about ipas
newsroom
what we do
where we work
products
publications
contact

July 7, 2005
Ugandan woman
The combined mifepristone/misoprostol regimen is a safe and effective method for early termination of unwanted pregnancy, much needed in the developing world.
Photo courtesy of Fred Hoogervorst / Panos Pictures.
Ipas, the only organization that works exclusively and comprehensively on the issue of unsafe abortion internationally, was pleased to learn this week that the World Health Organization (WHO) has decided to include a widely used combined regimen of mifepristone and misoprostol on its list of medicines that are essential to good health. A WHO Expert Committee recommended inclusion of the drugs on the list several months ago because they have been demonstrated to be a safe way to terminate unintended pregnancy and save women’s lives.

Political pressure from the U.S. Department of Health and Human Services to override the recommendation of the Expert Committee on Selection and Use of Essential Medicines held up final approval of the list. News of the delay prompted leading physicians, academicians, and public-health leaders from around the world to call and send letters urging the WHO Director-General to withstand U.S. political pressure. An editorial in the prestigious medical journal, The Lancet, sent a similar message on May 28.

“Every year, 68,000 women die needlessly because they don’t have access to safe abortion care,” said Dr. Laura Castleman, Ipas’s Medical Director. “Deaths related to abortion are almost totally preventable when safe abortion methods are made accessible to all women in their communities. WHO's decision to support the availability of these drugs will help save thousands of lives.”

However, despite gaining final approval, the mifepristone/misoprostol combined regimen is included on the essential medicines list with a bold box stating “Where permitted under national law and where culturally acceptable.” The entry also includes an asterisk indicating that the drugs “require close medical supervision.” (Mifepristone is widely used in the United States, where it is commonly known as “RU486” or the “abortion pill;” it is marketed under the brand name “Mifeprex®.”)

“The essential medicines list also includes morphine, considered a ‘controlled substance’ by the U.S. Drug Enforcement Agency, as well as general anesthetics,” said Dr. Castleman. “These drugs should only be prescribed under close medical supervision. However, none of these—or any other drug—are singled out for special concern.”

The mifepristone/misoprostol combined regimen is a safe and effective method for early termination of unwanted pregnancies, much needed in the developing world. Globally, 19 million women risk their lives each year by seeking unsafe abortion to end unwanted pregnancy. Rural and poor women, without access to high-quality medical care, are most at risk.

Some experts suggest that political pressure played a role in the additional cautionary language. According to Dr. Castleman, there is no medical reason the abortion regimen should be singled out when it could save many lives. “What’s culturally acceptable about letting women die?”

Ipas, a private, nonprofit organization based in North Carolina, is the only international organization dedicated solely to ending the preventable deaths and injuries caused by unsafe abortion. Through local offices and partnerships around the world, Ipas trains health-care providers, distributes reproductive-health technologies, and works with policymakers and advocates to promote women’s reproductive health and rights.

For more information, contact:
Kirsten Sherk
Senior Associate, Media Relations
e-mail: sherkk@ipas.org
phone: 919.960.5612
fax: 919.929.0258