Quinacrine Victory at Planned Parenthood But the Struggle Continues

Author(s): Betsy Hartmann
Date Published: July 17, 2006
Source: (Political Environments #7, Fall/Winter 1999-2000)

On November 13 the Medical Committee of Planned Parenthood Federation of America (PPFA) put a motion before the Board of Directors that would have endorsed the participation of PPFA affiliates in human trials of quinacrine chemical sterilization before the completion of sufficient toxicology tests. In response, CWPE members Jael Silliman, Judy Norsigian and Marlene Fried, circulated a letter to the Board in opposition to the motion. The letter was signed by many women's health advocates in the US and overseas, and was a vital factor in preventing Planned Parenthood from moving ahead with the trials. The letter is printed on the following page, and the Board's decision is below.

While this is good news, the struggle against quinacrine is entering a critical phase. In Chile, the Ministry of Health recently considered rescinding its ban on quinacrine trials and allowing experimentation on 1000 women through public hospitals. Fortunately, the Latin American and Caribbean Women's Health Network launched a successful protest and the ban remains in place.

In the US, we can also anticipate further pressure from quinacrine supporters. There is a possibility that the FDA could allow clinical trials to proceed if the one-year neo-natal mouse studies currently undertaken by Family Health International show no indication of carcinogicity. This would be before the completion of a longer two year study in rats. Thus, women's groups may need to take their case directly to the FDA and demand that there be no human trials until all toxicology studies are completed.

Although this may be a necessary short-term strategy, many women's health advocates believe that quinacrine research should not continue at all. The present research helps legitimize the unethical and unscientific processes by which the drug has been tested on over 100,000 poor women. An easily abusable method of chemical sterilization could also have grave consequences for women's health in population control-oriented programs. The strategy of quinacrine's supporters is to win legitimacy and approval in the US in order to expand quinacrine distribution overseas.

At the same time that we resist and monitor these developments, we should seriously consider the possibility of using the Helsinki Declaration and other internationally accepted standards of medical research to hold quinacrine's promoters accountable for their unethical experiments on women.

Excerpt from PPFA Board resolution:

FURTHER RESOLVED THAT: participation of affiliates in clinical trials for Quinacrine sterilization may be considered if and only when the FDA signifies that the toxicological studies permit the initiation of phase two and/or phase three clinical trials
AND FURTHER RESOLVED THAT: the board recommends that during this period of time that the national office work with affiliates, women's groups, other stakeholder groups, and with the public to determine:

• women's need for simple transcervical sterilization methods,

• means for preventing abuse of contraceptive and sterilization methods, and

• alternate methods of long-term contraception/sterilization.

November 1999

Dear PPFA Board Member:

We are deeply troubled by the proposal that the PPFA go forward in the near future with clinical trials of quinacrine, a sclerosing agent that has been used to perform a type of chemical sterilization in women. Although unapproved by any drug regulating authority in the world for use as a means of sterilization, quinacrine has been used unethically on over 100,000 women in about 19 countries. Many of these women have had no understanding of the experimental nature of this use of quinacrine, and, in some cases, they did not even understand that a sterilization was being performed.

We urge you to vote against plans for any clinical trials of quinacrine primarily for the following reasons:

1. The basic animal/toxicology research on this drug has not been completed. Family Health International has already begun these studies, but the results will not be in for some time. It is inappropriate to go forward with clinical trials until toxicology work on a drug is completed.

2. Because of the unethical way in which this drug has already been used, quinacrine has become a world-wide symbol among women's health advocates of how the "population control mentality" has taken precedence over women's overall health and well-being, over the need to follow basic rules of scientific inquiry as put forth in the Helsinki Principles. Even if the toxicology studies were to indicate no specific toxicity, this drug is already so tainted in the minds of so many women, that the credibility of those institutions embarking upon clinical trials would suffer severely.

3. Given the widespread problems we have seen worldwide with disregard for women's dignity and basic right to information, it is unwise to pursue yet another method that so easily lends itself to abuse and misuse in this imperfect world we live in. As Dr. Rachael Pine of the Association for Voluntary Surgical Contraception pointed out at the PPFA Medical Committee meeting this past September, quinacrine is easily and quickly administered without client knowledge, and thus particularly prone to misuse. Not all technologies related to improving women's reproductive health present this type of problem, and we believe that we should devote what scarce resources there are to developing technologies such as microbicides, which many women's groups already have been advocating for several years.

If you are unfamiliar with quinacrine, here are a few additional points to consider:

- Quinacrine is a known mutagen and past laboratory studies have pointed to potential risks of cancer, birth defects and toxicity. In addition, quinacrine may be less effective than surgical sterilization and may increase the risk of ectopic pregnancy.

- The drug has primarily been promoted by two US population control extremists, Stephen Mumford and Elton Kessel, with substantial financial backing from foundations and individuals linked to conservative anti-immigrant organizations. These two individuals often portray those who oppose quinacrine as "anti-choice" and/or in "collusion" with the Vatican. Along with many others who oppose quinacrine, we are strongly pro-choice and have long been actively engaged in expanding access to safe and legal abortion.

- Most human trials of quinacrine have taken place in the absence of adequate informed consent, screening and follow-up. Last year the Supreme Court of India banned quinacrine sterilization in that country after serious abuses came to light in trials conducted there.

As Dr. Shree Mulay stated in her presentation to the PPFA Medical Committee, "science and ethics cannot be placed in two separate compartments." There already has been such a breach of ethics in the pursuit of this method, it is best to choose other avenues for improving the reproductive health of women.
For a more thorough discussion of this issue, we urge you to read the lengthy, award-winning Wall Street Journal piece by Alix Freedman (June 18, 1998).

Sincerely,

Marlene Fried
Dr. Shree Mulay
Judy Norsigian
Jael Silliman

Organizational Endorsements

Cindy Pearson for the National Women's Health Network, USA
Judy Norsigian, Boston Women's Health Book Collective
Francine Coeytaux, Founder, and Dr. Helen Rodriguez-Trias, Associate for the
Pacific Institute for Women's Health
Adrienne Germaine for the International Women's Health Coalition (IWHC)
Co-ordinating Unit, Women's Global Network for Reproductive Rights, Netherlands
Asian Pacific Research and Resource Center, ARROW, Malaysia
Red de Salud de las Mujeres Latinoamericanas y del Caribe/Latin American
and Caribbean Women's Health Network
DAWN, Development Alternatives for Women in a New Era
Committee on Women, Population and the Environment
Saheli, India,
Stephen Viederman and Wilma Montanez for the Jessie Smith Noyes Foundation, New York
SPEAK, A Woman's Organization Against Violence, Indonesia
Robin Teurlings for Dutch Council on Youth and Population
Loretta Ross, Director, for the Center for Human Rights Education, Atlanta.
Toni M. Bond and Dionne L. Carey for African-American Women Evolving
and the Chicago Abortion Fund
Dazon Dixon Diallo for Sister Love Women's Aid Project, Atlanta
Global Sisterhood Network [GSN], Australia.
Junice L. Demeterio- Melgar, MD for Likhaan, Phillipines.
HealthWatch Trust, Jaipur, India
Maria Chin Abdullah Executive Director Women's Development Collective, Malaysia
Rebecca C. Schwartz for ACCESS / Women's Health Rights Coalition Oakland, CA
Dr. Vijay Rukmini Rao, on behalf of the women's organisations from villages of
Medak district and the Deccan Development Society, Hyderabad, India

Individual Endorsements

Dr. Anibal Faundes, Full professor of Obstetrics, Universidade Estadual de Campinas, Brazil*
Dr. Marlene Fried, President, National Network of Abortion Funds*,
and Director, Civil Liberties and Public Policy Program at Hampshire College
Dr. Shree Mulay, Department of Medicine, McGill University, Canada*
Marge Berer, Editor, Reproductive Health Matters, London
Dr. Rosalind Petchesky, Mac Arthur Fellow and Professor of Political Science, Hunter College*
Dr. Jocelyn Scutt, Human Rights Commissioner, Tasmania, Australia
Amparo Claro, Latin American and Caribbean Women's Health Network, Chile*
Professor Dorothy Roberts, Northwestern University School of Law, *
Julia R. Scott, President/CEO National Black Women's Health Project*
Maria Isabel Matamala, Chile,
Maggie Kilbourne-Brook/PATH*
Adriana Gomez, Chile
Betsy Hartmann, Director, Population and Development Program, Hampshire College,
Dr. Jael Silliman, Women's Studies Program, University of Iowa *
Dr. Lynette J. Dumble, University of Melbourne, Australia *
Anne Firth Murray, Founding President, Global Fund for Women*.
Dr. Davy Chikimata, Population Council, Kenya *
Dr. Ellen Hardy, Brazil *
Loes Keysers, Women, Population and Development, Institute of Social Studies,
The Hague, Netherlands *
Judith Richter, Germany
Bruce Shapiro, Columnist, The Nation*
Onnie Wilson, Gobal Sisterhood Network, Melbourne, Australia.
Sarah Siddiqi, Pakistan Peace Coalition, Pakistan
Aly Ercelawn and Muhammad Nauman, Creed Alliance, Pakistan
P. Jamuna, Gramya Women's Resource Centre, Secunderabad, India
Aleyamma Vijayan, Sakhi Resource Centre for Women, Kerala, India.
Fleur van Baer, Belmont Consortium, Melbourne Australia
Sofia Gruskin, Francois Xavier Bagnoud Center for Health and Human Rights,
Harvard School of Public Health
Dr Judy Hope, Medical Practitioner, Melbourne, Australia
Indira Narayan, Friends of the Earth, Melbourne, Australia
Larissa McFarlane, Friends of the Earth, Melbourne, Australia.
Dr. Lisa Jackson, Medical Practitioner, Melbourne, Australia
Kerry Lee, Women's International Network, Melbourne, Australia.
Dr. Viviene Lerner, Hawaii, USA.
Thelma Solomon, Matrix Guild, Melbourne, Australia
Sam de Silva, Freelance Journalist, in the main SBS, Melbourne, Australia.
Kathleen Maltzahn, Women's International Network, Melbourne, Australia.
Sarah Lantz, Pro Choice Coalition, Melbourne Australia.
Margarita Windisch, Resistance, Melbourne, Australia.
Sasha Claire McInnes, Hamilton, Ontario, Canada
Douglas Hayman, Hamilton, Ontario, Canada
Mary Von McInnes, Vancouver, British Columbia, Canada
Kate Davison, Women's Student Union, University of Melbourne, Australia.
Professor Johanna Schoen, University of Iowa
Frescia Carrasco, Manuela Ramos (Peru)*
Rosa Geldstein, CENEP-CONICET, Buenos Aires, Argentina*
Angela Heimburger, The Population Council, Regional Office for Latin America and
the Caribbean*
Sandra Garcia, The Population Council, Regional Office for Latin America and the Caribbean *
Monica J. Casper, Ph.D, Sociology Department, University of California at Santa Cruz*
Susanna Rance, consultant, Population Council, Bolivia*
MeredithTax, President, Women's World Organization for Rights, Literature
and Development. *
Penney Kome,author of Wounded Workers: The Politics of Musculoskeletal Injuries
Micere Githae Mugo, Professor, Poet/Playwright/Literary Critic
Dr Jo Murphy-Lawless, Centre for Women's Studies,University of Dublin, Ireland
Dr. Lisa Richey, Center of African Studies, University of Copenhagen
Dr. Mabel Bianco, FEIM, Foundation for Studies and Research on Women,Argentina.*
Olumide Olayomi, Special Assistant to Execuive Director, Churchgate Group,Lagos, Nigeria.*
Sultana Alam, USA
Professor Adele Clarke, University of California at San Francisco*
Leela Visaria HealthWatch Network, Delhi, India*
Reem Bahdi, Coordinator, Women's Human Rights Resources, Faculty of Law,
University of Toronto*
Susana Medina, The Population Council, Regional Office for Latin America and
the Caribbean *
Adele Clarke
Lisa J Bourgeault, student, University of Califronia
Martha Rosenberg, Foror Por Los Derechos Reproductivos, Buenos Aires, Argentina*
Uta Eser, History and Philosophy of Science Program,University of California, Davis*
Anika Rahman, USA
Aubrey Manning
Marcia Mikulak, Anthroopology, University of New Mexico
Jeanne Rudd, Librarian, Family Planning NSW, UK*
Soheir A. Morsy, Independent Scholar/International Consultant.
Alma Gottlieb, USA
Andrea Eschen, Association for Voluntary Surgical Sterilization, International *
Dr. Eric B. Ross, Convenor, Population & Development program, Institute of Social Studies
The Hague, The Netherlands*
Maria Hamlin Zuniga, Nicaragua, International People's Health Council*
Mark Haslam
Lynn Freedman, USA
Sadia Chowdhury, World Bank*
Ramya Sundararaman
Professor Pamela Feldman-Savelsberg, Department of Sociology and
Anthropology, Carleton College*
Dr. Andrea Cornwall, IDS, UK*
Carolyn Gordon, Director of Youth Projects, Illinois Caucus for Adolescent Health*
Arachu Castro, Ph.D., MPH, Harvard School of Public Health *
Dr. Rita Arditti, Union Institute, US*
Patricia Herrera-Ascencio- Mexico
Helen Lobato, Melbourne
Dr. Stacy Leigh Pigg, Dept. of Sociology and Anthropology, Simon Fraser University*
Cecilia Van Hollen

* organizations are for identification purposes only.