Drug could prevent 500,000 maternal deaths a year- why it won’t…

uganda-clinic.jpgUganda maternal health clinic

AP just announced the results of a landmark study that can save the lives of countless of the poorest mothers in the world as reported by Yahoo.  They just skipped the part why it will be blocked for political reasons! The reson is at the end of the post…

They report- A cheap, easy-to-use drug that prevents bleeding after childbirth could help to save the lives of thousands of women in poor countries.  Hemorrhaging is a leading cause of maternal death in the developing world where more than half a million women die each year during labor, delivery or shortly after giving birth.  But a study done in rural Indian showed the drug misoprostol, which is manufactured by Pfizer under the brand name Cytotec, is an effective way to prevent bleeding.

Moss and her colleagues tested the drug on women in rural villages in the Belgaum District in Karnataka State in India. The estimated maternal death rate in India is 407 women for every 100,000 births each year.  About 50 percent of women in poor areas of the country give birth at home or in a facility without a doctor. The drug oxytocin, which causes the uterus to contract, is the standard treatment to prevent excessive bleeding after childbirth in developed countries.  But the drug is not suitable for use in many poor nations because it must be kept cold and be given by trained medical staff.

Misoprostol is a pill which does not need to be refrigerated and costs about 14 cents a tablet.  The study showed a dramatic reduction in life threatening post childbith bleeding and was reported in the lancet.

Ok docinthemachine why would there be a problem?  Who would stop this and why?  Will the US be sending crateloads of this inexpensive lifesaver?  — Yes there is a problem, no we won’t be sending it, and the reason is that misoprostol has two other major uses – #1 protects stomach from aspirin like drugs.  #2 Its is a very efficient, simple, inexpensive abortion pill.   That’s right and its probably the #1 use of it by gyns I know in the USA.  Misoprostol is a prostaglandin (PGE actually) that strongly stimulates the uterus to contract and expel a pregancy.  Websites exist telling women how to do so.

Now The purpose of my post is not a discussion of if abortion is right or not.  THe purpose is to let you know that the potential use of this drug for abortions is why it has been blocked for use in a majority of countries where it is needed to save the lives of women bleeding to death from trying TO HAVE a child!  The ob gyns know this.  Don’t believe me?  Professor Fathalla former President of the International Federation of Gyn Ob writes

Misoprostol, an E1 prostaglandin analogue, is approved in more than 85 countries since its first marketing in 1985.  So far it is approved only for treatment of gastric ulcer, (except in France, Brazil and Eygpt).  This is remarkable given the abundant amount of literature supporting its safety and effectiveness for several important indications in obstetrics and gynaecology.  Furthermore misoprostol is life-saving in some of these situations. Also, WHO has included misoprostol in it’s List of Essential Drugs in spring 2005. It is therefore save to conclude that misoprostol is one of the most basic drugs in obstetrics and gynaecology.

However, the current patent holder has not applied for any of these indications so far.  Consequently it is used off label in most countries.  This site contains detailed information on these indications.  Tragically, misoprostol is not approved at all in many countries which require it most i.e. misoprostol is not marketed in most parts of Africa, explaining in part the high maternal mortality.

In January 2006, Pfizer has stopped selling Cytotec in Germany without prior notice. The official reason given by the company is that misoprostol is an outdated treatment regimen and not “state of the art” anymore. Also the company stated that this decision is limited to Germany.   However it is known that Pfizer and formerly Searle have been unhappy with the use of Cytotec in OB/Gyn. And it is left to speculation how much this withdrawal is a way to get rid of the product and whether or not other countries will follow.

Strange how AP and Yahoo missed this part…

Leave a Reply

Your email address will not be published. Required fields are marked *

You may use these HTML tags and attributes: <a href="" title=""> <abbr title=""> <acronym title=""> <b> <blockquote cite=""> <cite> <code> <del datetime=""> <em> <i> <q cite=""> <strike> <strong>