[Dash of SAS] Harmful side effects of SC TRO on contraceptives

Ana P. Santos
The TRO gave anti-RH officials the perfect excuse to restrict the implementation of the RH Law in accordance with personal beliefs

 It’s a scene right out of the dystopian novel, The Handmaid’s Tale. Contraceptives are vanishing from our drugstore shelves and public health clinics. Modern birth control as we know it is on the verge of being extinct.

The Commission on Population (Popcom) says that only 23 out of the 48 existing hormonal contraceptives are available in the market and most of them are expected to expire by 2018.

The debacle can be traced back to 2015 when the Supreme Court issued a temporary restraining order (TRO) on two contraceptive implant brands, Implanon and Implanon NXT and suspended the product certification and re-certification of all hormonal contraceptives.

Product certifications are like a license to sell. By not allowing their issuance and renewal, the supply of hormonal contraceptives in the market stopped. We were left with existing stock that is now about to run out.

To be very clear, the Supreme Court is correct when they say they did not issue a TRO on the Reproductive Health Law (RH Law) which covers a range of health provisions like building health centers and sex education. They did, however, issue a TRO on contraceptives which is the very essence of the RH Law’s promise to give every Filipino the right and the access to birth control services and products.

Several aspects of the public health supply chain has been impacted in the years that the TRO has been in place.

Community workers, women’s health advocates share their experience about the harmful side effects of the TRO:

  1. Fear mongering about contraceptive implants.

Contraceptive implants, which make use of rod-shaped-like matchsticks inserted into the upper arm, are a relatively new birth control technology. They were warmly received by women because they offered long-term birth control (up to 3 years) in a non-evasive manner.

When news about the TRO came out, some women thought or were made to believe that implants cause cancer. “They feared that the product’s 3-year efficacy would mean that they would die after 3 years,” said Lina Bacalando, a barangay health worker for the Likhaan Women’s Health Center. According to Lina, many women scrambled to have their implants taken out.

2. It emboldened anti-RH local government officials to carry out policies that restrict people from accessing contraceptives.

The mayor of Sorsogon reportedly returned their family planning supplies to the Department of Health. In February 2015, Sorsogon City Mayor Sally Lee had already come out with an Administrative Order saying that the city is pro-life and banned condoms, injectables, IUDs and all other forms of modern contraception, alleging they are abortifacients.

The TRO gave anti-RH officials the perfect excuse to restrict the implementation of the RH Law in accordance with personal beliefs.

3. Confusion among local service providers

Only the DOH and its agents (public health centers/hospitals under it) were prohibited from administering Implanon and Implanon NXT. Service providers at the local government unit (LGU) level were not covered by the TRO and were free to offer implants to women as long as their supplies did not come from the DOH.

However, most local service providers thought that the TRO covered them so they refused to provide implants to women.

Even some pro-RH local service providers took a prudent stance and decided not provide or offer implants just to be sure that they would not be seen as violating the Supreme Court decision.

4. Burdening and restraining the Food and Drug Administration (FDA) from performing its mandate and regulatory functions

In a statement, the DOH retraced all the way:

“Considering all the circumstances and incidents in the pending case, the FDA is surprised by the latest SC statement to the effect that “what has been issued was a TRO against two specific contraceptives only, referring to Implanon and Implanon NXT,” read the statement.

“The language of the 2015 TRO is CLEAR:

A.  The TRO  required the FDA to suspend its certification/re-certification of all contraceptives.

B. The FDA was tasked to revise all the relevant procedure and IRR, conduct hearings and decide on all applications under the revised procedure – the very conditions on which the lifting of the TRO has been made to depend.”

5. It affected an estimated hundreds of thousands of women from managing their fertility

According to the DOH, the FDA has already finalized the amended Rules of Procedure/Guidelines for the certification and re-certification of all contraceptive products and is set to hold the first round of summary hearings under the amended procedure this August 21, 2017.

The Supreme Court has included a “sunset provision” that says that the TRO will automatically be lifted once the FDA complies with recertification requirements.

So there is hope but that will take time.

As confirmed by Juan Antonio Perez, Popcom executive director, one brand of the progestin-only-pill (recommended for breastfeeding mothers) is already out of stock. This will affect an estimated 500,000 breastfeeding moms. The TRO on the implants already affected 200,000 women who use them.

“Once the remaining stocks are gone, there will be no more available until new product registrations are issued by the FDA. DOH procurements typically take 6-9 months before new supplies come in,” said Juan Antonio Perez, Popcom executive director.

By 2018, there will hardly be hormonal contraceptives available and we face a possible future where birth control options will be limited to vasectomy, ligation, condoms, and abstinence.

All of this is just a reminder to continue fighting for your right to birth control until the TRO is lifted. 

Post about it. Write about it. Talk about it. Do not stop doing so until the TRO is lifted. Make yourself heard and align with others who are doing the same by using the hashtag #DontTakeAwayMyBirthControl and #ImplementRH when you post. – Rappler.com

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