Zimbabwe Bans Dangerous Contraceptive, Depo-Provera

The international women's health movement recently achieved a great victory when the government of Zimbabwe banned the dangerous contraceptive, Depo-Provera. Some credit belongs to a U.S. group, the Boston Women's Health Book Collective, for supplying the Zimbabwean government with evidence of the drug's harmful effects. Already, Zimbabwe's ban is being felt across Africa, stirring debate in Kenya over the safety and advisability of the contraceptive.

Depo-Provera is a long-lasting, injectable contraceptive manufactured by the Michigan-based Upjohn Corporation. It can cause heavy bleeding, weight gain, headaches, nervousness and depression. More serious risks include infertility, diabetes, and breast, cervical, and endometrial cancer (See MM, 8/80). The drug has never been approved for use as a contraceptive in the U.S.

As a contraceptive, DepoProvera is administered by injection to women once every three months. "It totally eliminates control on the part of the women," says Judy Norsigian, a member of the Boston Women's Health Book Collective.

On July 13, Zimbabwe's Minister of Health, Dr. Herbert Ushewokunze banned the contraceptive from use in Zimbabwe, announcing that Depo-Provera "may at this very moment be posing a serious threat to the health of our women and children." Ushewokunze also denounced the discriminatory distribution of the drug. "It is racism," he said. "White women do not use it."

"Somewhere between 90,000 and 100,000 women are currently using Depo" in Zimbabwe, says John Paul James, population adviser for the Africa bureau of the U.S. Agency for International Development (AID). That's about 7.5-9.5% of all Zimbabwean women of reproductive age, and it represents about 1% of all users of the contraceptive world-wide. The Family Planning Association, a private. organization in Zimbabwe, supplies the drug, spending "$1 million a year on Depo" through a "Zimbabwean pharmaceutical chain representing Upjohn," James says.

The Boston Women's Health Book Collective got involved when its contacts in Salisbury heard "a decision was being made" on the issue, Norsigian says. "They telegrammed us, and we sent material directly to the Minister of Health," she explains. "His press releases had statements taken directly from our material."

Kenya picked up quickly on the controversy. "DepoProvera: Women not guinea pigs," ran an editorial in The Standard, one of Nairobi's two daily papers, dated July 24. "We cannot afford to experiment with our womenfolk," the editorial said, citing the Zimbabwe ban with approval.

This press coverage prompted a response by Dr. Karuga Koinange, Director of Medical Services for the Kenyan government, who declined to ban the contraceptive at first, stating on July 26 that "There is no drug that has no risks."

Koinange, however, appears to have "reversed himself on that issue," says one knowledgeable source in Washington. He "has contemplated the suspension of Depo," confirmed AID's James.

In Kenya, there are "no more than 3,000 women" who are using Depo-Provera, says James. Unlike Zimbabwe, Kenya had restricted the use of the contraceptive. "This method is only given to women who have more than four children and who are over 30 years old," said health minister Koinange. According to the August 4 edition of the Nation, Nairobi's other daily paper, "Most of the women leaders in Kenya have strongly condemned the use of Depo-Provera."

The promotion of DepoProvera by international "aid" agencies became evident in both the Zimbabwe and Kenya cases. Michael Sogi, African regional director of the International Planned Parenthood Federation (IPPF), declared at an IPPF regional conference on July 23 in Nairobi that Depo-Provera is "safe and reliable."

And AID also has taken a pro-Depo-Provera stance in Zimbabwe. "The experience has been a marvellous one indeed," says AID's James, who admits that the agency interceded with the Zimbabwean government on behalf of a nurse from the Family Planning Association on the subject of Depo-Provera. "Chief nursing officer Louise Westwater, asked AID to talk with the Deputy Minister of Health, Dr. Mazorotze," says James. Although he denies AID made any policy recommendations, "we did mention Depo to the Deputy Minister of Health," James said.

"The official position of international agencies on DepoProvera is not necessarily scientific nor well-informed," said Zimbabwe's Minister of Health, Dr. Ushewokunze, on July 14. "It clearly reflects the political orientation, male dominance and perhaps undue influence of the pharmaceutical industry at policy-making levels."