A/69/62
African American, low-income women. 192 When reviewed by the Administration, the trial data showed egregious misconduct by the presiding clinicians, including enrolments without informed consent; enrolments of women with medical contraindications (e.g., cancer, type 2 diabetes, obesity, hypertension); and inconsistent data collection with more than half the women lost to follow-up. The Administration declined to give its approval three times (1967, 1978 and 1983). In 1991, WHO completed a study that satisfied outstanding safety concerns and in 1992 the Food and Drug Administration approved DMPA. 193 309. In the case of quinacrine, the controversies were transnational. Quinacrine hydrochloride pellets inserted into the vagina dissolve into liquid, burning and scarring the fallopian tubes and leading to permanent sterilization. Although major family planning organizations and government agencies, including WHO, opposed the use of quinacrine for sterilization, the procedure was performed on more than 104,410 women by 2001, through a network mobilized by two doctors. The drug lacked approved testing for long-term side effects or possible effects on foetuses. The United States ordered an end to its production and export in 1998, and the product is banned in India and Chile. 194 310. The political mobilization of women’s rights groups in response to such cases fuelled the demands for a human rights basis for health and the achievements of the International Conference in that regard, and changed the criteria on the basis of which technological and service innovations were evaluated and received investment. Numerous population and development agencies, including the WHO Special Programme of Research, Development and Research Training in Human Reproduction (now the Department of Reproductive Health Research) and UNFPA, established gender or women’s advisory panels to ensure that future priorities and investments were women-centred and met more stringent criteria on side effects, user control and reversibility. WHO pursued regional “common ground” dialogues bringing women’s reproductive health advocates, activists, scientists, government ministers and family planning leaders to a common table to establish collaborative agreement about family planning programme priorities. WHO also established an
__________________ 192
193 194
106/286
A. L. Nelson, “DMPA: battered and bruised but still needed and used in the USA”, Expert Review of Obstetrics and Gynecology, vol. 5, No. 6 (2010), pp. 673-686; K. Hawkins and J. Elliott, “Seeking approval”, Albion Monitor, 5 May 1996; P. F. Harrison and A. Rosenfield, eds., Contraceptive Research and Development: Looking to the Future (Washington, D.C., National Academy Press, 1996), p. 297; Committee on Women, Population and the Environment, “Depo-Provera fact sheet”, 6 January 2007; available from http://cwpe.org/node/185 (accessed 14 August 2013); T. W. Volscho, “Racism and disparities in women’s use of the Depo-Provera injection in the contemporary USA”, Critical Sociology, vol. 37, No. 5 (2011), pp. 673-688. Hawkins and Elliott, “Seeking approval”. J. A. M. Scully, “Maternal mortality, population control, and the war in women’s wombs: a bioethical analysis of quinacrine sterilizations”, Wisconsin International Law Journal, vol. 19, No. 2 (2001); C. Pies, M. Potts and B. Young, “Quinacrine pellets: an examination of nonsurgical sterilization”, International Family Planning Perspectives, vol. 20, No. 4 (1994); R. Bhatia and A. Hendrixson, “Quinacrine controversy”, Women’s Health Activist Newsletter, May/June 1999.
14-22369