ABOUT THIS NEWSLETTER:

This newsletter is prepared and distributed as a voluntary activity on behalf of the American Society for Emergency Contraception and the international Consortium for Emergency Contraception. It is distributed electronically twice each year to anyone who wishes to receive it. To contribute a news item, please send it to AmSocEC@aol.com , to Tara Shochet (shochet@princeton.edu), or to Charlotte Ellertson (cellertson@popcouncil.org.mx). Annik Sorhaindo (asorhaindo@popcouncil.org.mx) is currently the editor of the newsletter, but will retire as of December 31st 2000. We reserve the right to check and edit items as appropriate. To join or remove your name from the newsletter circulation list, please write to AmSocEC@aol.com. To learn more about ASEC and the International Consortium on EC, look at the end of this newsletter.

****NorLevo still available through ASEC****

NorLevo, a progestin-only EC product, was recently approved in France for pharmacist provision. Due to the change in labeling required when the product moved from prescription-only status to pharmacist provision or p status, HRA Pharma, the company marketing NorLevo, had to recall a large amount of the product. Last year, they generously made these supplies available for research or humanitarian purposes through ASEC. The offer was made with the following provisions:

• the product cannot be used for any reason in France or its overseas territories;
• ASEC and organizations requesting supplies agree that the product should in no instance be traded or used for commercial purposes;
• HRA Pharma will not re-label the boxes (the packaging and patient leaflet are in French);
• HRA Pharma is prepared to send the boxes at its own cost to organizations provided that individual orders are of not less than 2,000 boxes;
• ASEC and users agree to forward to HRA Pharma any information regarding side-effects which occur with the use of these products;
• the data generated by research using these products should be made freely available to the medical and scientific community;
• if a publication is made with results obtained with the products, HRA Pharma should be entitled to review the manuscript for information 30 days before its submission; in addition, it will be acknowledged that NorLevo was donated by HRA Pharma ;
• if a patent is filed based on discoveries made with the product, HRA Pharma would automatically be granted a free license to use this patent.

Please contact ASEC if your organization is interested in obtaining supplies of Norlevo. Please provide us with the amount of product you would like to receive, the purpose for which you intend to use it, and where it should be shipped. ASEC has agreed to serve as a clearing house for requests, and requests will be considered on a first-come, first-serve basis.

There are still 20,000 boxes available. The product expiration date is April 2001, so hurry and place your order!

Contact:

Andre Ulmann
HRA-Pharma
63, Rue de la Colonie
75013, Paris
FRANCE
Tel: 33-1-4033-1130
Fax: 33-1-4033-1231
Email: infohra@hra-pharma.com

Tara Shochet
Office of Population Research
Princeton University
Notestein hall
21 Prospect Street
Princeton, NJ 08544
USA
Tel: 609-258-5402
Fax: 609-258-1039
Email: shochet@princeton.edu

PRODUCT NEWS

Discounted PREVEN available without pregnancy test

The emergency contraceptive kit, PREVEN, is now available to clinics without a pregnancy test. The new kit's wholesale price is $15.95. The regular kits are still available in the public sector for between $2.05 and $2.25. More expensive kits containing pregnancy tests are available in most pharmacies.

Contact:

Richard Grace
Gynetics Inc.
105 Raider Boulevard
Suite 203
Belle Mead, NJ 08502
USA
Tel: 908-359-2429
Fax: 908-359-6660
Email: gynetics@aol.com

Plan B now has 18 month expiration date

The U.S. Food and Drug Administration recently lengthened Plan B's expiration date to 18 months. The longer expiration date helped to move Plan B into retail distribution in August. The expiration date is expected to be lengthened again to 24 months by the end of November 2000.

Contact:

Sharon Camp
Women's Capital Corporation
8930 Camp Road
Wellcome, MD 20693
USA
Tel: 301-753-1926
Fax: 301-753-1927
Email: scamp8930@aol.com

Dedicated products approved in Latin America

This summer, the dedicated levonorgestrel emergency contraceptive product marketed by HRA Pharma, NorLevo, was approved in Brazil and Peru. In Mexico, it should be approved soon and will be sold under the trademark Vikela.

Also in Mexico, Postinor 2 has also been approved and will be available in pharmacies in January 2001. Füstery, the organization distributing Postinor 2 in Mexico, says they will apply for over the counter status within one year of the product's release. It will be sold in the private sector for about $5.

Contact:

André Ulmann
HRA Pharma
63, Rue de la Colonie
75013 Paris
FRANCE
Tel: 33-1-4033-1130
Fax: 33-1-4033-1231
Email: infohra@hra-pharma.com

Raffaela Schiavon
Population Council
Escondida 110
Colonia Coyoacan
México DF 04000
MÉXICO
Tel: 525-659-8839
Fax: 525-554-1226
Email: rschiavon@popcouncil.org.mx

Levonelle-2 approved in the UK, may go OTC

In February 2000, Levonelle-2, a progestin-only dedicated EC, was approved in the UK on a prescription-only basis. Before the introduction of Levonelle-2, the only other dedicated product available was the Yuzpe regimen, Schering PC4. Although PC-4 is less expensive, many EC providers throughout the country are prescribing Levonelle-2, citing reduced side effects.

Also this year, Schering Health Care Ltd. applied for the removal of the prescription-only status on Levonelle-2 The Medicines Control Agency submitted a recommendation to reclassify the product for over the counter pharmacy sale to women 16 and older. A change in classification must first be approved by health ministers and ratified by the parliament. If approved by the parliament, the Medicines Control Agency could change the license on the product before the end of the year and Schering Ltd. would make the product available in stores sixteen weeks later. Although there is support for reclassification, many see a middle ground, particularly if experiments with pharmacist distribution (see later story in this newsletter) prove to be successful and are instituted nationally. Moreover, there is concern that pharmacy sale without a prescription would lead to over use. EC advocates in the UK hope that some combination of pharmacist distribution and over the counter sales will increase access to women nationwide.

Contact:

Ann Furedi
Director of Communications
British Pregnancy Advisory Service
Austy Manor, Wootton Wawen, Solihull
West Midlands B95 6BX
UNITED KINGDOM
Tel: 44-156-4796-1033
Fax: 44-020-7580-2995
Email: anne-furdi@easynet.co.uk

EC approved for sale in Italy, Vatican backyard

In early October, the Italian Health Ministry approved the sale of NorLevo. The emergency contraceptive is now available with prescription through Italian pharmacies. Monsignor Elio Sgreccia, the Vatican's leader on bioethical issues expressed the church's disapproval of the decision.
He said the decision was an appeal to women who oppose abortion but accept contraception. He added, "In reality, the fertilized egg is an embryo and an embryo is an individual human being, Therefore, blocking the implantation in the uterus is the same as suppressing it. Morally, it's the same thing as a surgical abortion".

Contact:

Andre Ullman
HRA Pharma
63, Rue de la Colonie
75013 Paris
FRANCE
Tel: 33-1-4033-1130
Fax: 33-;1-4033-1231
Email: infohra@hra-pharma.com

COUNTRY UPDATES

EC goes over the counter in British Columbia, Canada

Beginning December 1st in British Columbia, Canada, emergency contraceptive pills will be available from a pharmacist without a prescription. In late October, the Cabinet changed regulations to allow pharmacists prescriptive authority for emergency contraception. Under the new regulation, pharmacists must take a half day training session to become certified providers. So far, over 800 have already received certification. The pills cost between $8 and $15 and are available to all women regardless of age. A public education campaign is scheduled for the December 1st launch.

Contact:

Judith Chrystal
Director, Communications
British Columbia Pharmacy Association
Richmond, BC
V6X 2W2
CANADA
Tel: 604-279-2053
Fax: 604-279-2065
Email: judith@bcpharm.bc.ca

Ontario Women's Health Council pilot project puts EC over the counter

Next spring, the Ontario Women's Health Council will begin a pilot project to allow women to get emergency contraception from Ontario pharmacies without a prescription. The two year research project is designed to develop recommendations for the best way to make the method available to women. The Ontario Women's Health Council hopes to reduce unwanted teenage pregnancy through this project. Although they have not yet confirmed the sites, they expect to run the project through 24-hour pharmacies in high density areas of Greater Toronto. The pilot won preliminary support from the Ontario College of Pharmacists, the Canadian Medical Association and the Society of Obstetricians and Gynecologists.

Contact:

Jane Pepino
Women's Health Council
880 Bay Street
4th Floor
Toronto, Ontario M7A 1R3
CANADA
Tel: 416-327-8348
Fax: 416-327-3200

US Senators block funding ban for emergency contraception in schools

In September, the U.S. House of Representative approved a Senate provision in the FY 2001 Labor, Health and Human Services, and Education Appropriations bill to outlaw the use of federal funds to distribute emergency contraception in elementary and secondary schools. The bill, written by Senator Jesse Helms from North Carolina, will affect at least 180 schools that currently provide EC to students.

Contact:

Alison Browett
Kaiser Daily Reports
1501 M St. NW
Washington, DC 20005
USA
Tel: 202-672-5952
Fax: 202-672-5767
Email: report@kff.org

NGOs in Latin America consider creating a consortium for the region

As part of the two-day International Consortium for Emergency Contraception meeting in October, representatives from NGOs in Latin America met for a third day to plan for a Latin American Emergency Contraception Consortium. Representatives from several organizations in Latin America came to New York to discuss the region's needs regarding emergency contraception and how forming a consortium among organizations in the region may address those needs. The LAC EC Consortium would be modeled after the International Consortium, but with a focus on issues concerning the Latin America and the Caribbean. The group was enthusiastic, but are still in the planning stages.

Contact:

Angela Heimburger
Population Council
Escondida 110
Col. Coyoacan
Mexico DF 04000
Tel: 525-659-8839
Fax: 525-554-1226
Email: aheimburger@popcouncil.org.mx

PIWH collaborates with NGOs in Latin America to increase knowledge about EC

For the past several years, the Pacific Institute for Women's Health (PIWH) has worked together with NGOs throughout Latin America to increase availability of and knowledge about emergency contraception throughout their communities. Recently, PIWH presented EC workshops for women's groups and health professionals in Nicaragua, Brazil and Mexico. Soon they will work with a collective of seven NGOs in El Salvador to conduct workshops throughout the country.

Contact:

Angeles Cabria
Barbara Pillsbury
2999 Overland Avenue, Suite 111
Los Angeles, California 90064
USA
Tel: 310-842-6828
Fax: 310-280-0600
Email: acabria@piwh.org
bpillsbury@piwh.org

Profamilia works to bring EC to Colombia

Profamilia, the International Family Planned Parenthood Federation (IPPF) affiliate in Colombia, has been working for several years to increase awareness and access to emergency contraception in the country. This year, Profamilia's social marketing department ran a series of radio spots and magazine ads on emergency contraception aimed at young adults. Since the advertisements, Profamilia has received an increase in the number of calls made to the clinic for emergency contraception.

Profamilia is also registering Postinor 2 in Colombia. They expect it to be available in pharmacies this fall.

Contact:

Maria Isabel Plata
Profamilia
Calle 34, No 14-52
Santa Fe de Bogota
Bogota
COLOMBIA
Tel: 571-338-3160
Fax: 571-338-3159
Email info@profamilia.org.co

EC questions to be added to nation-wide health surveys in Honduras and Brazil

The Honduran Encuesta Nacional de Epidemiologia y Salud de la Familia (ENESF) for 2001 will include several questions on EC. The nation-wide survey is run by USAID, U.S. Centers for Disease Control, and the International Planned Parenthood Federation affiliate in Honduras, ASHONPLAFA. They added emergency contraception as an option to many of the survey's standard contraception questions and also added several new questions on EC.

The Brazil DHS may also add four questions on emergency contraception to its 2000 DHS questionnaire. They plan to contact the U.S. Centers for Disease Control as well as Macro International to recommend that they include questions on EC in all of their future surveys.

Contact:

Sandra Garcia
Population Council
Escondida 110
Col. Coyoacan
México DF 04000
MÉXICO
Tel: 525-659-8839
Fax: 525-554-1226
Email: sgarciag@popcouncil.org.mx

Irma Mendoza
Population Council
Residencial Casavola No. 37
Area Bancatlan, Miraflores
Tegucigalpa
HONDURAS
Tel: 504-232-6021
Fax: 504-239-5449
Email: irma@mayanet.hn

Loren Galvao
Population Council
Caixa Postal 6509, Ciudad Universitaria
13084-970 Campinas
Sao Paulo
BRAZIL
Tel: 55-19-3-249-0121
Fax: 55-19-3-249-0216
Email: lgalvao@popcouncil.org.br

APPRENDE moves into Phase II of their program to introduce EC to Venezuela

Since 1993, the Asociacion Para la Prevencion de Embarazos No Deseados (APRRENDE) has worked to introduce EC to Venezula. As part of Phase I, they researched both prospective providers and potential users of EC in the country, informed several gynecologists about the method and registered Postinor 2 for sale in Venezuela. Phase II of the introduction began in March this year. Based on the results of Phase I, APPRENDE designed and distributed an array of informational materials and trained providers about EC through workshops at their annual professional conferences. They also installed a 24 hour EC hotline (576-3DIAS) where women can get information and referrals for emergency contraception to nearly 1000 providers.

Following the March 2000 launch, several Venezuelan media ran stories, interviews and dedicated entire programs to discussion of emergency contraception. By the end of August, APPRENDE had sold over 20,000 cycles of Postinor 2. In its first month of operation, the EC hotline received 1,038 calls and is currently receiving about 30 calls a day. Unlike other hotlines, this one is not toll-free.

Although, APPRENDE considers the introduction of EC to Venezuela a success, they have identified parts of the program that need improvement. They want to design a EC training course for providers and further educate pharmacy staff about the method. In addition to their current media efforts, APPRENDE wants to fund a toll-free number for the hotline and advertise it through television spots.

Contact:

Alan Lambert
APPRENDE
Torre Mayo
Piso 1 Oficina 1-C
Av. Eraso, entre Avs. Panteón y Sorocaima
San Bernardino
Caracas
VENEZUELA
Tel: 58-2-575-0272
Fax: 58-2-576-5010
Email: prosalud@cantv.net

In the UK, BPAS clients not interested in advanced prescriptions for EC

The demand for prescription for emergency contraception in advance of need has been lower than expected at the British Pregnancy Advisory Service (BPAS). Doctors involved in recent advanced provision projects say that their clients seem to be as embarrassed to admit that they may have unprotected sex and may need EC in the future as they are to admit that they have had unprotected sex in the past 72 hours. Even women who present for abortions claim that they do not need ECs in advance because they will not risk pregnancy again. BPAS thought this program could help to make women feel as though they were taking responsibility for their reproductive health by preparing for unprotected sex, but instead they found that women are reluctant to acknowledge that they need to take such precautions.

Contact:

Ann Furedi
Director of Communications
British Pregnancy Advisory Service
Austy Manor, Wootton Wawen, Solihull
West Midlands B95 6BX
UNITED KINGDOM
Tel: 44-156-4796-1033
Fax: 44-020-7580-2995
Email: anne-furdi@easynet.co.uk

EC available in a British airport

The Manchester Airport in Britain now offers emergency contraception to travelers through a drop-in health center located in Terminal One. From the health center, travelers can get advice on STDs, emergency contraception kits and condoms. The health center is staffed by 18 nurses who are trained to treat a wide range of ailments from travel sickness to heart attacks. Patients do not need an appointment.

Contact:

Allison Browett
Kaiser Daily Reports
1501 M St., N.W.
Washington, DC 20005
USA
Tel: 202-672-5952
Fax: 202-672-5767
Email: report@kff.org

EC again available to through schools in France

In early October, the French National Assembly voted to allow the distribution of the emergency contraceptive brand NorLevo to minors without parental consent or a doctor's prescription. The vote overturned an earlier ruling that prohibited school nurses from giving EC to students. NorLevo is a levonorgestrel-only product distributed by HRA Pharma.

Contact:

Andre Ullman
HRA Pharma
63, Rue de la Colonie
75013 Paris
FRANCE
Tel: 33-1-4033-1130
Fax: 33-1-4033-1231
Email: infohra@hra-pharma.com

Media campaign raises EC awareness in India

Staff at the Population Council in India recently completed work on a media campaign to increase awareness and knowledge about emergency contraception among providers and potential users. As part of the campaign, several leading newspapers, magazines, radio and television programs ran messages on EC.
Researchers evaluated the success of the campaign by assessing the medias' willingness to run messages on EC and by determining which populations were reached by the campaign. Staff at the Council continue to disseminate information on emergency contraception and to work closely with the Indian government and other NGOs to integrate emergency contraception into reproductive health programs throughout the country.

Contact:

Anjali Nayyar
Population Council
Ground Floor, Zone 5A
Habitat Center
Lodi Road
INDIA
Tel: 91-11-464-2901
Fax: 91-11-464-2903
Email: anjali@pcindia.org

The Population Council studies public sector EC provision

Researchers at the Population Council in Bangladesh are examining methods of providing EC in public sector clinics. They are studying approaches that build on traditional practices of inducing menstruation to find out the most effective way to make EC available to the population. Through the national program, oral contraceptives will be available to women living in rural areas. The best program will be measured by reduction in abortions and miscarriages and actual EC use. The study will also provide a gauge for acceptable dedicated product pricing.

Contact:

Anjali Nayyar
Population Council
Ground Floor, Zone 5A
Habitat Center
Lodi Road
INDIA
Tel: 91-11-464-2901
Fax: 91-11-464-2903
Email: anjali@pcindia.org

DKT International train pharmacists in the Philippines about ECPs

Since late 1999, DKT International has been conducting training sessions on contraception for pharmacists and their assistants in 6 to 8 urban areas in the Philippines. The program focuses on providing OCs for use in emergency contraception. The project aims to train 520 pharmacists and 950 assistants by May 2001. They also plan to develop referral systems and to distribute information on EC in the communities of each of the target areas.

Contact:

Andrew Piller
DKT International
1120 19th Street, NW
Washington, DC 20036
USA
Tel: 202-785-0094
Fax: 202-223-5351
Email: C

NEW MATERIALS AND CAMPAIGNS

The ASEC newsletter available on PATH webpage

The ASEC electronic emergency contraception newsletter can now be found on the PATH organization's website, www.cecinfo.org. Readers can access previous editions of the newsletter in addition to other information on legislation concerning EC in the United States and internationally. There is also a link to the newsletter from the references section of the emergency contraception website, www.not-2-late.com, maintained by Princeton University's Office of Population Research.

Contact:

Tara Shochet
Office of Population Research
Princeton University
Notestein Hall
21 Prospect Street
Princeton, NJ 08544
USA
Tel: 609-258-5402
Fax: 609-258-1039
Email: shochet@princeton.edu

New Consortium publication and updated medical guidelines

The Consortium for Emergency Contraception recently released a publication documenting the Consortium's history and experiences introducing a dedicated emergency contraception product. The publication is designed for policymakers, reproductive health program managers, and women's health advocates. Expanding Global Access to Emergency Contraception: A Collaborative Approach to Meeting Women's Needs is divided into two sections.

Part I describes the Consortium's collaboration with member organizations, their relationship with private-sector manufacturers and distributors, and their strategy for stimulating discussion about emergency contraception. The first section also presents case studies from the introduction activities in four model countries (Indonesia, Kenya, Mexico, and Sri Lanka), and it includes results from each project's final evaluation reports. Part II of the publication includes emergency contraception resources for providers and clients. The section has been updated and expanded to include revised versions of instruments from the original Consortium information packet, such as the Medical and Service Delivery Guidelines, sample client information materials, and an introduction framework.

The Consortium's updated Medical and Service Delivery Guidelines also are available as a separate publication for use during training or for distribution to clinical staff.

All of these publications can be viewed on the Consortium web site, www.cecinfo.org . Please contact the Consortium to request copies.

Contact:

Kimberly Evans
PATH
4 Nickerson Street
Seattle, WA 98109
USA
Phone: (206)285-3500
Fax: (206)285-6619
Email: kevans@path.org

Emergency contraception materials database

The Consortium for Emergency Contraception and the American Society for Emergency Contraception are developing an EC materials database. The database, which will include examples of materials from around the world, is designed allow for organizations to share and adapt information, ideas, and graphics related to emergency contraception introduction and promotion. When completed, the database will be a comprehensive catalogue of available materials about emergency contraception and will include client educational materials, media materials (TV, radio, and print materials), medical guidelines, training curricula and novelty items. In addition, the database will include information about target audiences, languages, copyright status, availability and ordering information for all materials.

Contact:

Kimberly Evans
PATH
4 Nickerson Street
Seattle, WA 98109
USA
Phone: (206)285-3500
Fax: (206)285-6619
Email: kevans@path.org

US EC hotline and website expand to Canada

The emergency contraception website and hotline maintained by staff at the Office for Population Research at Princeton University has recently expanded to Canada. Now, information is available on names and telephone numbers of clinicians in British Columbia who are willing to prescribe emergency contraception by calling 1-888-NOT-2-LATE or logging on to www.not-2-late.com. The hotline also has a new Spanish mnemonic 1-866-ENTRESDIAS.

Contact:

Tara Shochet
Office of Population Research
Princeton University
Notestein hall
21 Prospect Street
Princeton, NJ 08544
USA
Tel: 609-258-5402
Fax: 609-258-1039
Email: shochet@princeton.edu

Planned Parenthood of Maryland starts "EC to Go" campaign

Planned Parenthood of Maryland and the Baltimore City Health Department are working together to distribute information about the recently launched "EC to Go" campaign. "EC to Go" provides prescriptions for emergency contraception in advance of need to women who present at either Planned Parenthood health centers or state health clinics. In the first six months of this fiscal year, 600 prescriptions for emergency contraception were filled. The dedicated products PREVEN and Plan B are also being distributed through these clinics.

Contact:

Roberta Geidner-Antoniotti
Planned Parenthood of Maryland
610 N. Howard Street
Baltimore, MD 21201
USA
Tel: 410-576-1400
Fax: 401-385-2762
Email: ppmd@erols.com

Boulder County, Colorado, Health Department launches unintended pregnancy project including EC

Recently the Boulder, Colorado, health department began a program to educate their community about emergency contraception. The "Unintended Pregnancy Project" was launched at the end of March in the University of Colorado and University Hill communities to reduce the rate of unwanted pregnancy. The health department distributed posters and wallet-sized cards with information on EC and then measured actual usage to determine if the intervention was successful. They distributed approximately 13,800 cards on campus and an additional 5,000 cards through local businesses. Also, during the seven week program, researchers at the health department surveyed women who requested prescriptions for emergency contraception. A month after the program began, providers were issuing twice as many prescriptions for EC as were prescribed the previous year.

Contact:

Allison Smith
Boulder County Health Department
3450 Broadway
Boulder, CO 80304
USA
Tel: 303-441-1100
Fax: 303-441-1452

NARAL and others petition the FDA for over the counter ECPs in the US

This past June, several women's health research and advocacy organizations testified before the FDA to urge sales of emergency contraception over the counter in the United States. The National Abortion and Reproductive Rights Action League (NARAL) and other organizations argued that emergency contraception does not require a doctor's diagnosis or other guidance. They say it is safe and effective and meets the FDA's standards for over the counter distribution. As part of the testimony, many advocates made reference to a recent study of providers listed on the Emergency Contraception Hotline (888-NOT-2-LATE) showing that the prescription requirement for EC is a barrier to access for many women. A NARAL representative added that when women called during regular business hours, only three out of four attempts to obtain ECPs resulted in appointments or telephone prescriptions within 72 hours.

Contact:

Kate Michelman
NARAL
1156 15th Street
Suite 700
Washington, DC 20005
USA
Tel: 202-973-3000
Fax: 202-973-3096
Email: naral@naral.org

Zero Population Growth campaigns against Wal-Mart for refusing to carry EC

Since the introduction of the dedicated EC products Preven and Plan B in the United States, all except one large pharmacy chain has stocked the products. In the fall of 1999, Wal-Mart, the fifth largest pharmacy chain in the country sent a memo to all company pharmacists prohibiting them to order, stock or dispense Preven. Since then, many EC research and advocacy groups protested the company's decision. Recently, Zero Population Growth (ZPG) began a media campaign to raise public awareness about the ban on emergency contraception and to encourage the company to reverse their position. ZPG's president, Peter Kostmayer, held televised news conferences in 19 cities and media coverage appeared in 12 more cities. ZPG estimates that coverage of the story reached 11 and a half million households in the country. In addition to their media campaign, ZPG has helped to deliver 41,000 petitions to Wal-Mart's CEO, Lee Scott. The organization continues to campaign against Wal-Mart and posts more infor mation on how others can help on their website, www.zpg.org.

Contact:

Jay Keller
National Field Director
Zero Population Growth
1400 16th St. NW Suite 320
Washington, DC 20036
USA
Tel: 202-332-2200
Fax: 202-332-2302
Email: jay@zpg.org

Pharmacists in Great Britain continue to distribute EC

Since December 1999, pharmacists in three inner-city health action zones in Great Britain have been providing emergency contraception to women free and without prescription. So far, more than 70 pharmacies in Manchester, Trafford, and Salford have joined the pilot program. Women receive a ten minute consultation and sign a consent form before they start the therapy. Over half of the women who present for emergency contraception were in their 20s. The project is now being evaluated based on:

• how practical the program has been for pharmacists,
• how acceptable and accessible it has been for women, including how the learned about the program,
• and the program's effect of epidemiological data such as local abortion trends.

If the pilot proves to be successful based on these criteria, it may be adopted nationally.

Contact:

Ann Furedi
Director of Communications
British Pregnancy Advisory Service
Austy Manor, Wootton Wawen, Solihull
West Midlands B95 6BX
UNITED KINGDOM
Tel: 44-156-4796-1033
Fax: 44-020-7580-2995
Email: anne-furdi@easynet.co.uk

PIWH and PSI start EC promotion project in Sacramento, California

The Pacific Institute for Women's Health (PIWH) is working with Population Services International (PSI) to develop a social marketing project in Sacramento, California, aimed at young women aged 15 to 24. The project promotes awareness of and access to emergency contraception in Sacramento county, and hopes to reduce the number of unintended pregnancies and abortions among the target population. The project includes provider training, a media campaign and a follow-up evaluation. If successful, the project could be used as a model for interventions in other cities. Work in Sacramento will continue through October 2002.

Contact:

Angeles Cabria
Barbara Pillsbury
2999 Overland Avenue, Suite 111
Los Angeles, California 90064
USA
Tel: 310-842-6828
Fax: 310-280-0600
Email: acabria@piwh.org
bpillsbury@piwh.org

The Consortium plans EC meeting in Sri Lanka

In collaboration with the Family Planning Association of Sri Lanka, the Turner Foundation and the Concept Foundation, the Consortium is planning a regional meeting in South Asia on emergency contraception and Cyclofem. Discussion topics cover different EC methods available, registering a dedicated product, and marketing strategies for countries in the region. For more information please contact the Consortium.

Contact:

Elisa Wells
Consortium for Emergency Contraception
3224 Purdue Street
Anchorage, AK 99508.
USA
Tel: (907) 279-2055
Fax: (907) 279-2055
E-mail: elisa@alaskalife.net.

RESEARCH RESULTS AND UPDATES

Women more likely to use EC when needed if they have it on hand

A recent study published in the June edition of Obstetrics & Gynecology found that women are three times more likely to use emergency contraception when needed, if it was provided in advance. Researchers at the University of California, San Francisco provided female clients at a publicly funded family planning clinic between the ages of 16 and 24 either emergency contraception pills and education about their use or education alone. Of the women who were given both pills and education in advance, 28% used them and of women who were given only information, just 7% returned to the clinic for pills following a contraceptive accident. Both groups had similar frequencies of unprotected sex. The study suggests that providing EC pills in advance increases appropriate use for more than does providing just information.

Source: Raine T, Harper C, Leon K, Darney P Emergency contraception: advanced provision in a young, high-risk clinic population. Obstetrics and Gynecology 2000 July; 96(1):1-7.

Contact:

Tina Raine
University of California, San Francisco
Dept. of OB/GYN & Reproductive Health Sciences
505 Parnassus Ave. M1490
San Francisco, CA 94143
USA
Tel: 415-476-2564
Fax: 415-476-1811
Email: tinar@ob.ucsf.edu

Population Council completes multi-center trial on modification of the Yuzpe regimen

Researchers at the Population Council have recently completed a large multi-center trial on three modifications on the Yuzpe regimen for emergency contraception. In the main trial, nearly 2000 women in three countries were randomized to one of three study arms: standard Yuzpe control, a variant of yuzpe that used ethinyl estradoil plus norethindrone in place of the levonorgestrel, or a single dose regimen, consisting of only one dose of the Yuzpe regimen rather that two. In a related observational protocol, researchers studied efficacy of treatment when given between 73 and 120 hours after unprotected intercourse. The failure rates for all the arms in the main study were not statistically different form one another, and comparable to those in the published Yuzpe literature. The failure rate for the day 4 and 5 arm was also relatively low suggesting that the 72 hour cut-off is too restrictive and women who present to the clinic 3 to 5 days after unprotected sex should not be turned away.

Contact:

Charlotte Ellertson
Escondida 110
Col. Coyoacan
México DF 04000
MÉXICO
Tel: 525-659-8839
Fax: 525-554-1226
Email: cellertson@popcouncil.org.mx

Catholic hospitals are not informing rape victims of EC in the US

Researchers at the University of Pennsylvania recently conducted a study to examine whether rape victims are adequately informed about emergency contraception when they come to the emergency rooms of Catholic hospitals for treatment. They surveyed a set of the largest Catholic and non-Catholic American Hospital Association-member hospitals in large cities in states with either permissive conscience clause laws, no laws or standard laws to examine whether conscience clauses influence EC prescribing practices. All of the 30 non-Catholic hospitals surveyed reported that they routinely offered emergency contraception. Of the 27 Catholic hospitals surveyed, twelve prohibited informing rape victims about emergency contraception, seven did not allow their doctors to prescribe the treatment and 17 did not allow their pharmacies to dispense it. Researchers say that Catholic hospital's policies towards emergency contraception prevents providers from acting in the best interest of the patient.

Contact:

Allison Browett
Kaiser Daily Reports
1501 M St., N.W.
Washington, DC 20005
USA
Tel: 202-672-5952
Fax: 202-672-5767
Email: report@kff.org

Canadian high school students not aware of EC

A new study published in the current issue of the Canadian Journal of Human Sexuality reports that Canadian high school students are not well informed about emergency contraception. Dr. Don Langille from Dalhousie University surveyed 351 female high school students in Nova Scotia, between the ages of 14 and 19. Among the girls surveyed 45% had had intercourse at least once and 80% were aware of the morning after pill. However only 8% understood that the pill must be taken within 72 hours of unprotected sex to prevent pregnancy. In addition, although only 2% had ever used EC, 18% of sexually active female students said they did not use a condom or oral contraception the last time they had sex. Researchers concluded that although young women know about EC, they are not likely to use the therapy even if they have had unprotected sex.

Source: Langille DB, Delaney ME "Knowledge and use of emergency postcoital contraception by female students at a high school in Nova Scotia" Canadian Journal of Public Health Jan-Feb;91(1):29-32

Contact:

Dr. Donald B. Langille
Medicine, Faculty of Division of Medical Education
Community Health and Epidemiology
Dalhousie University
Halifax, Nova Scotia B3H 3J5
CANADA
Tel: (902) 494-1312
Fax: (902) 494-22-11
Email: Donald.Langille@Dal.CA

The WHO and the Population Council survey IPPF affiliates on EC

In collaboration with the World Health Organization (WHO), the Population Council is conducting an informal survey about emergency contraception provision with forty-two affiliates of the International Planned Parenthood Federation (IPPF) in the Western Hemisphere. The survey is designed to gather information to formulate strategies for further work on this topic in Latin America and the Caribbean. The sixteen-question survey was administered in Spanish, English or French, depending on the primary language of the recipient country. Preliminary results showed lack of education among physicians, providers, government officials, and women themselves. Even in countries where there is an approved, dedicated EC product, campaigns to inform and educate women about the availability and use of EC are rare. Additionally, fully 20% of the countries surveyed indicated that one reason they did not provide EC was because clients had not expressed the need, whereas it is much more likely that clients were unaware such a post-coital method existed. Complete results are expected within the next month.

Contact:

Abigail Norris
Population Council
Escondida 110
Colonia Coyoacan
Mexico DF 04000
Tel: 525-659-8839
Fax: 525-554-1226
Email: anorris@popcouncil.org.mx

CORRECTION

The Spring 2000 edition of the newsletter printed an article titled, "Washington state pharmacy project brings AMA attention to EC." The article incorrectly stated that the AMA was planning to focus on issues concerning EC. The AMA is only planning to study the issue of access to EC including research on after hours access and access in communities served by hospitals and pharmacies that restrict EC from their inventory. A report on their decision is due at the next interim meeting in December 2000.

FAREWELL FROM THE EDITOR

Dear Readers,

After working as the editor of the ASEC emergency contraception newsletter for two years, I will be handing over my responsibilities to the new executive director of ASEC, Tara Shochet at the end of December. I am leaving my position at the Population Council and ASEC to continue my education. It has been a pleasure working with you all. Keep up the good work and thank you for all your support these past two years.

Sincerely,

Annik Sorhaindo
Editor

ABOUT THE AMERICAN SOCIETY FOR EMERGENCY CONTRACEPTION:

The American Society for Emergency Contraception (ASEC) is a voluntary collaboration of organizations that promote the availability of emergency contraception for women. Founded in 1997, ASEC has four mandates:

1) to serve as a source of information for the media and others who want information on emergency contraception;

2) to serve as a watchdog for inaccurate or biased articles in the press and respond with accurate letters to the editor, and to watch for abuses of reproductive rights related to emergency contraception, and draw attention to these problems;

3) to promulgate policies on emergency contraception and to support and disseminate the statements and guidelines of other organizations willing to endorse the method; and

4) to link the members of the emergency contraception field, primarily by sending out (in collaboration with the International Consortium on Emergency Contraception) this semi-annual electronic newsletter on recent events in emergency contraception and by organizing an annual meeti ng (held on the first Monday in October in New York) to share information with researchers, policy makers and the pharmaceutical industry.

ASEC is open to industry participation, although it will not endorse one method or regimen over others that are also safe and effective. Membership is free, and although the focus is primarily on the United States, international affiliates are welcome. To receive a list of the member organizations, please write to AmSocEC@aol.com.

STAFF CHANGES AT ASEC

Kelly Blanchard has retired as Executive Director of ASEC. She is replaced by Tara Shochet from Princeton University's Office of Population Research. Tara can be reached at (609) 258-5402 or shochet@princeton.edu. ASEC is managed by a volunteer steering committee consisting of Charlotte Ellertson (Population Council), Kelly Blanchard (Population Council), James Trussell (Princeton University), Kirsten Moore (Bass and Howes), Laneta Dorflinger (Family Health International), Allan Rosenfield (Columbia University), Elisa Wells (Consortium for Emergency Contraception), Jackie Buster Lawrence (Planned Parenthood Federation of America) and Elizabeth Raymond (Family Health International).

ABOUT THE INTERNATIONAL CONSORTIUM ON EMERGENCY CONTRACEPTION:

The Consortium for Emergency Contraception is an innovative collaboration among twenty-five nongovernmental and public sector organizations and a private sector industry partner. The mission of the Consortium is to expand access to emergency contraception worldwide, as well as its safe and locally appropriate use, within the broader context of family planning and reproductive health and with emphasis on developing countries.

The Consortium's immediate objectives include the introduction of a dedicated product for emergency contraception into the public and private sector markets of four developing countries;Indonesia, Kenya, Mexico, and Sri Lanka. The specific objectives of the Consortium are to:

• Serve as an authoritative source of information about emergency contraception.
• Be a voice for expanded access to and safe and appropriate use of emergency contraception.
• Serve as a strategic planning forum for emergency contraception service delivery and information, education, and communication efforts.
• Set high-quality medical and service delivery guidelines for emergency contraception based on the most current information available.
• Facilitate information sharing and networking among Consortium members and other groups working to broaden the knowledge of and access to emergency contraception.
• Encourage partnerships between public-sector organizations and private industry that are designed to make high-quality products for emergency contraception available to large numbers of women worldwide at an affordable price.
• Seek and promote new emergency contraceptive methods that are safe and effective.

The larger goals of the Consortium's introduction program are to identify and disseminate "best practices" for the delivery of emergency contraceptive services and to demonstrate for the world's policymakers, health care providers and pharmaceutical manufacturers, the widespread acceptability and need for the method.

For information about the Consortium please contact the Consortium Coordinator, Elisa Wells, 3224 Purdue Street, Anchorage, AK 99508. Phone/fax: (907) 279-2055. E-mail: elisa@alaskalife.net.