A setback for RH advocates

The decision of the Supreme Court not to lift the Temporary Restraining Order (TRO) on implants is a big letdown for reproductive health advocates.

The Forum for Family Planning and Development expresses “grief” over the denial by the SC on September 16 of the plea of the Office of the Solicitor General to lift the temporary restraining order on the health department’s distribution and sale of implants, a contraceptive that can prevent pregnancies for up to three years.

The decision sets back the full implementation of the RH Law, remarks FORUMpresident Benjamin de Leon.

The SC had issued the TRO on June 17, 2015, enjoining the government from “procuring, selling, distributing, dispensing and administering, advertising and promoting” implants. The court had granted the plea for a TRO of the Alliance for the Family Foundation Philippines which alleged that  the implants Implanon and Implanon NXT have “abortifacient” side effects.

The SC ruling also stopped the Food and Drug Administration (FDA) from granting pending applications for reproductive products, including contraceptives.

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It had taken decades for the Responsible Parenthood and Reproductive Health Act of 2012 to be passed and ruled by the Supreme Court as constitutional. The developments were hailed as a victory for reproductive health advocates who worked long and hard for legislative approval of their efforts to help women make decision on their health and bodies. Then came the blow: the issuance by the SC of the TRO prohibiting the distribution of contraceptives on June 17, 2015. Hopes of the TRO being lifted were raised by the declaration of the new president Rodrigo Duterte for the implementation of the Reproductive Health Law. Then hopes were blurred by the SC’s non-lifting of the TRO.

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The US Food and Drug Administration has approved Implanon, as a new implantable hormonal contraceptive for women.

Implanon is a thin, matchstick-sized rod, called an implant. It is made of soft, plastic-like material and contains progestin. It is inserted beneath the skin of the arm and a very small amount of the hormone is released continuously to prevent pregnancy. It is effective for up to three years.

“This method is great news for women who want long-term, reversible birth control and the freedom of not having to remember a pill every day,” said Planned Parenthood Federation of America vice president for medical affairs Vanessa Cullins, MD, MPH. “Planned Parenthood applauds this addition to the array of contraceptive choices for women.”

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In its September 16 decision, the SC tasked the Food and Drug Administration (FDA) to determine whether certain contraceptive drugs and devices are abortifacients or non-abortifacients as it nullified the certification and re-certification earlier issued by the agency covering 77 contraceptive drugs and implants. The court said the agency did not observe due process, notice and public hearing for the benefit of the anti-reproductive health body.

The SC took 15 months to decide not to lift the TRO. Such a long wait that has been, although Health Secretary Paulyn Ubial said the “bad news” was “good news” in that a decision – not to lift the TRO – was finally made.

The court gave the FDA 30 days within which to formulate rules of procedure in the screening, evaluation, and approval of all contraceptive drugs and devices that will be used under Republic Act No. 10354 (the Responsible Parenthood and Reproductive Health Act of 2012).

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The TRO has temporarily struck down not only the purchase and distribution of the implants, but also of other contraceptive drugs. Women’s rights advocate Elizabeth Angsioco in an interview during the waiting period, has said that if the TRO was not lifted, no new purchases could be made of any other contraceptive. “This means that what we have now will either be used up or expired. In fact, by 2018, more than 80 percent of all contraceptives on stock will expire.”

There is a strong preference among women for Inpanol. Angsioco said “There are family planning methods, but the implant’s effectiveness (lasts) for three years, that is why it is more effective. The effect on it will be poor women, since the rich can access this extensive method from their private doctors.”Indigent family planning acceptors avail of the procedure for free. Otherwise it costs P12,000 in private sources.

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The 30-day deadline given FDA to formulate rules in screening contraceptive drugs means further extension of the TRO.This means that by 2018, 90 percent of contraceptive brands will no longer be available in the market. This includes P248 million worth of hormonal contraceptives that will be expiring.

“The expiration of these modern contraceptives would result in a limited brand or kind of contraceptive for the couples to choose from,” said Lydio Español, Commission on Population Region IV-B director, during a forum in Quezon City.

“Unless the TRO is lifted, government investments like that of the procured subdermal implants which are now on stock in the Department of Health (DOH) warehouses and will be expiring by 2018 will all go to waste,” Español said. “Aside from the procured implants, investments made in the training of health practitioners are also wasted.”

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Ben de Leon, FORUM president, said, “It would have been better for the Filipino people had the Supreme Court lifted the TRO and remanded the issue to the FDA which has the responsibility of determining whether modern methods of contraception are abortifacient or otherwise, after observing due process.”

“Empowering the country’s women to make more sensible life decisions will create a strong impact on the country’s social and economic development,” he said.

The latest figures from the Family Health Surveys reveal that the number of Filipino women who have died due to pregnancy and child-birth related complications remain high at 221 deaths per 100,000 live births. This means that there are 14-15 maternal deaths daily, de Leon added.

Besides pushing for the use of contraceptives, the Responsible Parenthood and Reproductive Health Law also calls for maternal health care and awareness. The RH law stresses education among the public, the women especially, on how to take care of themselves before and during pregnancy, de Leon said.

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