What’s new in contraception

Hand holds the BD Uniject injection system.In London tomorrow, the British government and the Bill & Melinda Gates Foundation are hosting an international family planning summit with an ambitious goal: to give 120 million women in developing countries who have unmet needs for contraceptives access to voluntary birth control. PATH has been working on family planning solutions since our founding more than 30 years ago. In advance of the London summit, we asked Jane Hutchings, leader of PATH’s program in reproductive health, about the need for contraceptive options and what PATH is doing to help fill it.

Q. You were PATH’s first intern in the 1980s, and you’ve been working in family planning ever since. What’s changed and what’s stayed the same?

A. When PATH was founded, a lot of new contraceptives were becoming available, and PATH was working to find ways to get them to the people who wanted to use them. It seems to me that’s a constant theme in our work. PATH is still identifying what’s needed and then doing what’s necessary to get it to people—whether it’s vaccines or diagnostics or contraceptives.

And another thing that’s been constant is that family planning work has always had an element of controversy. But at its core, it’s about people choosing when to have children and how many children to have. The evidence shows us that those decisions have a profound impact on the health of women, their families, and communities. That’s been a constant element of family planning programs, and it’s not controversial.

Q. What’s it take to get contraceptives and family planning services to women who want to use them?

A. Being able to access a range of contraceptives so people have choices is key. Providing information is also important—people need to know about their options and what the benefits and risks are so they can make informed choices. People also need innovative products that are designed to work well for them, in their circumstances. One thing that sets PATH apart is that we work in all three areas.

Q. Tell me about some of the options you’re excited about today.

A. Let’s take just one area of our work: adapting existing technologies so they work for people in developing countries. We’re working to deliver a popular injectable contraceptive using the Uniject™ injection system—depo-subQ in Uniject. It’s light, it’s small, it’s very easy to use and we believe it will make life easier for health workers. And potentially, it could be used by women themselves in their homes. We’re now doing qualitative research to determine how feasible and acceptable an option that is.

Two hands, one holding the body of the Uniject injection system, the other holding the cap.
The Uniject injection system is small, light, and easy to use. Photo: PATH/Patrick McKern.

Another example: 20 percent of women who don’t want to get pregnant but who are not using contraceptives say it’s because they have sex infrequently. So, with our partner Gynuity Health Products we’re asking is it possible to adapt an existing oral contraceptive into a pill that a woman could take before or after she has sex to protect her from pregnancy? And what would the market for such a pill be like?

We’re also getting close to seeing a new female condom come into the international market. The PATH Woman’s Condom has been designed for women and tested by them so it’s acceptable to them.

Q. What do you hope comes out of this week’s summit in London?

Resources. I’m hopeful the summit will ratchet up resources and commitment to family planning. That will be huge. It’s not the answer to everything, but it’s a really important part of the answer.

You know, I think there’s been a shift since the 1970s and 80s. Then, there was a focus on introducing people to the concept of family planning and supporting family planning programs.  Now, we’re at a point where women are asking for family planning information and contraceptives and can’t always reliably get them. We don’t want to miss this opportunity to improve women’s health. We don’t want to say, “Sorry. We can’t help you.”

Uniject is a trademark of BD.

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