Betsy Hartmann

On

November 13, the Board of Directors of Planned Parenthood of America (PPFA)

turned down a motion from its own Medical Committee which have put the

organization in the position of supporting unethical human experimentation. The

drug in question was quinacrine chemical sterilization. The Medical Committee

was prepared to involve PPFA affiliates in human trials of quinacrine before

sufficient toxicology laboratory studies were completed. The Board voted that

participation in trials would be considered if and only when the FDA gave the

go-ahead. The vote is a victory for women’s health advocates, whose timely

intervention helped prevent Planned Parenthood from making a wrong and very

dangerous decision. Coercive medical research on concentration camp inmates and

prisoners of war during World War II gave rise to the Nuremberg codes and later

the Helsinki Declaration on human experimentation. This declaration states that

"In any research on human beings, each potential subject must be adequately

informed of the aims, methods, anticipated benefits and potential hazards of the

study and the discomfort it may entail." Furthermore, subjects should be

free to withdraw from participation at any time and be advised of alternatives,

including non-treatment, in language they can understand. Doctors should obtain

their freely given informed consent, preferably in writing.

At

the Nuremberg trials Nazi doctors were taken to task for their chemical

sterilization trials on women, which included intrauterine instillation of

formaldehyde and phenol. Now over 40 years later, over 100,000 women in 19

countries, most of them in the Third World, have been sterilized with quinacrine

pellets. These trials have largely taken place in the absence of adequate

informed consent, medical screening and follow-up, in violation of the Helsinki

Declaration.

The

main promoters of the quinacrine method are two population control and

anti-immigrant extremists from the United States, Drs. Stephen Mumford and Elton

Kessel, who have the backing of wealthy donors. These include Donald Collins,

Sally Epstein, and Leland Fikes, all supporters of the conservative Federation

for American Immigration Reform. Donald Collins is also on the board of the

right-wing Scaife Family Foundation.

Previously

developed as an anti-malarial treatment, quinacrine is a known mutagen and

preliminary laboratory studies point to potential risks of cancer, birth defects

and toxicity. In addition, quinacrine may be less effective than surgical

sterilization and may increase the risk of ectopic pregnancy. Injected into the

uterus with a modified IUD inserter, quinacrine works by burning the fallopian

tubes, resulting in scar tissue that blocks the egg’s passage into the uterus.

Quinacrine is much cheaper than surgical sterilization, and thus is viewed by

its promoters as a cost-effective weapon in the war against population growth.

The Wall Street Journal quotes Mumford as saying that the drug is

"essential to population growth-control;" Mumford, in fact, believes

that overpopulation is a more serious national security threat than nuclear

weapons.

Quinacrine

has not been approved for sterilization purposes by any drug regulatory agency,

including the World Health Organization and the FDA. Nevertheless, Mumford and

Kessel have carried the pellets around the world in suitcases, recruiting local

doctors willing to engage in their vast unethical experiment. In Viet Nam alone,

over 30,000 women were sterilized until the government finally stopped the

trials. In India more than 10,000 quinacrine sterilizations have been performed

in the state of West Bengal alone. The two most zealous quinacrine supporters in

India espouse openly anti-Muslim politics; poor Muslim women, in fact, are their

preferred target.

The

international family planning community now widely accepts that many quinacrine

trials have violated based medical and informed consent protocols. Press

reports, including an award-winning piece by Alix Freedman in the Wall Street

Journal, have helped to document the extent of quinacrine abuse. Last year

women’s groups and public health specialists in India succeeded in getting the

Supreme Court of India to ban further trials there, and women activists in Chile

secured a similar ban from national health authorities in that country. Yet

Mumford and Kessel continue to operate with impunity. Their latest strategy is

to target the United States.

Extolling

themselves as ‘pro-choice’ and falsely depicting the women’s health opposition

as "handmaidens of the Vatican," Mumford and Kessel have set out to

woo abortion and family planning providers in the U.S. This past April, for

example, they showed up at the National Abortion Federation meeting in Atlanta.

Unfortunately,

given the intersection between population control and family planning interests

in this country, quinacrine is being taking seriously as a potential method.

With private population control funding, Family Health International in North

Carolina is now performing the laboratory tests required for the official FDA

process. Without that funding, it is doubtful such tests would have ever taken

place since the results of earlier lab studies were not promising.

The

more cautious among quinacrine’s supporters urge that these tests be completed

before any further human trials are conducted. The motion put before the PPFA

Board of Directors would have jumped the gun, endorsing human trials at PPFA

sites before sufficient toxicology results were in.

The

motion might have passed if a number of prominent pro-choice women’s health

advocates and organizations had not organized a major campaign to alert the

Board to the serious consequences of such an action. Their letter to the Board

not only opposes human trials in the absence of completed laboratory tests, but

also makes the point that even if the lab results indicate no specific toxicity,

the "drug is already so tainted in the minds of so many women, that the

credibility of those institutions embarking upon clinical trials would suffer

severely." In addition, it remarks on quinacrine’s easy potential for abuse

and calls for scarce research funds to be redirected to more promising

technologies, such as microbicides which could prevent sexually transmitted

diseases.

While

the PPFA Board heeded the message and voted the right way for now, the

quinacrine battle is far from over. Currently,in Chile the Ministry of Health is

considering rescinding its ban and allowing a new human trial of quinacrine in

public hospitals. Because they have big money behind them, Mumford and Kessel

will no doubt continue their campaign to win support for quinacrine in the U.S.

Approval here would help give them legitimacy overseas; they hope, for example,

that it would help lift the Supreme Court ban in India.

Further

research on quinacrine, including the present laboratory tests, only serves to

legitimize the illegitimate process by which the drug has been used to

experiment on poor women. It sends a message that there is no punishment for

those who conduct unethical drug experiments on human subjects. Instead of

further research, the priority now should be to use the Helsinki Declaration and

other internationally accepted codes of conduct to hold Stephen Mumford and

Elton Kessel accountable for their actions.

—

Betsy Hartmann is the Director of the Population and Development Program at

Hampshire College and a founding member of the Committee on Women, Population

and the Environment (CWPE) and the Quinacrine Alert Network. For further

information on quinacrine, visit CWPE’s web page, www.cwpe.org.