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Published 11 Jul, 2012 03:33pm

Is Pakistan ready for a male contraceptive pill?

Indonesia, the world’s “poster child” for family planning is geared up for another breakthrough.

At the Airlangga Universitas in Surabaya, Indonesia, the world’s first non-hormonal contraceptive pill for males has entered its third phase of clinical trials and will be ready to reach the shelves soon. While the research for creating the pill was launched under the leadership of Professor Bambang Prijogo in 1987 and funded by BkkbN – Indonesia’s family planning body, small-scale production has been launched by a herbal medicine company called Naturoz.

Justicia Gendarussa, an innocent-looking shrub next door, is what these pills are made of. It is mostly found in Papua, Indonesia. The pill, according to Bambang, “disturbs the enzyme system of spermatozoa” and affects its “function, capacity, migration, binding and inhibition.” Simply put, the shrub weakens the ability of the sperm to penetrate an ovum during intercourse.

Once this pill is available world over, would it be a good idea to introduce it in Pakistan, the world’s fifth most populous nation? This World Population Day, Pakistan’s current population clock has ticked past 180121027 (as of July 10, 2012), according to the Population Census Organization of the Government of Pakistan. The Pakistan Demographic and Health Survey (PDHS) 2007 shows that only 30 per cent of married women use any form of contraception.  It would be safe to assume that the percentage of males using contraceptives would be much lower, if not entirely negligible.

Barring condoms and natural methods like Coitus Interruptus (withdrawal method), men mostly are out of the contraceptive game, and even these two methods are used with a lot of reluctance. Vasectomy, a permanent contraceptive technique, is a no-no for many reasons: it is more invasive, it is not allowed by most religions and it takes away the feeling of being ‘in control’ for men. As for female contraceptives, more mythical and less real side-effects make it a less than ideal choice for people. In a country like Pakistan where the FP decisions are still made by the man of the house and the mother-in-law, particularly in the under-privileged and rural setup where FP is most needed, the eventual result is more children than the family can handle and in turn, more children than Pakistan can possibly handle.

In such a scenario, if the Gendarussa pill were to be introduced in Pakistan, it could be a break through. Free of harmful side-effects, it can be the solution to many problems, but men have their reservations. An unnamed interviewee admitted his reluctance to use the pill despite his wife’s openness to the idea. “I have two reservations.  Firstly, what if it causes impotency or effects my sexual performance? Even if the label says there are no side effects, this will always be at the back of my mind. Secondly, is it really a fool-proof contraceptive method?”

Conspiracy theories and myths regarding contraceptives being introduced as ploys to reduce male virility and fertility in general are common. Judging from the reaction polio vaccination campaigns and iodized salt met in Pakistan, it would not be an easy option for males to accept. It was interesting to note that men interviewed were very scared of the possible side effects, especially the possible effects on sexual performance or fertility in the long run. However, the pill’s trials indicate quite the opposite. Turns out that Ganderussa does affect sexual performance, by acting as an ‘enhancer.’ The effect is also temporary and reversible once the pill is discontinued.

“A major concern would be that my fertility is not permanently hampered. If there are no side-effects, I have no issues using it, especially when I compare it to using the condom, which I do not prefer,” says one interviewee, who believes that the couple are a team who should decide mutually and work in collaboration. Why, then, are men not comfortable when presented with this option. “Mostly, it is the ego of us males that gets in the way of using contraception. But men should realise that a woman bears the child for nine months, feeds and takes care of the children – his children! If she can do that, why can’t he take a simple pill?”

Women, when asked, were excited about the idea. Somewhere, they felt that now the ball could be in the men’s court, and that the women would not have to be singly responsible for using contraceptives. Yet, they also expressed their apprehensions that their men could not be trusted to take the pill regularly. “If he skips it or lies about taking it, it is me who is going to end up pregnant yet again,” says an unnamed mother of four.

The author is a freelance journalist.

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