From the beginning, the pill known as RU 486 has been controversial. Then, last week, the Paris-based pharmaceutical company Roussel-Uclaf announced that it was suspending distribution of the abortion-inducing drug because of mounting protests by anti-abortion organizations and because company executives and their families had received anonymous threats. Although antiabortion groups applauded the move, medical experts, family-planning associations and women’s groups argued that women would be denied the benefits of scientific progress. At the World Congress of Gynecology and Obstetrics in Rio de Janeiro, some of the more than 9,500 doctors and other medical experts attending the conference collected more than 1,000 signatures for a petition urging the company to reconsider—or at least to pass the drug’s patent on to another manufacturer. After two days of protests, the French government unexpectedly intervened. In Paris, Health Minister Claude Evin announced that the government had ordered Roussel-Uclaf to resume production of RU 486 “in the interest of public health”—and that the company had agreed to do so.
A spokesman for Roussel-Uclaf explained that the Paris-based firm had no choice but to comply with Evin’s wishes. About 36 per cent of the company’s shares are owned by the French government, while the majority of shares are held by the West German chemical giant Hoechst AG. At the same time, officials at Roussel-Uclaf insisted that there was no medical reason behind the original decision to withdraw the drug from distribution, just a month after the drug first became available in France and China.
Evin’s dramatic action served to focus heightened attention on RU 486, a steroid that, when taken in the first six weeks of pregnancy, interferes with the production of the hormone progesterone. That causes menstruation and the elimination of the fertilized egg in a woman’s womb. Although the drug is not yet available outside of France and China, supporters of women’s right to abortion in Europe and North America welcomed RU 486 as an alternative to surgical abortion, while opponents objected to it on both moral and practical grounds.
Still, medical evidence suggested that, in the early stages of pregnancy, the new drug provided a safe alternative to other forms of abortion. The respected Boston-based New England Journal of Medicine reported last December that three 200-mg tablets of RU 486—which was developed by Dr. EtienneEmile Baulieu of Paris—terminated pregnancies in 85 of 100 pregnant women when taken within 10 days of a missed menstrual period. The drug’s reported side effects include strong uterine contractions when the abortion occurs, slight nausea and fatigue.
The controversy over the new drug mounted in September when the French government authorized Roussel-Uclaf to market RU 486 in France under the name Mifepristone. The Chinese government approved the drug for use at the same time. Since then, said Baulieu, about 4,000 women have used the drug in France, with a reported success rate of 95.5 per cent.
Then, on Oct. 26, the company announced that it was withdrawing the drug because of the outcry in France, the United States, West Germany and other countries. In mid-September, anti-abortion groups began their demonstrations outside the Paris headquarters of Roussel-Uclaf. They also threatened a worldwide boycott of the firm’s products. Said Roussel-Uclaf vice-chairman Pierre Joly: “We witnessed an orchestrated campaign that became more and more powerful.” Other critics expressed anger at the decision to stop production of the drug. In a statement calling on the company to keep the drug on the market, the Geneva-based World Health Organization noted that about 500,000 women die each year from pregnancy-related causes. According to Dr. Allan Rosenfield, dean of the Columbia University school of public health in New York City, as many as 200,000 of those deaths are due to botched abortions.
Following his announcement last week that the drug would be put back on the market, Evin explained that the 1974 law legalizing abortion in France made voluntary abortions a right of women. Roussel-Uclaf’s Joly welcomed the govemment’s move. He told the French daily Le Monde: “We are relieved of the moral burden weighing on our group. For us, the problem is now solved.”
Even though the drug is not available in Canada—the company has not applied to federal authorities to have it licensed—last week’s events were watched with keen interest by observers on both sides of the abortion issue. Robin Rowe, national co-ordinator of the Toronto-based Canadian Abortion Rights Action League, said that it is important that abortions be done as early as possible. Preventing the availability of RU 486 would only make later abortions necessary, she said. And James Hughes, national president of the 200,000-member Campaign Life Coalition, said that his organization might consider a boycott of all French-made products selling in Canada. Despite its apparent medical benefits, RU 486 will clearly continue to provoke bitter debate.
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