Transforming Women's Health

Sexually transmitted infections is one of the great public health challenges of our time 

Millions of women and around the world are still unable to protect themselves from sexually transmitted infections, with more than a million people contracting such infections every day. Half of them are young people - mostly women. In fact women are five times more likely to get STIs than men. Also, currently 222 million women have an unmet need for contraception and approximately 290,000 women in developing countries die from complications related to pregnancy and childbirth every year.

While in India unmet need of contraception has remained static around 15-21 percent since the last one decade, the Philippines has the highest rate of teen pregnancy in the Asean region, recording a 70 percent increase in teen pregnancy in the past decade. Birth control information and devices have been banned for decades because of the opposition of the Catholic Church, although it is hoped that last year’s passage of a Reproductive Health Act – now before the Supreme Court – will change that.

The consequences of unsafe sex are a great public health challenge of our times. Women risk unintended pregnancies as well as HIV and other infections, leading to high rates of maternal and child mortality. With 86 million unintended pregnancies around the world every year and a young woman getting infected with HIV every minute, women need user-friendly products that provide more comprehensive protection.

The female condom is perhaps one of the very few currently available female-initiated methods that provide multiple protections against a range of STIs including HIV, and unintended pregnancies. It also provides bi-directional protection to both partners. However, although female condoms were approved by the US Food and Drug Administration in 1993, more than 20 years later even today they represent only 1 percent of all condoms distributed worldwide.

In India they are still far from being available and accessible to women, while male condom use continues to hover around 5 percent despite it being an effective multipurpose prevention option for STIs and unintended pregnancies.

Multipurpose Prevention Technologies

Multipurpose Prevention Technologies for sexual and reproductive health are new tools in development that are designed to address multiple sexual and reproductive health needs, including prevention of unintended pregnancies, sexually transmitted diseases including HIV, and other reproductive tract infections (RTIs). MPTs that are safe, acceptable, affordable and easily available would save lives and money and improve the health of women and their families across the world.

Promising and innovative MPTs in the pipeline include multipurpose vaccines and gels, easier-to-use vaginal rings and single sized diaphragms that may provide simultaneous protection against unintended pregnancy and STIs and have a major impact on the health of women and their families. New microbicide gels can lead to declines in HIV and STIs while contraceptive technologies appropriate for dual use can increase the positive global health impacts of family planning.

Jeross Aguilar, Chairperson, Youth Steering Committee, Family Planning Organization of the Philippines and a Member of International Steering Committee of the 7^th Asia Pacific Conference on Reproductive and Sexual Health and Rights being held in Manila, said: "MPTs can be great tools to empower women and improve their sexual and reproductive health. Devices like intra-uterine devices (IUDs), male and female condoms, all should be available free of cost, if possible, to those in need. Women should have a wide variety of choices, which are most conducive to their life style, available when it comes to choosing family planning techniques as no one method suits all. Some women may not like taking pills and maybe more amenable to using injectables or IUDs.”

So while there should be more research to have better devices, Aguilar said, “merely inventing new and better techniques is not enough. It is equally important to make them freely available and informing people adequately about their use to remove the stigma and misconceptions surrounding them. I feel that to increase male condom use we need to change the method of propaganda and promote it innovatively. We need to propagate that one who uses the condom and understands and respects the women is a cool and responsible guy. 'You are not a man if you do not use condoms'; 'it is sexy and cool to use condoms'; 'a man who does not use a condom is irresponsible'; 'you are cool if you respect women' - these are the kind of slogans and advertising we need."

MPTs, many of them though still in the research and development stage, can empower women, make them healthier and improve their economic opportunities. These products that can simultaneously address multiple sexual and reproductive health needs of women will go a long way in helping policymakers meet multiple health and development goals.

A survey, facilitated by Citizens News Service and an Initiative of Multipurpose Prevention Technologies for Reproductive Health, is also being carried out with delegates of the 7th conference. This survey was earlier carried out at the International Conference on Family Planning 2013, 11th International Congress on AIDS in Asia and the Pacific and the International Conference on AIDS and STIs in Africa (ICASA) 2013.

(Shobha Shukla is Managing Editor of Citizen News Service (CNS))