Misanet.com / IPS, 9 January - Norlevo, commonly known as "the day-after pill", is now available over-the-counter to Cameroonian women who want to avoid unwanted pregnancies after unprotected, or poorly protected, sex. While government officials hope the pill will reduce the demand for abortion, parents and rights advocates fear that its availability will encourage promiscuity.
A study conducted in 1999 on 485 patients at the University of Yaounde showed that to prevent a pregnancy, almost nine percent of women take a large dose of nivaquine after sexual intercourse, and 20 percent take a large dose of contraceptive pills.
According to the study, 15 percent either swallow or insert potentially dangerous concoctions in the vagina to prevent pregnancy. The concoctions include mixing whiskey with honey, or using salt water, tree bark, herbs or other potions. Forty percent prefer to wait before seeking either an illegal or legal abortion.
Lydienne Noumbissi, a midwife in charge of a Yaounde clinic, says women who use concoctions risk sterility, serious infection, or even death. To avoid the risks of concoctions, the Ministry of Health authorised a year ago importation of Norlevo into Cameroon. Pharmacists began to sell the drug in Yaoundé, the capital, on 19 December.
Dr. Francis Mboudou, a gynaecologist-obstetrician at Yaoundé's general hospital, says Norlevo is a 97-percent effective method of preventing unwanted pregnancies if it is taken soon after sexual intercourse. The first 759-microgramme tablet must be taken within 72 hours, and the second tablet, 12 to 24 hours later.
- If you wait more than three days after intercourse to take the first dose, it will have no effect, says Dr. Doh Anderson, a physician at the hospital. According to him, "the day-after pill" does not cause an abortion, as it has no effect on the union between egg and sperm.
Even so, parents remain sceptical. They believe that Norlevo will make girls to become sexually overactive. "Those who abstain, even if only during their fertile periods, now have nothing more to fear since 'the day-after pill' is now availability in every corner drugstore," Desire Kamdoum, mused glumly.
Adeline Mekue, a housewife, agreed. "While aiming to reduce voluntary abortions, the authorities may be encouraging children to be promiscuous."
Josephine Madiese, who is a rights activist, fears that the pills' use will be subverted so that it will become the only available method of contraception. "I don't use condoms because they interfere with your pleasure. As a consequence, I am often at risk of becoming pregnant when I don't abstain during my fertile periods," says Berte Ayissi Edzoa, a sociology student at the University of Yaoundé. She says she has "used Norlevo twice after having unprotected sex."
- I was afraid of getting pregnant, Edzoa says. "The first time, I had sex on the thirteenth day of my cycle. I went to the pharmacy and a lady there suggested Norlevo, which I hadn't heard of. The second time, it was the sixteenth day. I used Norlevo again and everything was fine."
Saad Harti, the Norlevo brand manager for HRA Pharma, the company which markets Norlevo in Europe, thinks that "the high cost of the product will be a sufficiently dissuasive factor for those who think they're going to use it regularly." A packet of two tablet course of treatment costs 3,315 CFA francs (US$ 4.50 or Euro 5.05).
To provide access to poor women, Harti says 20,000 boxes should be provided to non-governmental organisations (NGOs) in Cameroon between now and March. The drug will be sold cheaply to women in need.
Etienne Kenfack of Distrimed, Norlevo's distributor in Cameroon, says the pill is only supposed to be used in cases of extreme emergency, such as when a male or female condom rips during sexual intercourse. Or when a woman forgets to take two or more birth control pills, when an ovulation date has been miscalculated, or, in the worst case, after a rape.
After a course of Norlevo, he says, it is imperative to take additional contraceptive precautions, such as the use of condoms or spermicide, until the beginning of one's next menstrual period. "Then, to go to a family planning centre where health professionals can give you all kinds of advice on the usual contraceptive methods," he says.
He warns that "the day-after pill" provides no protection whatsoever against AIDS or other sexually-transmitted diseases (STDs). Regular use of a condom, as well as sticking to one partner, or abstinence, is still the only effective method to avoid AIDS and STDs, he says.
Developed by the French pharmaceutical firm Bestin-Iscovesco in 1989, Norlevo has been used by more than two million European women.