Quinacrine Update

Date Published: July 17, 2006

Issues no. 1 and 3 of Political Environments addressed the controversies surrounding quinacrine chemical sterilization. First developed as an anti-malarial in the 1920s, quinacrine has been used to sterilize over 100,000 women in 19 countries despite the fact that it is not approved for this use by any major drug regulatory agency. With a modified IUD inserter, quinacrine pellets are put into the uterus which cause local inflammation, scarring of the fallopian tubes and thus occlusion of the tubes. Two American population control advocates, Dr. Stephen Mumford and Dr. Elton Kessel, have made quinacrine their mission, dispensing thousands of pellets to third world doctors for over a decade. Quinacrine is a known mutagen, and preliminary laboratory studies point to potential risks of cancer, birth defects and toxicity. Both the U.S. Food and Drug Administration and the World Health Organization have recommended against further human trials of quinacrine until further animal studies are done. Yet Mumford and Kessel continue to defend and promote the method with funding from private U.S. foundations and individuals. CWPE believes quinacrine trials on women must be stopped now.

Quinacrine Alert Network

As the result of a workshop sponsored by CWPE at the 8th International Women and Health Meeting in Brazil, CWPE is helping to coordinate a Quinacrine Alert Network. In cooperation with the Women's Global Network on Reproductive Rights (WGNRR) in Amsterdam, we are dispensing information packets on quinacrine and monitoring recent developments as best we can. The goal is to have an informal network, with regional bases from which people can acquire information.
If you could act as a focal point in your country or region for information and action; if you have information or action plans that you would like to share; or if you would like a copy of the information packet, please contact CWPE or the WGNRR office in Amsterdam (NZ Voorburgwal 32, 1012 RZ Amsterdam, Netherlands; fax:31-20-620-96-72; e-mail:wgnrr@antenna.nl).

FDA Warning About Self-Sterilization Kits

In June the FDA issued an alert about self-sterilization kits advertized over the Internet which contain pellets of quinacrine hydrochloride, "an unapproved drug which can cause ectopic pregnancy, abnormal pregnancies, and permanent damage to a woman's reproductive organs." The kits are being promoted by a company in Bogota, Colombia named Femestra. The Internet server has removed the advertisement, but the FDA urges anyone who has suffered adverse effects from the method to contact the FDA at 1-800-FDA-1088.

In a recent interview, Stephen Mumford claimed the kits are a "hoax" because Kessel and he were the only source of quinacrine pellets (which are manufactured by the Sipharm company). The manufacturing process is complex, he said, and requires several machines for sequential processing. "Nobody can cook this up in their kitchen." However, in the most recent issue of the Quinacrine Sterilization Newsletter, Dr. Biral Mullick notes that in his first quinacrine trial in India, the pellets were prepared by a local chemist. (vol.2, no. 1, July 1997, p.2)

True or not, the current scare about the kits underscores the danger of the method becoming more widely available. Dr. Kessel wrote recently that "probably the most important need is to encourage expansion of QS [quinacrine sterilization] in the private sector as an 'off label' drug as it is approved almost anywhere for the treatment of malaria. Official government approvals for this use of quinacrine are desirable but not necessary." (E. Kessel, "100,000 Quinacrine Sterilizations," Advances in Contraception, 1996, vol. 12, p. 74) 'Off-label' use of a drug is the therapeutic use of a drug for purposes other than that for which it was licensed. Because the FDA permits the off-label use of drugs, Mumford stated that Kessel and he are preparing to supply quinacrine to clinicians in the U.S. who have agreed to use it in their practices for female sterilization.

Pressure Mounts in India Against Quinacrine

Since quinacrine trials were stopped in Vietnam, India appears to have become the major target. In West Bengal alone over 10,000 quinacrine sterilizations have taken place, and there are plans to sterilize 25,000 women in Karnataka in the next two years. Fortunately, public health advocates at the Center of Social Medicine at Jawaharlal Nehru University (JNU) and activists with the All India Democratic Women's Association have launched a campaign against quinacrine, including a public interest law suit to force the Indian government to halt all trials. Already the West Bengal state government has ordered a stop to trials. According to Dr. Mohan Rao of JNU, a recent film 'A Yellow Haze' documents women who went to clinics for IUDs, but instead were sterilized with quinacrine. Investigative articles and editorials against quinacrine have appeared in the Indian press.
The case of India shows the possibilities of organizing successfully against quinacrine and making it a widely known public issue. Hopefully, the campaign that has started in India will spread elsewhere.

For more information on India, see articles in the Lancet (May 17, 1997), New Scientist, and Frontline (May 2, 1997).