve.co.uk

NorLevo launched in India

 

In April 2002, Contech Devices Pvt. Ltd., in collaboration with HRA Pharma, officially launched NorLevo emergency contraceptive pills in India. With its vast experience in the contraceptive market, Contech Devices hopes to introduce NorLevo to the majority of gynecologists throughout the country. In order to increase awareness among these doctors, information on NorLevo has been mailed to all members of the Federation of Obstetrics & Gynecology Society of India. Complete product details were also sent to all medical colleges in the country. In addition, the product was introduced to doctors at the All India Congress of Obstetrics & Gynecology held in January 2002 at Bhubaneshwar

Contact: 

S. M. Buch

Contech Devices Pvt. Ltd.

A-46/47, Sector-57

Noida-201 301

INDIA

Tel: 91-120-4581136, 4581336, 4581287

Fax: 91-120 4581296

Email: ception@del2.vsnl.net.in

Emergency contraception to become available directly from pharmacists in New

Zealand

 

Starting in late July 2002, women in New Zealand will be able to obtain emergency contraception directly from a pharmacist, without a clinician's prescription. Last year, the Ministry of Health approved the non-prescription status for Levonelle, a levonorgestrel-only EC product, in an attempt to increase availability of EC and reduce the nation's rising abortion rate. This summer, a series of training programs will be available for pharmacists who wish to dispense EC; more than 600 pharmacies have already signed up for the required training course. Pharmacists dispensing Levonelle will be required to ask patients a set of questions to ensure that the drug is being used for the intended purpose, and to explain how to take the drug and how it works. The women will be required to give informed consent. The pill and the 10-minute consultation will cost approximately $30-$40. [Adapted from the May 24, 2002, Kaiser Daily Reproductive Health Report. View the entire Report, search the archives, or sign up for email delivery at: www.kaisernetwork.org/dailyreports/reproductivehealth. The Kaiser Daily Reproductive Health Report is published for kaisernetwork.org (www.kaisernetwork.org), a free service of the Kaiser Family Foundation, by National Journal Group Inc. © 2002 by National Journal Group Inc. and Kaiser Family Foundation. All rights reserved.] 

Contact: 

Alyson Browett

Kaiser Daily Reproductive Health Report

600 New Hampshire Ave. NW

Washington, DC 20037

USA

Tel: 202-672-5952

Fax: 202-672-5767

Email: dailyreports@kaisernetwork.org

Israel Defense Force makes EC available to all women soldiers at no cost

 

As of May 2002, Israel's Army, the IDF (Israel Defense Force) announced that EC will be available to all IDF women soldiers, at all IDF health centers, at no cost. Israel has a mandatory military service and all women generally serve for about 2 years from age 18-20. Up until now, IDF women soldiers had to obtain EC from civilian pharmacies which are sometimes difficult to get to given the timeliness of using EC and the nature of military service. IDF soldiers will also be able to purchase their prescription birth control pills at a discounted price from the IDF health centers. Up until now, IDF soldiers paid out of pocket for their prescription birth control pills at civilian pharmacies. Both of these new services were made available through collaborative work between the IDF's Advisor on Women's Issues, the IDF's Advisor on Health, and the Chief of the IDF. 

Contact: 

Sharon Cohen

Pharmacy Access Partnership

614 Grand Avenue, Suite 400

Oakland, CA  94610

USA

Tel: 510-272-0150, Ext. 103

Fax: 510-272-0285

Email: scohen@phi.org

Emergency contraception banned in Uganda

 

Under the pressure of the Catholic Church, the Uganda government has declared that emergency contraception is an abortion and has therefore banned it. As a consequence, CMS, the company that markets HRA Pharma's Vikela (a levonorgestrel dedicated product) will have to withdraw it from the market. 

Contact: 

André Ulmann

HRA Pharma

19, rue Frédérick Lemaitre

75020 Paris

FRANCE

Tel: 33-1-40-33-1130

Fax: 33-1-40-33-1231

Email: infohra@hra-pharma.com

Argentina bans EC product

 

In March 2002, the Supreme Court of Argentina ruled against the production and commercialization of Imediat, a combined EC product, which had been sold since September 1997. Such procedure was motivated by their assumption that this product is abortifacient. This prohibition applies only to Imediat and not to Imediat N, a

levonorgestrel-only EC product, which was introduced into the Argentine market in September 2000. Given this situation, it was the company's decision to replace Imediat with Imediat N, in view of its advantages regarding efficacy and tolerability over the combined product. Therefore, Imediat N is commercialized all over the country and hence, it is available to every Argentine woman. 

Contact: 

Valentina Carricarte

Product Manager - Hormonal Line

Gador S.A.

Darwin 429

1414 Buenos Aires

ARGENTINA

Tel: 54-11-4858-9000

Email: vcarricarte@gador.com.ar

NEW MATERIALS AND CAMPAIGNS

Alaska pharmacists to provide EC through collaborative agreements

 

On April 25, 2002 Alaska became the third state to permit pharmacists to provide EC under collaborative protocol with a prescriber. As with both California and Washington, pharmacist scope of practice in Alaska pertaining to EC has its own characteristics. To date, five pharmacies have signed on to establish the service. Below is a summary of Alaska's new regulations pertaining to EC (Pharmacy Access Partnership, 2002). 

  • Collaborative protocols may be with either a MD or Nurse practitioner.
  • Protocols must first be approved by the State Board of Pharmacy.
  • Protocols are limited to two years, and then must be resubmitted to the State Board for renewal. 
  • Regulations require pharmacists to have training on EC - Alaska's recommended pharmacy training program is the online EC program at www.aphanet.org
  • Regulations require a plan for providing the authorizing practitioner with EC patient information, and stipulate a quarterly review process. 
  • Protocols may apply to whole community including individuals with no established relationship with a provider, although prescriber can establish limits.
  • Participating pharmacists must register with the national EC Hotline (1-888-NOT-2-LATE)

 

Contact: 

Dr. Colleen Murphy

Project Leader

Alaska Emergency Contraception Project

Tel: 907-243-1939

Email: drcolleen@gci.net

Web: http://www.akemergencycontraception.org

Pharmacy Access Partnership in California training pharmacists across the state, Governor announces California HMOs must cover EC

 

The Pharmacy Access Partnership's EC Program in California has trained 800 pharmacists and has activated over 200 pharmacies across the state. The Partnership is now beginning a statewide information campaign. A number of chain pharmacies are actively involved such as Costco, K-Mart, Longs, Rite Aid, SavMart, Sav-On, Target, Vons and Walgreens. California has a variety of ACPE certified EC training programs for pharmacists including live programs by the California Pharmacists Association and the University of California San Francisco self-study training program that uses VHS video vignettes with commentary by a panel of experts as well as an accompanying syllabus. There has been a great deal of interest on the part of pharmacists and physicians in the state wanting to get involved. By the end of 2002 there is expected to be 2000 pharmacists trained and over 500 pharmacies activated. There has been a considerable amount of media attention in California in the past five months with several hundred media and print stories, virtually all of which have been positive. Furthermore, on March 27, 2002, Governor Gray Davis announced that all HMO's must cover EC for women. For more information about the Pharmacy Access Partnership's EC Program please visit: http://www.pharmacyaccess.org. 

Contact: 

Jane Boggess, PhD

Director

Pharmacy Access Project

614 Grand Avenue #400

Oakland, CA 94610

USA

Tel: 510-272-0150

Email: jboggess@phi.org

Web: http://www.ec-help.org/

“Back Up Your Birth Control” campaign earns wide support, media coverage

 

Together with over 130 national, state and local organizations, the Reproductive Health Technologies Project (RHTP) launched “Back Up Your Birth Control” Day on March 20, 2002. The “Back Up Your Birth Control” campaign positioned EC as a common sense back-up to other contraceptive methods in the minds of providers and the general public by encouraging women to ask their health care providers for an advanced prescription of EC. During March and April, the “Back Up Your Birth Control” campaign earned media coverage in more than 70 markets, including 16 of the nation's top 20 with the help of Public Interest Media Group. In just two months, stories featuring the campaign, messages, and/or goals reached more than 25 million Americans through earned media placements in both print and broadcast outlets. Campaign materials featuring Rosie the Riveter and additional information are available at www.backupyourbirthcontrol.org.  RHTP is currently conducting an evaluation of the campaign in preparation for “Back Up Your Birth Control” Day 2003. 

Contact: 

Stacy Robison

Reproductive Health Technologies Project

1300 19th Street, NW, Second Floor

Washington, DC 20036

USA

Tel: 202-557-3416

Fax: 202- 728.4177

Email: stacy@rhtp.org

ARHP working to expand EC Hotline provider list, promote EC awareness

 

The Association of Reproductive Health Professionals (ARHP), the official managing organization for the Emergency Contraception Hotline (1-888-NOT-2-LATE) and Website (http://not-2-late.com) continues to work on increasing the provider database, promoting the EC Hotline and Website, and increase funding. ARHP was part of a coalition of organizations that launched the ongoing Back up your Birth Control campaign, which features the Hotline and Website. ARHP is currently working with the Colorado NARAL Access Project to increase the number of emergency contraception providers listed on the Hotline and Website for the entire state of Colorado. ARHP is also part of an effort headed by the Planned Parenthood League of Massachusetts whose main goal is to promote awareness of emergency contraception within targeted areas of Massachusetts. The Hotline is also being featured as part of a large EC media campaign being launched by the Pacific Institute for Women's Health (PIWH) in California. ARHP plans to partner with PIWH in order to expand the EC campaign to the national level. After surveying people who have downloaded ARHP's award winning Emergency Contraception: Train the Trainer teaching curriculum, results showed that over 80% of participants ranked it to be a 4 or higher (with 5 being the highest rating). This slide set can be accessed by anyone, free of charge, on ARHP's website, www.arhp.org/ec/

Contact: 

Natalia Barolin

Communications Coordinator

Association of Reproductive Health Professionals

2401 Pennsylvania Avenue, NW, Suite 350

Washington, DC 20037

USA

Tel: 202-466-3825

Fax:  202-466-3826

Email: nbarolin@arhp.org

Web: http://www.arhp.org

PPFA raising EC awareness on college campuses

 

For the 2001-2002 academic year, Planned Parenthood Federation of America received a grant to raise awareness among college students about emergency contraception.  Twenty-six PPFA affiliates participated in the campaign, educating students at over 40 schools about EC through ad placement, tabling on campus, residence hall presentations, peer educator trainings, and other events. In addition, 19 affiliates participated in the Back Up Your Birth Control Campaign on March 20, providing further EC education on 31 campuses. PPFA has applied for another grant to continue EC education on campus during the 2002-2003 academic year. A list of the targeted schools is available upon request.

Contact: 

Deborah Weiss

Campus Outreach Associate

Planned Parenthood Federation of America

810 Seventh Avenue

New York, NY 10019

USA

Tel: 212-261-4697

Fax: 212-247-6342

Web: http://www.plannedparenthood.org/vox/

Open Society Institute grants over $1 million for EC projects during past 1.5 years

 

The Open Society Institute's Program on Reproductive Health and Rights gave almost

$1.3 million in EC-related grants in 2001 and the first quarter of 2002: Advocates for Youth, $330,000 to raise awareness about emergency contraception among young women nationally and in several key states (2001-2003); American Civil Liberties Union Foundation of Pennsylvania, $14,775 to support "Emergency Contraception for Rape Survivors: Policies to Ensure a Uniform Standard of Care" (2001); Association of Reproductive Health Professionals, $100,000 to support provider education initiatives on emergency contraception and early abortion options (2001-2003); Center for Reproductive Health Research and Policy, University of California, San Francisco, $183,166 to support clinical trials comparing the effects of three emergency contraception service delivery methods on access, unintended pregnancy rates, sexually transmitted disease rates, regular contraceptive usage, and frequency of unprotected intercourse (2002-2003); NARAL/NY, $155,000 to support the Campaign for Access for Emergency Contraception (2002-2003); Pacific Institute for Women's Health, $50,000 to support "Increasing Demand for and Access to Emergency Contraception and Medical Abortion in California" (2002-2003); Planned Parenthood of Central and Northern Arizona, $114,000 to support the Emergency Contraception and Medical Abortion Public Awareness Campaign (2002-2003); ProChoice Resource Center, $150,000 to support EC Does It, a project to assist pharmacists and other grassroots groups in promoting awareness of, and access to, emergency contraception (2001-2003); Public Health Institute, $150,000 to support the Pharmacy Access Partnership (2002-2003); Reproductive Health Technologies Project, $50,000 to support "Demand Your EC" Day: An Activist Campaign (2001-2002). 

Contact:

Tiana Norgren, Ph.D.

Program Officer

Program on Reproductive Health and Rights

Open Society Institute

400 W. 59th Street

New York, NY 10019

USA

Tel: 212-547-6994

Fax: 212-548-4677

Email: cnorgren@sorosny.org

MergerWatch, Duvall Projects working to ensure EC access to rape survivors

 

The MergerWatch Project of the Education Fund of Family Planning Advocates of NYS is working closely with the Clara Bell Duvall Project of the ACLU of Pennsylvania to ensure the consistent offering of emergency contraception to rape survivors receiving treatment at hospital emergency departments. MergerWatch staff are monitoring the progress of proposed legislation in various states and comparing the outcome with alternative policy approaches, including regulation, voluntary adoption of hospital policies and potential litigation strategies. The Duvall Project is working to improve the relationship between pro-choice groups and sexual assault survivor organizations in order to forge a coalition in support of EC in the emergency departments' policies. 

Contact: 

Lois Uttley

Family Planning Advocates of NY State, MergerWatch Project

17 Elk Street

Albany, NY 12207

USA

Tel: 518-436-8408

Email: lois@mergerwatch.org

Advocates for Youth seeks to raise awareness, improve access to EC for adolescents

 

Advocates for Youth is currently working at national, state, and local levels to raise awareness and improve access to emergency contraception for adolescents. Advocates' national communications and media strategy includes public service announcements, radio tours, and briefings with producers and writers of teen-focused television shows to encourage placement of story lines related to teens and EC. Advocates' Clearinghouse on Adolescents and Emergency Contraception provides strategic technical assistance, training, resources and networking opportunities to state teen pregnancy prevention coalitions, sexuality educators, youth serving professionals, and adolescent health providers. The Clearinghouse has developed a number of publications related to EC use among adolescents, including: a Fact Sheet for program planners with basic information on efficacy, mechanism of action, public opinion, and barriers to teen access; an Issues at a Glance, describing innovative efforts to increase teen access to EC and listing resources for advocates and program planners; a teen pamphlet written by and for young people answering frequently-asked questions about EC; and an issue of Advocates' quarterly publication, Transitions, exploring pharmacists' attitudes and awareness of EC for adolescents and offering a lesson plan for sexuality educators.  

Contact: 

Tamarah Moss

Program Manager

Emergency Contraception Initiative

Advocates for Youth

1025 Vermont Avenue, NW, Suite 200

Washington, DC 20005

USA

Tel: 202-347-5700

Fax: 202-347-2263

Email: tamarah@advocatesforyouth.org

Web: www.advocatesforyouth.org

EC Access Campaign launched to promote knowledge of and access to EC in New York

The Emergency Contraception Access Campaign, a coalition of public health advocates, lawmakers, medical and health professionals and community organizations across New York State, was recently launched to promote widespread knowledge of and access to emergency contraception. The Campaign has a threefold mission: to educate the general public about EC; to encourage health care providers to take a pro-active approach to patient education, awareness and use of EC; and to reduce specific barriers to the timely availability of EC, including enabling registered nurses to make ECPs readily available and qualified pharmacists to dispense ECPs

Contact: 

Destiny Lopez

Emergency Contraception Access Campaign

NARAL/NY

462 Broadway, Suite 540

New York, NY 10013

USA

Tel: 212-343-0114

Fax: 212-343-0119

Email: eccampaign@webcom.com

EC Expansion Campaign to bring EC to unserved counties in three states

 

The Institute for Reproductive Health Access, a project of the NARAL/NY Foundation, is running an EC Expansion Campaign with other state NARAL affiliates to create new EC providers in unserved counties in New York, Texas and Michigan. Working from research compiled by the state affiliates, the project is contacting physicians practicing in counties with no identifiable EC provider in order to gauge their interest in providing EC to their patients or any woman in their area who may need it. Affiliates will work to cultivate interested physicians and provide them with the necessary information in order to help them integrate EC in their practice and to list themselves with referral services such as 1-888-NOT-2-LATE. 

Contact: 

Mary Alice Carter

NARAL/NY

462 Broadway, Suite 540

New York, NY 10013

USA

Tel: 212-343-0114

Fax: 212-343-0119

Email: macarter@naralny.org

North Carolina Dial EC project - increasing timely access to ECPs

 

In February 2001, Family Health International (FHI) and the North Carolina Planned Parenthood affiliates launched a Dial EC project in order to 1) increase awareness of and access to emergency contraceptive pills for women in North Carolina; and 2) to demonstrate program feasibility and potential for replication in other states. Via a toll free number, clients are connected to a centralized call center. Specialists at the call center provide counseling about ECPs (and about other methods for preventing pregnancy and STIs), gather information from the caller, and determine eligibility. Prescriptions for ECPs are sent to a Planned Parenthood clinic or a pharmacy located as close to the caller as possible.  As of April 2002, the service had provided almost 4,400 prescriptions for ECPs.  

Contact: 

Elizabeth Raymond, MD

Family Health International

PO Box 13950

Research Triangle Park, NC 27709

USA

Tel: 919-544-7040

Fax: 919-544-7261

Email: eraymond@fhi.org

International Consortium for Emergency Contraception to compile country-specific information on EC activities

This summer, the International Consortium for Emergency Contraception is working to compile more complete information on EC activities currently underway or recently completed by member organizations and those of other large multinational organizations working in Africa, Asia, and Latin America. Information will also be gathered on the status of emergency contraceptive pills' approval and availability by country. A summary document will be produced citing who is working, where, and on what EC-related activities. Noted trends and interesting findings will be highlighted. Information will be gathered from key individuals and from informal reports, in addition to a formal review of the literature. Readers of this newsletter can assist in this endeavor by including the International Consortium for Emergency Contraception in the distribution of any country-specific reports covering EC activities by their organization. Email updates also appreciated! The summary will ultimately be posted on the Consortium's Web site at: www.cecinfo.org.  

Contact: 

Susan McIntyre, Coordinator

International Consortium for Emergency Contraception

C/o Family Health International

P O Box 13950

Research Triangle Park, NC 27709

USA

Email: smcintyre@fhi.org

Regional meeting of parliamentarians on EC

 

In April 2002, the Inter-American Parliamentary Group on Population and Development (IAPG) in collaboration with the Asociación Chilena de Protección de la Familia (APROFA) and with financial support provided by UNFPA and IPPF/WHR, organized a meeting of parliamentarians on EC in Santiago, Chile. Parliamentarians, IPPF/WHR affiliates and NGOs from Argentina, Bolivia, Brazil, Chile, Colombia, Ecuador, Paraguay, Peru and Uruguay were present at the meeting. The goal of the meeting was to train parliamentarians on EC and build partnerships between policy makers, experts, international cooperation agencies and IPPF/WHR affiliates. Topics of discussion included: medical aspects of EC, the importance of EC in sexual and reproductive health, and strategies to promote EC and increase EC access. In addition, there were presentations on the politics of EC as well as the Profamilia experience on how to counteract the opposition with sound legal and scientific arguments. As a follow up, the IAPG along with the Latin American Consortium on EC will be organizing a meeting with parliamentarians and Ministry of Health representatives in October 2002 in Quito, Ecuador

Contact: 

Giselle Carino

Program Associate

IPPF/WHR

120 Wall Street, 9th Floor

New York, NY  10005-3902

USA

Tel: 212-214-0220

Fax: 212-248-4221

Email: gcarino@ippfwhr.org

Web: www.ippfwhr.org

Pacific Institute for Women's Health advocates for EC in Latin America

 

The Pacific Institute for Women's Health continues to work with women's groups, youth organizations and service providers in Latin America including Mexico, Nicaragua, El Salvador, Guatemala and Brazil to advocate for emergency contraception (EC) as a women's sexual and reproductive right and to disseminate information about EC in the context of women's sexuality and the prevention of STI/HIV and violence. In addition, the Institute is facilitating training for the media in Guatemala as well as building media skills among women's organizations. As the coordinating agency of the Latin American Consortium for Emergency Contraception (LACEC), the Pacific Institute is advocating for EC along with Consortium members from across the region and planning for an EC Regional Conference to be held in Quito, Ecuador, in October 2002. In California the Institute has trained "promotoras" in Los Angeles and has launched an EC media outreach campaign. Furthermore, the Institute is convening community meetings for an open dialogue on issues of sexual and reproductive health including EC. The Pacific Institute is actively participating in the advisory circle of the EC Pharmacy Access Partnership. 

Contact: 

Angeles Cabria

Senior Program Officer for Latin America

Responsable de Programas para America Latina

Pacific Institute for Women's Health

Coordinator / Coordinadora

Latin American Consortium for Emergency Contraception

Consorcio Latinoamericano de Anticoncepción de Emergencia

3450 Wilshire Boulevard, suite 1000

Los Angeles, CA 90010-2208

USA

Tel: 213-386-2600, Ext. 4807

Fax: 213-386-2664

Email: acabria@piwh.org

Web: http://www.piwh.org

IPPF/WHR publication describes EC promotion efforts

 

A new publication from IPPF/WHR describes Profamilia/Colombia's experience of promoting emergency contraception from a sexual and reproductive rights perspective. Their strategies included training providers, registering and marketing Postinor 2 (a levonorgestrel dedicated product), building coalitions with women's groups, and medical and scientific associations and informing the media. Profamilia also fought opposition from the church with sound legal and scientific arguments. The publication showcases letters and petitions by both groups for and against EC. Lastly, the publication offers recommendations for other organizations seeking to promote EC in the legal, medical, scientific, communications and social marketing arenas. Available at no cost; in Spanish only. 

Contact: 

Giselle Carino

Program Associate

IPPF/WHR

120 Wall Street, 9th Floor

New York, NY  10005-3902

USA

Tel: 212-214-0220

Fax: 212-248-4221

Email: gcarino@ippfwhr.org

Web: www.ippfwhr.org

UNHCR to publish guide on clinical management of rape survivors for use in refugee and displaced-person situations

 

The United Nations Health and Community Section is in the process of finalizing a guide entitled "Clinical Management of Survivors of Rape: A guide to the development of protocols for use in refugee and internally displaced person situations." This document is produced in conjunction with WHO and the Inter-agency Working Group on Reproductive Health in Refugee Situations. Its purpose is to assist field actors in developing a protocol for the clinical management of survivors of rape based on international standards and host country laws and procedures. To obtain this document, please address your request to: 

UNHCR - Health and Community Development Section

C.P. 2500

1202 Geneva

SWITZERLAND

Fax: 41 22 739 7366

Email: HQTS00@unhcr.ch 

or 

World Health Organization

Department of Reproductive Health and Research

Avenue Appia

1211 Geneva 27

SWITZERLAND

Fax: 41 22 791 4189

Email: rhrpublications@who.int

Council's Frontiers Program to hold EC workshop at LACEC Conference

 

The Population Council's Frontiers Program is organizing and funding a training workshop on EC, during the Latin American Consortium for Emergency Contraception (LACEC) Conference, to take place in Quito, Ecuador, October 16-18. Training on emergency contraception will be provided to invitees during the LACEC Conference. The Population Council will also auspice the participation of experts and consultants who will provide technical assistance after the meeting in Quito to help establish or consolidate country specific EC programs. The training curricula in Quito will include mechanisms of action, alternative treatments, counseling of clients, dissemination and promotional strategies, and a review of experiences in different countries. Participants will also prepare a plan for follow-up activities in their countries. These plans will include a section on the technical assistance they would like to receive to implement these activities. Finally, participants will be given a set of scientific articles, service delivery guidelines from countries that have included them and available training and dissemination materials (brochures, slide shows, press kits, etc., will be included). 

Contact: 

Toni Martin

Regional Communications Officer

Fronteras of Reproductive Health

Population Council

Escondida 110

Villa Coyoacán

México DF, 04000

MEXICO

Tel: 5255-5554-8610

Email: tmartin@popcouncil.org.mx

Population Services International piloting community-based EC promotion

 

Over the past two years, PSI piloted a comprehensive, community-based approach to promoting emergency contraception in Portland, OR and Sacramento, CA. PSI combined strategic community mobilization, a media campaign and health worker training (clinical and non-clinical providers) to increase awareness of EC as a means of reducing unintended pregnancies and abortions. The final evaluation of this promotion project showed an increase in EC awareness and access on several different levels. For instance, during the media campaign, calls to the 1-888-NOT-2-LATE EC Hotline tripled in the Portland area and quadrupled in the Sacramento area. Calls to the Hotline still remain above baseline data in these cities. Furthermore, follow-up studies with providers showed a significant increase in knowledge of EC as well as an increase in the number of providers giving advance prescriptions or supplies of EC to their patients after attending PSI's EC trainings. PSI is now building on this experience to launch a statewide EC policy advocacy project in California to help reduce the barriers that teens face in accessing EC. 

Contact: 

John Beleutz

Director of US Programs

Population Services International

406 Main Street, Suite 423

Watsonville, CA 95076

Tel: 831-722-1878

Fax: 831-722-9279

Email: jbeleutz@psicc.org 

RESEARCH RESULTS AND UPDATES

Effect of increased access to ECPs on pregnancy and STIs

 

FHI is collaborating with investigators from Indiana University, the University of California at San Francisco, and Planned Parenthood Mar Monte (Reno, NV) on a study to evaluate the impact of increased access to ECPs on the probability of pregnancy and STIs. The study will include approximately 1500 women in Reno, Nevada and Indianapolis, Indiana who are using barrier methods, oral contraceptive pills, or no contraception at all. Participants will be assigned to one of two groups - Standard Care (SC) or Advanced Provision (AP). In the SC group, women will be informed about ECPs and invited to come to the study clinic to obtain them (at usual charges) when necessary. In the AP group, women will be given two packages of ECPs free of charge and can replace them at any time without charge. Participants will be seen 6 and 12 months following admission. At each visit, women will be tested for STIs and pregnancy. Data will be collected about intervening pregnancies, STIs, sexual activity, and the use of ECPs and other contraceptives. At four random times during the study, each participant will be mailed a survey about intercourse and contraception use. Study initiation is planned for summer, 2002; data collection is expected to take 2.5 years. 

Contact: 

Elizabeth Raymond, MD

Family Health International

PO Box 13950

Research Triangle Park, NC 27709

USA

Tel: 919-544-7040

Fax: 919-544-7261

Email: eraymond@fhi.org

Impact of advance provision of emergency contraception on adolescent sexual and contraceptive behaviors

 

Providing EC in advance has been advocated to increase timely access and improve efficacy, but there is concern over what impact dispensing advance EC might have on adolescent sexual and contraceptive behaviors. This randomized prospective study, conducted by researchers at the University of Pittsburgh School of Medicine, compares the sexual and contraceptive behaviors of adolescent females who are given EC education and an advance provision of EC vs. the Controls who receive EC education only. Each subject received six monthly 10-minute telephone interviews to assess sexual and contraceptive behaviors including unprotected intercourse, EC use, and condom and OCP use over the past month. Contrary to some providers' concerns, the Advance EC group did not report more frequent unprotected intercourse at the 1 or the 6-month follow up. At the 1st month follow-up interview, there were no significant differences in the frequency of unprotected intercourse or condom or OCP use between the Advance EC group and the Control group. At the 6th month and final interview, the Advance EC group and Controls reported an equal frequency of unprotected intercourse. However, the Control group (47%) reported using OCP significantly more often than the Advance EC group (33%).  Conversely, the Advance EC group (77%) reported using condoms significantly more than the Control group (62%). Across the entire study, the Advance EC group reported using EC more often if it was needed, they began the EC course more quickly than the Controls and reported fewer new pregnancies and STDs. Providing advance EC does not appear to have any detrimental impact on adolescent sexual or condom use behaviors. Study results will be presented at North American Society of Pediatric and Adolescent Gynecology national meeting, June 2002.  

Contact: 

Melanie A. Gold, D.O., FAAP, FACOP

Associate Professor of Pediatrics

Director of Family Planning Services

Director of Adolescent Medicine Research

Children's Hospital of Pittsburgh

3705 5th Avenue

Pittsburgh, PA 15213

USA

Tel: 412-692-8504

Fax: 412-692-8584

Email: magold@pitt.edu

Study finds that educating teens about EC does not increase EC use or level of sexual activity

 

According to a new study in the British Medical Journal, educating teenagers about emergency contraception does not lead to increased use of EC, nor does it lead to an increase in levels of sexual activity. It does, however, increase their knowledge about proper administration of the drugs. Researchers from the University of Bristol, Cardiff University, and the University of Southampton surveyed approximately 4,000 students in the United Kingdom ages 14 and 15. The students were divided into two groups: one group received a lesson on EC while the other group did not. Teachers with training in EC education gave students in the experimental group a single lesson on the use of ECPs and IUDs for emergency contraceptive purposes. Questionnaires on EC use and on sexual activity were administered to both groups six months after the lesson. The proportion of students who knew the correct time interval for both types of EC was significantly higher in the experimental group than in the control group. Furthermore, learning about EC did not lead to an increase in the students' sexual activity or in the number of students who had either used EC or planned to use it in the future. [Adapted from the May 20, 2002, Kaiser Daily Reproductive Health Report. View the entire Report, search the archives, or sign up for email delivery at: www.kaisernetwork.org/dailyreports/reproductivehealth. The Kaiser Daily Reproductive Health Report is published for kaisernetwork.org (www.kaisernetwork.org), a free service of the Kaiser Family Foundation, by National Journal Group Inc. © 2002 by National Journal Group Inc. and Kaiser Family Foundation. All rights reserved.]

Contact: 

Alyson Browett

Kaiser Daily Reproductive Health Report

600 New Hampshire Ave. NW

Washington, DC 20037

USA

Tel: 202-672-5952

Fax: 202-672-5767

Email: dailyreports@kaisernetwork.org

Study of comprehension of over-the-counter labeling for ECPs

 

Last year, FHI conducted a study to assess comprehension of a prototype over-the-counter package of Plan B ECPs. The study showed that by reading the prototype label, most women could understand key information necessary for safe and effective use of this product. A full report of this study has now been accepted for publication in Obstetrics and Gynecology. It is expected to come out in August. 

Contact: 

Elizabeth Raymond, MD

Family Health International

PO Box 13950

Research Triangle Park, NC 27709

USA

Tel: 919-544-7040

Fax: 919-544-7261

Email: eraymond@fhi.org

Study of over-the-counter use of ECPs

 

FHI has recently finished another study to estimate the frequency of inappropriate use of Plan B when the product is dispensed under OTC-like conditions. This study included more than 650 women at 5 Planned Parenthood affiliates across the U.S. and at 5 pharmacies in Seattle.  Data cleaning is currently underway; results are not yet available.  The data will be submitted to the FDA later this year. 

Contact: 

Elizabeth Raymond, MD

Family Health International

PO Box 13950

Research Triangle Park, NC 27709

USA

Tel: 919-544-7040

Fax: 919-544-7261

Email: eraymond@fhi.org

Maryland EC Project evaluates prescribing patterns of Maryland clinicians

 

Since September 19, 2000, Planned Parenthood of Maryland's Emergency Contraception Hotline, 1-877-99-GO-4-EC, has provided over 9000 women with information about EC and over 3100 women access to EC pills. Even though more individuals are learning about EC in Maryland, research gathered shows that there is a need to improve access to EC among medical professionals. According to a recent study conducted through the Maryland EC Project, 99% of Maryland physicians and nurses indicated they have heard of EC pills or “morning after pills,” however, only 68% have ever written a prescription for EC. Respondents were asked how often they had prescribed EC pills in the past year; 68% reported only once; 32% reported 2-10 prescriptions; and no respondents reported over 10 prescriptions in the past year. Among those respondents that do discuss emergency contraception with patients, only 16% reported it was part of routine contraceptive counseling. A large majority (47%) reported that discussions were in response to an “emergency” raised by a patient. Additionally, the main reason respondents gave for not prescribing EC was they “have never been asked for it.” The provider survey was modeled after the national research conducted by the Henry J. Kaiser Family Foundation in 1995 and 1997. Surveys were mailed to a total of 5614 Maryland physicians and nurses in February 2001. The overall response rate was 29 percent with a total of 1068 surveys considered complete and usable for analysis. 

Contact: 

Emily P. Thompson

EC Project Coordinator

Planned Parenthood of Maryland

610 N. Howard Street

Baltimore, Maryland 21201

USA

Tel: 410-576-2145

Fax: 410-576-7600

Email: emily.thompson@ppfa.org

Duvall Reproductive Freedom Project evaluating EC availability, knowledge of Pennsylvania pharmacists

 

The Clara Bell Duvall Reproductive Freedom Project is conducting research on the availability of EC in Pennsylvania pharmacies and pharmacists' knowledge about EC. This is a follow up to our study about EC for sexual assault survivors in Pennsylvania emergency rooms, where we found that at least 15% of survivors were leaving the emergency room with a prescription for EC. We sampled over 300 pharmacists, representing 10% in the state. The goals were to determine the kind of information given on EC and the percentage of pharmacies that can fill a prescription on the same day. Early analysis shows that not only are EC dedicated products rarely in stock abut also an abundance of misinformation is given to the caller regarding EC, including confusion with mifeprex, and wide misinformation about the 72-hour time frame. Complete results and procedural detail will be available by the end of June 2002. Research is being conducted by an MD/MPH student at the Robert Wood Johnson School of Medicine. 

Contact: 

Wendy Bennett / Carol Petraitis

The Clara Bell Duvall Project, ACLU-PA

P.O. Box 1161

Philadelphia, PA 19105-1161

USA

Tel: 215-629-0111

Fax: 215-592-1343

Email: duvall@aclupa.org

Evaluation of ECP provision and use in Venezuela

 

In March 2000, the Association for the Prevention of Unwanted Pregnancies ("APPRENDE") launched Postinor-2 in Venezuela. As of November 2000, it was available at approximately 4,300 pharmacies throughout the country, and in 2001 about 149,000 boxes were distributed. In March 2002, APPRENDE and Family Health International conducted an interview among 750 health care providers attending the annual OB/GYN meeting in Caracas. The survey was designed to describe knowledge, attitudes and practices related to provision of ECPs among Venezuelan providers. Data are being analyzed. FHI and APPRENDE are also preparing to conduct a telephone survey designed to examine characteristics, contraceptive practices, knowledge and attitudes of Venezuelan ECP clients who obtain Postinor-2. Issues relating to access and willingness/ability to pay will also be examined.  Recruitment slips will be placed inside Postinor-2 boxes prior to distribution. A toll-free phone number will be provided for participants to call and complete a survey. We also plan to document the steps leading to the successful launch of ECPs in Venezuela.

Contact:  

Alan Spruyt

Family Health International

PO Box 13950

Research Triangle Park, NC 27709

USA

Tel: 919-544-6979 x478

Fax: 919-544-7261

Email: aspruyt@fhi.org

Pharmacokinetic study of levonorgestrel to be published this month

 

A pharmacokinetic study of different dosing regimens of levonorgestrel for emergency contraception was conducted at the PROFAMILIA clinic in Santo Domingo, Dominican Republic. The results of this study will be published in the June 2002 issue of Human Reproduction.  

Contact: 

Vivian Brache

Departamento de Investigación Biomédica

Asociación Dominicana Pro Bienestar de la Familia, Inc.

Socorro Sanchez 160, Zona 1

Santo Domingo

DOMINICAN REPUBLIC

Email: biomedica@codetel.net.do

HRP evaluates single dose levonorgestrel regimen

 

Research on levonorgestrel undertaken by the UNDP/UNFPA/WHO/ World Bank Special Programme of Research, Development, and Research Training in Human Reproduction (HRP) is continuing in three multicentre studies. A large randomized, double-blind multinational study was completed during 2001, which investigates, among other things, the efficacy and side effects of a single dose of 1.5 mg (two tablets of 0.75 mg of levonorgestrel taken as one dose) compared to the regimen when the tablets are taken at 12-hour interval. The third arm in this study is 10 mg mifepristone. The treatment was given up to 120 hours of intercourse. A total of 4136 women were enrolled in this study in 15 family planning clinics in China, Finland, Georgia, Hungary, India, Mongolia, Slovenia, Sweden, Switzerland and the U.K. The results of the study will be published in 2002. In addition, a seven-centre study has started in Nigeria to investigate the efficacy and side effects of one-dose regimen of 1.5 mg of levonorgestrel compared to a two-dose  regimen (0.75 mg taken at 24-hour interval). This study will include a total of 3150 women and the clinical phase is expected to be completed by the end of 2003. 

Contact: 

Helena von Hertzen

World Health Organization

1211 Geneva 27 

SWITZERLAND

Email: vonhertzenh@who.ch

Study to examine efficacy of increased dose interval

 

The 12-hour interval between the two tablets is sometimes impractical and a double-blind, multicentre study is, therefore, investigating in China, whether this interval could be increased to 24 hours, as this would be more convenient for women. The recruitment of over 2000 women for this trial is expected to be completed by mid 2002.   

Contact: 

Helena von Hertzen

World Health Organization

1211 Geneva 27 

SWITZERLAND

Email: vonhertzenh@who.ch

Mifepristone studied as long-term post-coital contraceptive

 

Researchers at the University of Rochester have been studying 10 mg post-coital mifepristone for contraception. The study was discontinued on April 24, 2002. Four pregnancies out of 22 enrollees occurred and according to protocol, the study was discontinued. Two women who became pregnant reported compliance with the regimen. One woman was not compliant with the regimen, and one woman likely conceived prior to enrollment. The sample size was small and compliance according to protocol was based on the subject's report. The long-term use of a post-coital mifepristone regimen may not be effective, although no conclusions have been made at this time.  

Contact: 

Emily M. Godfrey, MD

Clinical Instructor

Reproductive Health Program

University of Rochester, Department of Family Medicine

1000 South Ave, Box 101

Rochester, NY 14620

USA

Tel: 585-341-6290

Fax: 585-341-6293

Mifepristone further evaluated for EC: 10 mg vs. 25 mg

 

HRP has collaborated with Chinese investigators in testing further the efficacy of the 10 mg dose of mifepristone. During a three-year collaborative initiative, funded by The Rockefeller Foundation, a randomized, double-blind study was carried out including 3052 women in 10 centres around China. The results indicated that the doses of 10 mg and 25 mg of mifepristone are equally effective with a pregnancy rate of 1.1%. Also, the treatments had very few, if any, side effects. The efficacy appeared to be higher the sooner the treatment was taken, so that the pregnancy rates were 0.9% within one day after intercourse and increased to 2.0% on day 3 and 4 and up to 3.0% on day 5. Another large study of 10 mg of mifepristone, carried out by Chinese investigators to evaluate further the efficacy and safety of the 10 mg dose of mifepristone, was recently completed. This study included a total of 30 family planning clinics in China. The Programme has given technical assistance to this project. The study included over 4000 women requesting emergency contraception within 120 hours of one act of unprotected intercourse. Final results of this study are currently being analyzed. 

Contact: 

Helena von Hertzen

World Health Organization

1211 Geneva 27 

SWITZERLAND

Email: vonhertzenh@who.ch

Gestrinone studied for use as emergency contraceptive

 

Gestrinone is a registered product and is used in more than 40 countries for the treatment of endometriosis. In addition to its antigonadotrophic activity, the compound also has some antiprogestogenic activity. It is anticipated that due to its fairly long duration of action - gestrinone is administered twice weekly in the management of endometriosis - one dose of the drug might be sufficient for effective emergency contraception. A randomized, double-blind study was, therefore, launched in China to compare 10 mg of gestrinone and 10 mg of mifepristone for emergency contraception when administered up to 120 hours after unprotected intercourse. The study will include 1200 women and the clinical phase will be completed by the end of 2002. 

Contact: 

Helena von Hertzen

World Health Organization

1211 Geneva 27 

SWITZERLAND

Email: vonhertzenh@who.ch

IUD further evaluated for use as emergency contraceptive

 

Several reports on the use of an IUD for emergency contraception suggested that it could be highly effective for this indication. However, due to lack of prospective, well-conducted studies on the efficacy and side-effects of the IUD in EC, it was not possible to give any recommendations regarding its use. To this end, a large multicentre study of the efficacy, side-effects and acceptability of the TCu380A for emergency contraception was launched in China. A total of 1800 women were recruited for the study and followed up for one year after IUD insertion. There were no failures after the insertion of CuT380A and short term side effects and removal rates did not differ from those seen in studies of interval insertion of the copper IUD. Due to the long follow-up the final results of the study are not yet available. 

Contact: 

Helena von Hertzen

World Health Organization

1211 Geneva 27 

SWITZERLAND

Email: vonhertzenh@who.ch

HRP planning EC mechanism of action studies

 

Several research initiatives have been planned together with the Programme's collaborating centres to investigate possible mechanisms of action of emergency contraceptives. As fecund cycles cannot be investigated in the human, a study was launched in Santiago, Chile, to test the feasibility of the Cebus apella monkey as a model for this research. Another study in Chile is examining the effects of a single dose of 1.5 mg of levonorgestrel on follicular growth and ovulation. Pharmacokinetics as well as the levels in the endometrial tissue will be examined after oral and vaginal administration of this levonorgestrel dose in the same study.

Contact:

Helena von Hertzen

World Health Organization

1211 Geneva 27 

SWITZERLAND

Email: vonhertzenh@who.ch

ABOUT THE AMERICAN SOCIETY FOR EMERGENCY CONTRACEPTION

 

The American Society for Emergency Contraception (ASEC) is a voluntary collaboration of organizations that promote the availability of emergency contraception for women.  Founded in 1997, ASEC has four mandates: 1) to serve as a source of information for the media and others who want information on emergency contraception; 2) to serve as a watchdog for inaccurate or biased articles in the press and respond with accurate letters to the editor, and to watch for abuses of reproductive rights related to emergency contraception, and draw attention to these problems; 3) to promulgate policies on emergency contraception and to support and disseminate the statements and guidelines of other organizations willing to endorse the method; and  4) to link the members of the emergency contraception field, primarily by sending out (in collaboration with the international Consortium on Emergency Contraception) this semi-annual electronic newsletter on recent events in emergency contraception and by organizing an annual meeting (held on the first Monday in October in New York) to share information with researchers, policy makers and the pharmaceutical industry.    

ASEC is open to industry participation, although it will not endorse one method or regimen over others that are also safe and effective. Membership is free, and although the focus is primarily on the United States, international affiliates are welcome. 

Tara Shochet

Executive Director

P.O. Box 1496

Princeton, NJ 08542

USA

Tel: 609-258-2661

Email: AmSocEC@aol.com

ABOUT THE INTERNATIONAL CONSORTIUM FOR EMERGENCY CONTRACEPTION

 

The mission of the International Consortium for Emergency Contraception is to expand access to and ensure safe and locally appropriate use of emergency contraception worldwide within the broader context of family planning and reproductive health, with emphasis on developing countries. The Consortium now has 29 member agencies worldwide.  

Recently, the Consortium was awarded funding by the Wallace Global Fund to continue its program in three key areas: 1) Key information gathering and dissemination on emergency contraception (EC), including enhancements to the Consortium's Web site; 2) facilitation of collaboration and networking among member organizations, other regional Consortia, the commercial sector and donor community; and 3) advocacy for the promotion of EC methods and their safe and effective use.   

Single copies of the following publication can be requested free of charge from the International Consortium:  

  • Expanding Global Access to Emergency Contraception: A Collaborative Approach to Meeting Women's Needs (includes Medical and Service Delivery Guidelines as an appendix)

 

While contained in the above publication, the Consortium has also published:

  • Medical and Service Delivery Guidelines for Emergency Contraceptive Pills, as a separate bound guide for use in training programs or for distribution to clinical staff.  Single copies also available free of charge. Multiple copies can be purchased.

 

Susan McIntyre

Consortium Coordinator

PO Box 13950

Research Triangle Park

Durham, NC  27709

USA

Email: cecinfo@fhi.org

Web: http://www.cecinfo.org