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Sunday, April 09, 2017

Sharing the Contraceptive Burden

"The fact that the big companies are run by white, middle-aged males who have the same feeling -- that they would never do it -- plays a major role."
"If those companies were run by women, it would be totally different."
Herjan Coelingh Bennink, gynecology professor, former head of research, Organon International

"In doing anything abroad, quite substantial money is required, and that can only come from the pharmaceutical industry."
"Why should the burden [of contraception] be borne by the female only? There has to be an equal partnership."
Dr. Sujoy Guha, biomedical engineer, Indian Institute of Technology, Kharagpur, India
Professor Sujoy Guha.
Photographer: Sumit Dayal/Bloomberg

The pharmaceutical giants, those post-national global money-making institutions who see fit to invest some of their profits in pharmaceutical science where it is seen that a successful product for diseases or medical conditions that afflict large numbers of people worldwide will gain them ever greater profits, are never too enthusiastic, to the point of complete disinterest, in finding cures for the conditions they produce drugs for the maintenance of, or orphan diseases which do not afflict a large number of people.

Of  'medical conditions' that affect more people than any other in the world what could be recognized as being more commonplace than pregnancy? Perpetuation of the species is nature's blueprint for species' survival, and when sufficient numbers of progeny are produced it hardly matters to indifferent nature whether it is difficult or inconvenient for a woman to raise children in conditions of endemic poverty. As far as nature is concerned, lose a few, others will survive.

Conventionally, society has looked at women to bear the brunt of avoiding conception. Medically speaking, science has found it easier to invent ways and means for women to practise pregnancy avoidance. Whether through mechanical means or ingested drugs, birth control has been a woman's precinct. Not that research hasn't been undertaken to discover the male equivalent of birth control pills, but there are complications and each time science has felt it has solved the dilemma it soon discovers it has not.

Now, it appears, what the unlimited investment capabilities of Big Pharma has been unable to achieve, a small rural India university startup bioengineering laboratory has succeeded in producing. The male contraceptive has moved beyond human trials and is ready for regulatory approval for the safe, effective and convenient injectable sperm-inhibiting product, but it seems that drug manufacturers are giving it wide berth.

Not surprisingly, companies like Bayer AG, Pfizer Inc., and Merck & Co. among others prefer the income they reliably bank on from conventional contraceptives, content to disregard this new birth control method meant for males, unwilling to gamble with the $10-billion market the female contraceptives currently guarantee them. This new reversible process out of India can be made available in poor countries for as little as $10; singularly unattractive as an investment.

A method whereby fertility can be controlled, where compliance is not an issue, and the ongoing outlay from the poor for condoms and female birth-control pills taken daily, seems an ideal solution to an ages-old problem; avoiding conception. The estimated 225-million women of child-bearing age in developing countries whose need for contraception remains unmet, could hugely benefit from this product on the market and readily available.

Dr. Guha's invention represents a polymer gel injected into the sperm-carrying scrotum tubes to impair male fertility by damaging the heads and trails of negatively charged sperm by the gel which carries a positive charge. The infertile sperm can no longer succeed in fertilizing a female egg. The treatment is called reversible inhibition of sperm under guidance (RISUG), and is reversible when a second injection breaks down the gel and the sperm is allowed to act normally.

Its success rate is 98 percent effective at pregnancy prevention, similar to the success rate of scrupulously used condoms, and with no major side-effects, assures R.S. Sharma, head of reproductive biology and maternal health at the Indian Council of Medical Research. During the trials period roughly 540 men received the treatment in India. This is providential for India, with its huge population of women urgently requiring a protocol for family planning.

Across the globe close to 60 percent of women use the contraceptive pill or some other type of modern contraception, up to 2015, according to a report out of the United Nations, while 8 percent placed their reliance on a male partner with the use of condoms. According to Organon, a Dutch drugmaker, in the 1990s it partnered with Germany's Schering AG hoping to develop a male birth control pill, anticipating that up to half of the female contraceptives market would be dissolved with the contraceptives reliance switching to men.

Responding to the disinterest of the pharmaceutical industry, Dr. Guha licensed his new male-centric contraceptive technique to the Parsemus Foundation, an American non-profit, in an effort to establish a market for the technology outside of India. The manufacture of Dr. Guha's product or another very similar one that Parsemus is working on could be distributed at near cost; $10 to $20 per person in low- and middle-income countries -- and $400 to $600 per person in richer markets.

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