September 27, 2010 — In the next decade, contraceptives will undergo a "high-tech revolution that will affect more people in a more intimate way than almost any other technological stride," New York Times columnist Nicholas Kristof writes, adding that this new generation of contraceptives "will be cheaper, more effective and easier to use." Although contraceptives and family planning products date back "three millennia," Kristof writes that "we're often still outwitted by wandering sperm" because "research on contraception is pitifully underfunded" and "just hasn't received the resources it deserves." He notes that "we have state-of-the-art digital cameras and decades-old family planning methods."
According to Kristof, the issue is "particularly dire in poor countries, where some 215 million women don't want to get pregnant, yet can't get their hands on modern contraceptives." This can result in "continued impoverishment and instability for these countries: it's impossible to fight poverty effectively when birth rates are sky high," he writes.
However, "impressive new contraceptive technologies are in trial and should address this problem," Kristof continues, adding that some of the new products "are expected to hit the market in the coming years, in the United States as well as in the developing world." For example, the Population Council recently completed Phase III trials of a hormone-releasing vaginal ring that could be effective for up to one year. The Phase III trials included more than 2,200 women in the U.S. and abroad, and the ring was found to be highly effective, according to Ruth Merkatz, director of clinical development of the ring for the council. She added that women said the ring was easy to insert and that their sexual partners were often unaware of the ring or untroubled by it. Kristof writes that the rings are "likely to be cheap," costing between $5 and $10 in developing countries. He notes that vaginal rings are also being tested with other medications, including microbicides to prevent HIV and other sexually transmitted infections, and medicines that can help prevent certain cancers.
"Another new contraceptive that could have far-reaching impact is the Sino-implant (II), a tiny pair of rods inserted just under the skin (typically in the arm) to release hormones," Kristof writes. Although other implants are currently used, "one great advantage of the Sino-implant is that is can last four or five years and costs $3 a year or less," Kristof writes. The implant, which has not had any safety issues so far, is currently on the market in China and Indonesia, where 100,000 units were distributed in 2009. "The only drawback is that it requires a trained health worker to insert and remove the implant," Kristof notes.
He continues that he is "happy to report that there are some nifty new technologies in the works for men," including a reversible sterilization procedure in development in India. The injection "hardens to create a plug in the duct carrying sperm," which can then be reversed with a solvent injection to dissolve the plug, according to Kristof. The procedure is expected to be introduced "on a broad scale in the next few years," he continues. In addition, researchers in France are "developing special male underclothing to raise the testes snug against the body and elevate their temperature, in effect cooking the sperm so that they are infertile," Kristof writes. The method provided "long-acting, reliable contraception in multiyear clinical trials, with no impact on testosterone," according to a report for the Bill and Melinda Gates Foundation.
"Family planning has long been a missing -- and underfunded -- link in the effort to overcome global poverty," Kristof writes, concluding, "Half a century after the pill, it's time to make it a priority and treat it as a basic human right for men and women alike around the world" (Kristof, New York Times, 9/26).