Women's Health Advocates Win a Victory in the Fight Against Chemical Sterilization
On November 13, the Board of Directors of Planned Parenthood of America (PPFA) turned down a motion from its own Medical Committee which have put the organization in the position of supporting unethical human experimentation. The drug in question was quinacrine chemical sterilization. The Medical Committee was prepared to involve PPFA affiliates in human trials of quinacrine before sufficient toxicology laboratory studies were completed. The Board voted that participation in trials would be considered if and only when the FDA gave the go-ahead. The vote is a victory for women's health advocates, whose timely intervention helped prevent Planned Parenthood from making a wrong and very dangerous decision. Coercive medical research on concentration camp inmates and prisoners of war during World War II gave rise to the Nuremberg codes and later the Helsinki Declaration on human experimentation. This declaration states that "In any research on human beings, each potential subject must be adequately informed of the aims, methods, anticipated benefits and potential hazards of the study and the discomfort it may entail." Furthermore, subjects should be free to withdraw from participation at any time and be advised of alternatives, including non-treatment, in language they can understand. Doctors should obtain their freely given informed consent, preferably in writing.
At the Nuremberg trials Nazi doctors were taken to task for their chemical sterilization trials on women, which included intrauterine instillation of formaldehyde and phenol. Now over 40 years later, over 100,000 women in 19 countries, most of them in the Third World, have been sterilized with quinacrine pellets. These trials have largely taken place in the absence of adequate informed consent, medical screening and follow-up, in violation of the Helsinki Declaration.
The main promoters of the quinacrine method are two population control and anti-immigrant extremists from the United States, Drs. Stephen Mumford and Elton Kessel, who have the backing of wealthy donors. These include Donald Collins, Sally Epstein, and Leland Fikes, all supporters of the conservative Federation for American Immigration Reform. Donald Collins is also on the board of the right-wing Scaife Family Foundation.
Previously developed as an anti-malarial treatment, quinacrine is a known mutagen and preliminary laboratory studies point 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. Injected into the uterus with a modified IUD inserter, quinacrine works by burning the fallopian tubes, resulting in scar tissue that blocks the egg's passage into the uterus. Quinacrine is much cheaper than surgical sterilization, and thus is viewed by its promoters as a cost-effective weapon in the war against population growth. The Wall Street Journal quotes Mumford as saying that the drug is "essential to population growth-control;" Mumford, in fact, believes that overpopulation is a more serious national security threat than nuclear weapons.
Quinacrine has not been approved for sterilization purposes by any drug regulatory agency, including the World Health Organization and the FDA. Nevertheless, Mumford and Kessel have carried the pellets around the world in suitcases, recruiting local doctors willing to engage in their vast unethical experiment. In Viet Nam alone, over 30,000 women were sterilized until the government finally stopped the trials. In India more than 10,000 quinacrine sterilizations have been performed in the state of West Bengal alone. The two most zealous quinacrine supporters in India espouse openly anti-Muslim politics; poor Muslim women, in fact, are their preferred target.
The international family planning community now widely accepts that many quinacrine trials have violated based medical and informed consent protocols. Press reports, including an award-winning piece by Alix Freedman in the Wall Street Journal, have helped to document the extent of quinacrine abuse. Last year women's groups and public health specialists in India succeeded in getting the Supreme Court of India to ban further trials there, and women activists in Chile secured a similar ban from national health authorities in that country. Yet Mumford and Kessel continue to operate with impunity. Their latest strategy is to target the United States.
Extolling themselves as 'pro-choice' and falsely depicting the women's health opposition as "handmaidens of the Vatican," Mumford and Kessel have set out to woo abortion and family planning providers in the U.S. This past April, for example, they showed up at the National Abortion Federation meeting in Atlanta.
Unfortunately, given the intersection between population control and family planning interests in this country, quinacrine is being taking seriously as a potential method. With private population control funding, Family Health International in North Carolina is now performing the laboratory tests required for the official FDA process. Without that funding, it is doubtful such tests would have ever taken place since the results of earlier lab studies were not promising.
The more cautious among quinacrine's supporters urge that these tests be completed before any further human trials are conducted. The motion put before the PPFA Board of Directors would have jumped the gun, endorsing human trials at PPFA sites before sufficient toxicology results were in.
The motion might have passed if a number of prominent pro-choice women's health advocates and organizations had not organized a major campaign to alert the Board to the serious consequences of such an action. Their letter to the Board not only opposes human trials in the absence of completed laboratory tests, but also makes the point that even if the lab results indicate no specific toxicity, the "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." In addition, it remarks on quinacrine's easy potential for abuse and calls for scarce research funds to be redirected to more promising technologies, such as microbicides which could prevent sexually transmitted diseases.
While the PPFA Board heeded the message and voted the right way for now, the quinacrine battle is far from over. Currently,in Chile the Ministry of Health is considering rescinding its ban and allowing a new human trial of quinacrine in public hospitals. Because they have big money behind them, Mumford and Kessel will no doubt continue their campaign to win support for quinacrine in the U.S. Approval here would help give them legitimacy overseas; they hope, for example, that it would help lift the Supreme Court ban in India.
Further research on quinacrine, including the present laboratory tests, only serves to legitimize the illegitimate process by which the drug has been used to experiment on poor women. It sends a message that there is no punishment for those who conduct unethical drug experiments on human subjects. Instead of further research, the priority now should be to use the Helsinki Declaration and other internationally accepted codes of conduct to hold Stephen Mumford and Elton Kessel accountable for their actions.
-- Betsy Hartmann is the Director of the Population and Development Program at Hampshire College and a founding member of the Committee on Women, Population and the Environment (CWPE) and the Quinacrine Alert Network. For further information on quinacrine, visit CWPE's web page, www.cwpe.org.