The Population Council, a non-profit NGO based in New York, works with pharmaceutical companies to make family planning, childbirth and postnatal health safer and better for women and their babies. It invests in testing solutions to meet women’s reproductive health needs.
As a result, the Population Council owns the patents to birth control methods including the contraceptive implants Norplant and Jadelle, and Mirena, the levonorgestrel-releasing intrauterine system. Among other patents and developments, it has invented microbicide gels that may help prevent HIV infection.
These products aim to give women the independence to make decisions on family planning. Julia Bunting, president of the Population Council, explains how its technology helps provide access to family planning methods women prefer.
Women and Girls Hub: The Population Council’s “bench-to-bedside” approach means you work to develop new technologies for family planning methods and HIV prevention. How does this work?
Julia Bunting: Every day, 830 women are dying from preventable causes related to pregnancy and childbirth. I’m so proud that the council is currently generating the world’s largest body of research on what works to improve health outcomes in girls and women.
We invest in developing contraceptives technologies. As of today, we estimate that some 170 million women around the world are using council-developed contraceptives or technologies based on our research.
We’ve been practically the full front-end leader in developing long-acting reversible contraceptives (LARCs). These are products such as contraceptive implants that are increasing in popularity around the world, as well as intrauterine devices (IUDs), which are also still the most preferred method of contraceptive for women globally.
Women and Girls Hub: What makes a birth control method effective for women in low-income countries? Are long-acting reversible products particularly attractive?
Bunting: We all know that when women have access to reproductive health supplies and family planning information and services, they are able to make decisions for themselves about whether, when and how many children to have.
What’s important about long-acting reversible contraceptives is that, once inserted, women don’t have to think about them again. This removes the burden of having to remember to take the pill every day or go back to the clinic every three months for an injectable or negotiate condom use.
When women can use these reversible long-acting methods, they have the opportunity to keep their fertility – which is what many women want. One of the constraints, of course, is that you need to have the health systems in place to counsel women properly, insert the method and remove it.
Women and Girls Hub: What are the challenges of expanding access to long-acting, reversible birth control methods? How is the Population Council approaching these challenges?
Bunting: The NuvaRing is very popular among women in the U.S., but it lasts for only four weeks. So in order to protect yourself from a year of pregnancy, you’d need to have 13 of these rings – that means lots of visits to the pharmacy, far from ideal for women in low-income countries. It also requires cold chain storage, meaning it has to be refrigerated; in the developing world, keeping those rings refrigerated is not going to happen.
One of the most exciting projects that the council is currently doing is developing a family of contraceptive vaginal rings. This ring is also long-acting, but it can be removed and inserted by a woman herself: It’s something they can have in their hands and use when they need to. It works for one full year and doesn’t need cold chain storage.
Women and Girls Hub: How long will it take to reach the women you’re targeting?
Bunting: This product has been [in development] for 20 years and has cost tens of millions of dollars to test it for safety and effectiveness; it’s going to be submitted to the U.S. Food and Drug Administration later this year. We expect that to take maybe 10–12 months for the FDA’s review. And, of course, we need to get it registered in other countries, and then we need to get it marketed, but we are hoping by probably late 2017, mid-2018, this ring will begin to be on the market and available for women around the world.
In the family of rings we have been developing, we have another one on the market in Latin America that is suitable for use by breastfeeding women. This is because it is a progesterone-only vaginal ring, which is a natural hormone. It provides three months of protection if women breastfeed at least four times per day. We’re doing trials on acceptability for its use in sub-Saharan Africa, and we’ve just recently gotten some very positive results in Kenya. We know that there is demand for this new method.
Correction, June 7, 2016: This interview was corrected to reflect the fact that the NES/EE ring has not yet been approved by the FDA.