For the Record

include options for fewer physicians’ Mi f epristone Rol l o u t visits and a lower dose of mifepris- Saudi Arabia’s Obaid Begins; FDA Okays to n e . ) To Head United Nat i o n s New Contraceptive Shot Population Fun d On September 28, 2000, four years Additional restrictions that according Effective January 1, Thoraya Obaid after first declaring it safe, effective to unconfirmed reports were actively of Saudi Arabia will become execu- and “approvable,” the Food and being considered by the FDA last tive director of the United Nations Drug Administration (FDA) gave summer were not included as part of Population Fund (UNFPA), succeed- final permission for the abortion the final approval. The apparent ing Nafis Sadik, who is retiring after drug mifepristone to be marketed in decision to drop these restrictions leading the world’s largest interna- the United States as an alternative to sparked an outcry from antiabortion tional source of population assis- surgical abortion. Initial rollout of members of Congress, notably Rep. tance since 1987. The first woman the drug, under the trade name Tom A. Coburn (R-OK), who had to receive a Saudi government schol- Mifeprex, began in November. previously attempted without success arship to study at a university in the Mifepristone was approved for use in to deny FDA funds for the testing United States, Obaid has held vari- conjunction with the drug misopros- and approval of mifepristone. In ous posts within the United Nations tol (which stimulates uterine con- Oc t o b e r , Coburn and Sen. Tim since the mid-1970s, in which her tractions and is already marketed in Hutchinson (R-AR) introduced the focus has been on programs to pro- the United States) for termination of RU-486 Patient Health and Safety mote gender equality. She became very early pregnancy—through 49 Protection Act, which would “rein- director of UNFPA’s Division for Arab days’ gestation. U.S. clinical trials state” several of the reported restric- States and Europe in 1998. demonstrated the combination regi- tions, including that only physicians men to be 92% effective in terminat- “legally empowered” and trained to Obaid is the first Saudi national to ing pregnancy during that time perform surgical abortions, and those be appointed to head a United period. Whether the availability of with admitting privileges at a nearby Nations agency. The Saudi govern- mifepristone will increase the total hospital, be allowed to prescribe ment is reported to have cam- number of abortions in the United mifepristone. Although Coburn is paigned vigorously on her behalf States, as antiabortion advocates retiring from Congress, the legisla- despite the fact that in Saudi Arabia, maintain, is highly questionable; tion he drafted is likely to be reintro- women still cannot drive, need writ- many prochoice advocates predict, duced next year. ten permission from their male rela- however, that the drug will increase tives to travel, cannot socialize with the proportion of early abortions, Not to be lost in the publicity sur- men and must be covered from head because it can be used before the rounding mifepristone, the FDA also to toe in public. Saudi Crown Prince point in pregnancy when surgical approved the first once-a-month Abdullah recently called for women abortions are generally performed. contraceptive injection, marketed to have a greater role in society, under the name Lunelle. Unlike the however, and during the five-year Mifepristone will not be available to three-month injectable contracep- review of the platform from the 1995 women directly in pharmacies by tive, depot medroxyprogesterone Beijing women’s conference in June, prescription; instead, it is being acetate (or Depo-Provera), Lunelle the Saudi government announced its made available to physicians. The combines progestin and estrogen, intention to ratify the Convention FD A ’s terms of approval require that allowing women to maintain normal on the Elimination of Discrimination a woman make three visits to a estrogen levels. It offers a more regu- Against Women. physician, first to receive the lar bleeding pattern and a return to mifepristone, then two days later for fertility within 60–90 days, or about Sadik, a Pakistani obstetrician- a dose of misoprostol and once again, twice as fast as that achieved by gynecologist, was the first woman to on day 14, for follow-up. (Already, Depo-Provera. Lunelle is 99% effec- head a United Nations agency. She ho w e v e r , protocols of the National tive when injected monthly and is played a major role in forging the Abortion Federation and Planned already in use in several other coun- landmark “Cairo consensus,” which Parenthood Federation of America tries. Research into a technique that put individual women’s health and permit additional means of adminis- would allow women to self-inject is empowerment at the center of popu- tering the drug that vary from the reportedly under way. lation stabilization and development current FDA labeling. These proto- efforts and was ratified at the United cols, based on more recent studies Nations International Conference on than those considered by the FDA, Population and Development in 1994.

The Guttmacher Report on Public Po l i c y D e c e m b e r 2 0 0 0 13