This year promises to be an interesting one for international family planning. Here are seven issues and trends to watch for:
1. The abortion pill.
The abortion pill is at the top of the list. Distribution and sales of these drugs are increasing everywhere they are available, including Mozambique, which recently liberalized its abortion policy. Although the combination of mifepristone and misoprostol is considered the gold standard, misoprostol alone is extremely effective and may be meeting close to half of worldwide abortion demand in countries where abortion is restricted. Social marketing groups sold 3.3 million combination packs and 16 million misoprostol-only tablets in 2013 and these numbers will increase.
2. Emergency contraceptive drugs.
The line between medical abortion and emergency contraception may blur further in 2015. Low doses of mifepristone have proven to be effective as emergency contraception for some years. Ulipristal acetate, an especially effective emergency contraceptive drug, appears to work similarly to mifepristone, and may be an abortifacient at early gestation periods. More research may make it possible for women who want to avoid or end pregnancy to take a pill at almost any stage after sexual activity.
3. More women using contraceptives.
In July 2012 at a meeting in London, the family planning community agreed on a target of 120 million more women to be using contraceptives by the year 2020. A recent FP2020 report announced that 8.4 million women had been added to the contraceptive user list in 2013 but the pace will have to accelerate if the goal is to be met. The 8.4 million number may be too low; contraceptive users of socially marketed contraceptives alone have increased by an estimated 6 million between 2012 and 2014.
4. Pfizer’s Sayana Press.
In addition to the introduction of Pfizer’s Sayana Press in West Africa, the game-changing injectable contraceptive that comes in an easy-to-use, pre-filled delivery system, additional launches are anticipated in 2015. Sayana’s unique subcutaneous injection mechanism, which can unofficially be used to self-inject, could alter the landscape for contraception.
5. Contraceptive social marketing.
Anticipate continued growth in contraceptive social marketing. 2013 saw an increase of 6.4 percent over the prior year and indications for 2014 suggest a similar rise. New programs are opening up and new products and services are being introduced. An increase of 10 percent by social marketing groups would cover an incremental 7 million women, contributing towards the FP2020 goals.
6. Increased use of IUDs.
Will we see continued increases in intrauterine device use in the USA? More doctors and health administrators who were once reluctant to recommend IUDs are now comfortable with advocating their use among young nulliparous women. Discussions about the IUD have returned to the mainstream media as the setbacks from the Dalkon Shield debacle fade.
7. New leaders.
2015 will see a world without Tim Black, the iconoclastic and passionate family planning pioneer who founded and led Marie Stopes International and co-founded Population Services International. The family planning world will require a new generation of leaders to innovate, take risks and challenge the status quo. We will miss him.
What family planning trends do you predict — or would like to see — in 2015? Chime in by leaving a comment below.
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