The Next Contraceptive Revolution

Abstract

The availability of modern birth control methods has wrought a veritable contraceptive revolution in both developed and developing countries over the past two decades. But concerns about safety, costly lawsuits involving current methods, as well as diverse and changing life-styles, have left the current array of contraceptives grossly inadequate to meet growing worldwide needs. Steroid implants and improved injectables, IUDs, barrier methods and sterilization devices should be widely available in the next few years. But the long-sought-after radically new methods that will constitute the next contraceptive revolution--like vaccines, a male contraceptive and a once-a-month pill--will not be developed in the foreseeable future without a massive infusion of new funds. The eight contraceptive research and development (R&D) programs that are responsible for more than half of all current product development efforts now spend about $30 million a year on contraceptive research. With an additional $23 million annually, they could considerably accelerate current research efforts and begin new ones on products that have become possible only as the result of recent scientific discoveries. Even this level of investment--representing a 75 percent increase over current expenditures by the eight groups--would probably not be sufficient to make optimum progress in the development of radically new methods. Since the pharmaceutical industry can no longer be depended upon to take the leading role that it did 20 years ago, current public-sector R&D organizations may need to expand their efforts to include most aspects of the process of contraceptive development and introduction, and new dedicated R&D centers will probably have to be established. However, current donors to contraceptive R&D--mainly the U.S. and other developed-country governments--are not yet sufficiently convinced of the grave social and health consequences of unintended pregnancies in their own countries, or of the worldwide adverse social and economic effects of high rates of population growth in the Third World, to provide the level and the pace of funding that are needed. Some kind of donor consortium, such as those that achieved such spectacular success in agricultural and tropical disease research--backed up by a similar political and public consensus--is needed, and needed soon, if the next contraceptive revolution is to become a reality