What is the first thing that the word “contraceptive” brings to your mind, I asked a number of people. “The pill” was a common answer. “And what does the word ‘pill’ bring to your mind”, I persisted. Side-effects, problems having a second child, weight gain: these were the answers. “For whom?” I badgered. Well, for the woman of course, they’d respond with a quizzical look on their faces as if saying “is that even a question?”
Turns out it is! In Airlangga Universitsas in Surabaya, Indonesia, the world’s first non-hormonal contraceptive pill for males (yes, you heard that right) is ready to reach the market shelves, as it is about to enter Phase 3 of human clinical trials. The research is funded by BkkbN, Indonesia’s FP body. Small scale production by a herbal medicine company called Naturoz has begun. Indonesia, the world’s “poster child” when it comes to Family Planning (FP) seems to be coming up with another breakthrough.
Justicia Gendarussa, an innocent looking shrub next door, is what these pills are made of. It is mostly found in Papua, Indonesia. Under the leadership of Prof. Bambang Prijogo, research is on since 1987.
How it works, according to Dr. Bambang, is that it primarily “disturbs the enzyme system of spermatozoa,” affecting its “function, capacity, migration, binding and inhibition.” In layman language, the shrub weakens the ability of the sperm to penetrate an ovum during intercourse.
Once this pill is available world over, would it be a good idea to introduce it in Pakistan, the country that is now the world’s fifth most populous nation, promising to soon become the fourth largest if nothing is done? As this write-up is published on the “World Population Day 2012”, Pakistan’s current population clock is ticking at 180121027 on the 10th of July 2012, (more than a 180 million people) according to the Population Census Organization, Govt. of Pakistan. The Pakistan Demographic and Health Survey (PDHS) 2007 shows that only 30% of married women use any form of contraception. It would be safe to assume that the percentage of males using contraceptives would be much lower.
Barring condoms and natural methods like Coitus Interruptus (withdrawal method), men mostly are out of the contraceptive game, and even the above two methods are used with a lot of reluctance. Vasectomy, a permanent contraceptive technique, is a no-no for many reasons: it is more invasive, it is not allowed by most religions and it takes away the feeling of being in control from men…the feeling that says “I am virile and I can get my wife pregnant whenever I want”. As for female contraceptives, more mythical and less real side-effects make it a less than ideal choice for people. In a country like Pakistan where the FP decisions are still made by the man of the house and the mother-in-law, particularly in the under-privileged and rural setup where FP is most needed, the eventual result is more children than the family can handle. Eventually, these choices are resulting in more children than Pakistan can possibly handle.
In such a scenario, if the Gendarussa pill were to be introduced in Pakistan, it could be a break through. Free of harmful side-effects, it can be the solution to many problems. But men have their reservations. An unnamed interviewee shared that his wife liked the idea but he is not comfortable with it. “I have two reservations. Firstly, what if it causes impotency or effects sexual performance? Even if the label says no side effects, this will always be at the back of my mind. Secondly, is it a fool-proof contraceptive method?”
Conspiracy theories and myths regarding contraceptives being introduced as ploys to reduce male virility and fertility in general are common. Seeing the reactions the Polio campaign and iodized salt met in Pakistan, it would not be an easy option for males to accept. It was interesting to note that men interviewed were very scared of the possible side-effects, especially the possible effects on sexual performance or fertility in the long run. However, the pill’s trials indicate quite the opposite. Turns out the Ganderussa pill DOES affect sexual performance by in fact acting as an enhancer, increasing stamina and sexual health. The contraceptive effect is also temporary and reversible once the pill is discontinued.
“My major concern would be that my fertility is not permanently hampered. If there are no side-effects, I have no issues using it, especially when I compare it to using the condom which is not a method of choice for me,” says one interviewee, candidly, who believes that the couple are a team who should decide mutually and work in collaboration. Why then are men not comfortable when presented with this option, I asked. “A lot of times, it is the ego of us males that gets in the way of using contraception. But men should realize that the woman bears the child for nine months, breast feeds and takes care of the children – his children! If she can do that, why can’t he take a simple pill?” he answers, very evidently a more emancipated man, who again chose to stay unnamed.
Women, when asked, were excited about the idea. Somewhere, they felt that now the ball could be in the men’s court, and that the women would not have to be singly responsible for using contraceptives. Yet, they also expressed their apprehensions that their men could not be trusted to take the pill regularly. “If he skips it or lies about taking it, it is me who is going to end up pregnant yet again,” says an unnamed mother of four.
Journalist Sumaira Jajja whose focus is health and development feels introducing such a contraceptive in Pakistan is “a great idea but I don’t see it as an indicator of ‘Gender equality’. Gender sensitive maybe, given that any man willing to take this pill would have to be a man with a responsible attitude towards sex and contraception who would value his partner’s body as more than a ‘baby making machine’.
The idea of a side-effects-free male contraceptive is a promising one. It could cause a positive change in the status quo situation of Pakistan’s FP program. But for changing the status quo, it is the mindset that would have to be changed.