“The Drugs Technical Advisory Board (DTAB) agreed to the introduction of the injectable contraceptive DMPA in the public health system under the National Family Planning Programme,” says the minutes of the last DTAB meeting held on August 18.
DMPA is the acronym for an injectable contraceptive called Depot-medroxyprogesterone acetate, which is registered in India for use by the private sector since 1993 — a year after it was approved by the US Food and Drug Administration.
It is sold under the brand name Depo-Provera. Indian Council of Medical Research carried out trials on the injectable since 1970s. But so far every government plan to bring in injectable contraceptives in the family welfare programme met with sharp objections from women activists and non-governmental organisations, on the ground of menstrual irregularity and other adverse health consequences for women. “We know DTAB has approved this, but the ministry will have to study several other aspects before going ahead with injectable contraceptives. It is not going to happen overnight,” a health ministry official involved with the family planning programme told Deccan Herald.
The caution is understandable because of the court cases surrounding these contraceptives. For instance on DMPA, there were two litigation against in the Supreme Court in 1990s. When the apex court asked the DTAB to examine the case in 1995, the drug technical body said, “DMPA should not be allowed to mass use in the National Family Planning Program and its use should be restricted to women who would be aware of all the implications of use”.
This recommendation of the DTAB was cited by the health ministry in an affidavit in August 2000 in the Supreme Court, which disposed off the case in 2001. Towards the end of the last decade, the ministry once again reviewed the utility of injectable contraceptives.
On July 24, a national consultative meeting on expanding the basket of choice in family planning came up with a consensus that injectables are suitable for introduction in the government programme.
Since they are in the private sector for the last 20 years without any side effects, the experts recommended that pilot scale programmes are not required.
The doctors recommended injectable should be introduced pan India, at all levels up to the sub-centres as restricting its availability only up to medical colleges or district hospitals, will defeat the purpose of its introduction.