Political, Not Scientific, Birth Control Solutions

In the article “Research on contraception still in the doldrums” (C. Holden, Reproductive Biology Special Issue, News, 21 June, p. [2172][1]), the title and lead paragraph assume that “there's a particularly pressing need for new forms of fertility control” to solve demographic problems. This grossly oversimplified cry for a technological fix has often been debunked ([1][2]). Holden ignores the well-documented fact ([2][3], [3][4]) that 12 to 20 years is the minimal time for development of practical new contraceptive “hardware,” during which time the Third World's population will increase by 1 to 2 billion. Hence, the focus must remain on improvements in birth control “software”—the crucial cultural, economic, public health, and women's rights issues that have been shown to work with existing methods. The remarkable drop in birthrate in China (the world's most populous country) or Mexico (11th most populous) in the past two decades was accomplished solely through “software” implementation using existing “hardware.” Even Japan's population, in spite of a limited birth control armamentarium (the Pill was only legalized in 1999), has been below replacement level for years. Thus, it is nonsense to think that the dismal demographic facts of, for instance, Pakistan or Nigeria will be solved by some new birth control method. It is shameless grantsmanship to suggest that more money for the truly exciting scientific advances outlined elsewhere in the Reproductive Biology Special Issue of Science will lead within the next two decades to any new practical contraception. The pharmaceutical industry focuses quite understandably on diseases (Alzheimer's disease, inflammation, cancer, and so forth) of the affluent, geriatric countries, rather than some new “cheap, safe, reliable, convenient, reversible, and culturally acceptable” contraceptive for the pediatric, Third World countries. It is the word “cheap” (indispensable for the Third World) and the long development times ([2][3]) that keep the pharmaceutical industry out of the birth control field. Calling skin patches, implants, or vaginal rings of old steroids “new” is a vain attempt to sugarcoat a bitter pill. Only industry can convert basic new science into practical birth control, and, as correctly stated in the article, that boat has sailed. Software improvements are the province of governments, not industry. The solution is political, not scientific, and it ill behooves Science to offer politicians an illusionary excuse. 1. [↵][5]1. C. Djerassi , This Man's Pill: Reflections on the 50th Birthday of the Pill (Oxford Univ. Press, Oxford, 2001). 2. [↵][6]1. C. Djerassi , Science 169, 941 (1970). [OpenUrl][7][Abstract/FREE Full Text][8] 3. [↵][9]1. C. Djerassi , Science 245, 356 (1989). [OpenUrl][10][Abstract/FREE Full Text][11] [1]: /lookup/doi/10.1126/science.296.5576.2172 [2]: #ref-1 [3]: #ref-2 [4]: #ref-3 [5]: #xref-ref-1-1 "View reference 1 in text" [6]: #xref-ref-2-1 "View reference 2 in text" [7]: {openurl}?query=rft.jtitle%253DScience%26rft.stitle%253DScience%26rft.issn%253D0036-8075%26rft.aulast%253DDjerassi%26rft.auinit1%253DC.%26rft.volume%253D169%26rft.issue%253D3949%26rft.spage%253D941%26rft.epage%253D951%26rft.atitle%253DBirth%2BControl%2Bafter%2B1984%26rft_id%253Dinfo%253Adoi%252F10.1126%252Fscience.169.3949.941%26rft_id%253Dinfo%253Apmid%252F4914725%26rft.genre%253Darticle%26rft_val_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Ajournal%26ctx_ver%253DZ39.88-2004%26url_ver%253DZ39.88-2004%26url_ctx_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Actx [8]: /lookup/ijlink/YTozOntzOjQ6InBhdGgiO3M6MTQ6Ii9sb29rdXAvaWpsaW5rIjtzOjU6InF1ZXJ5IjthOjQ6e3M6ODoibGlua1R5cGUiO3M6NDoiQUJTVCI7czoxMToiam91cm5hbENvZGUiO3M6Mzoic2NpIjtzOjU6InJlc2lkIjtzOjEyOiIxNjkvMzk0OS85NDEiO3M6NDoiYXRvbSI7czoyNToiL3NjaS8yOTcvNTU4NC8xMTIwLjQuYXRvbSI7fXM6ODoiZnJhZ21lbnQiO3M6MDoiIjt9 [9]: #xref-ref-3-1 "View reference 3 in text" [10]: {openurl}?query=rft.jtitle%253DScience%26rft.stitle%253DScience%26rft.issn%253D0036-8075%26rft.aulast%253DDjerassi%26rft.auinit1%253DC%26rft.volume%253D245%26rft.issue%253D4916%26rft.spage%253D356%26rft.epage%253D361%26rft.atitle%253DThe%2Bbitter%2Bpill%26rft_id%253Dinfo%253Adoi%252F10.1126%252Fscience.2667135%26rft_id%253Dinfo%253Apmid%252F2667135%26rft.genre%253Darticle%26rft_val_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Ajournal%26ctx_ver%253DZ39.88-2004%26url_ver%253DZ39.88-2004%26url_ctx_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Actx [11]: /lookup/ijlink/YTozOntzOjQ6InBhdGgiO3M6MTQ6Ii9sb29rdXAvaWpsaW5rIjtzOjU6InF1ZXJ5IjthOjQ6e3M6ODoibGlua1R5cGUiO3M6NDoiQUJTVCI7czoxMToiam91cm5hbENvZGUiO3M6Mzoic2NpIjtzOjU6InJlc2lkIjtzOjEyOiIyNDUvNDkxNi8zNTYiO3M6NDoiYXRvbSI7czoyNToiL3NjaS8yOTcvNTU4NC8xMTIwLjQuYXRvbSI7fXM6ODoiZnJhZ21lbnQiO3M6MDoiIjt9