To the attention ofBoard Chairperson
Japan Society of Obstetrics and Gynaecology /Japan Association of Obstetricians and Gynaecology
August 12th, 2020

We are pleased to write to you on behalf of the European Consortium for Emergency
Contraception and the International Consortium for Emergency Contraception, in orderto participate in the process of rethinking ways to improve access to emergency
contraception pills in Japan, in the context of the COVID-19 crisis.
The mission of the European Consortium for Emergency Contraception (ECEC) is toexpand knowledge about and access to emergency contraception (EC) in Europeancountries and to promote the standardization of EC service delivery in the Europeancontext. ECEC is the European branch of the International Consortium for Emergency
Contraception, which shares the same mission at the global level. ICEC and ECEC
collaborate with the World Health Organization, and follow and disseminate its
recommendations. ICEC also collaborates with FIGO, elaborating up-to-date andevidence-based guidelines for clinical practice.
With our participation in this process, we want to share with you the recommendations
issued by international authoritative sources during the times of the pandemic, regarding
access to EC, for your consideration.
•The UK Faculty of Sexual & Reproductive Healthcare, issued on March 2020
Essential Services in Sexual and Reproductive Healthcare. See
https://www.fsrh.org/documents/fsrh-position-essential-srh-services-duringcovid-19-march-2020/. EC (oral and, where possible, fitting copper intrauterine
device - IUD) is included in the list of sexual and reproductive health services
considered essential during the COVID-19 outbreak.

•On April 2020, the World Health Organisation (WHO) proposed the use ofemergency contraception (EC), and other self-care methods, if access to regularmethods is disrupted (Contraception/Family planning and COVID-19). WHO
also recalls that EC pills can prevent up to 95% of pregnancies when taken within
5 days after intercourse, and that they can be taken by anyone with or without ahealth condition. WHO also suggests policy makers to “ensure access toemergency post-coital contraception, including consideration of over the counter
provision.”
ThefullWHO
document
isavailable
here:
https://www.who.int/emergencies/diseases/novel-coronavirus-2019/questionand-answers-hub/q-a-detail/contraception-family-planning-and-covid-19.
Inaddition, since 2010 WHO has recognized that the LNG ECP regimen (the onlyone available in Japan) is simple to follow, and that medical supervision is notnecessary for correct use. It is approved for over-the- counter or non-prescription
use in many countries. Research demonstrated that both young and adult womenfindthelabelandinstructions
easytounderstand.
See:
https://www.cecinfo.org/wp-content/uploads/2014/01/ICEC_WHO-SafetyStatement_2010-english.pdf•The statement issued in April by the International Federation of Gynecology andObstetrics (FIGO) points at key actions to ensure access to contraception services
and supplies during the COVID-19 pandemic. FIGO’s statement is based in thenotion that contraception services and supplies are core components of essential
health services and access to these is a fundamental human right. Among others,
these key action points include pro-actively promoting and supplying self-care
contraception methods, including emergency contraception. The FIGO statement
can be found here: https://www.figo.org/covid-19-contraception-family-planning•And last, but not least, the American Society for Emergency Contraception(ASEC) has also stressed the importance of ensuring access to EC in the current
times, promoting advanced provision of EC pills. See ASEC’s statement,
published last May: https://www.ec-ec.org/wp-content/uploads/2020/05/ASECEC-in-the-COVID-19-Era.pdf

The European Consortium for Emergency Contraception, a partner organization of theEuropean Society of Contraception and Reproductive Heath, stands behind and supports
all the above recommendations. The International Consortium for Emergency
Contraception also calls on countries to implement these recommendations.
The organization that you chair has the potential to play a crucial role to minimize theimpact of the COVID-19 pandemic on women’s and couple’s reproductive health andlives, and to advance reproductive rights. Removing the mandatory prescription for EC
pills would tremendously improve accessibility to this contraceptive method, the only one
that provides a second chance to prevent pregnancy. Your valued opinion on this matter,
could improve the life and well-being of millions of women in Japan. In fact, a numberof countries that had historically been reluctant to make EC easily accessible, such asCosta Rica, Malta, Italy or Andorra, have made important changes in the past five years,to allow the sale of EC directly from the pharmacies. Other countries like the UK havealso reduced the price of EC pills to overcome financial barriers.
Japan is currently one of the very few developed nations in the world that still require a
medical prescription for LNG EC (along with Poland and Hungary), and one of thecountries where the relative cost of EC is higher. We would like to encourage the Society
you chair to undertake advocacy efforts to remedy this situation, in order to improve thequality of life of the women you so profoundly care for.
We hope our comments are valuable, and remain at your disposal to provide any
additional information or support. We thank you for your time and attention.

Amy Boldosser-Boesch, MIA
Coordinator

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Cristina Puig ECECXxx