WASHINGTON — The Clinton Health Access Initiative, working with the Gates Foundation and a host of foreign-aid agencies, including USAID, distributes millions of doses of birth-control injections to women in the developing world each year using tax dollars to support the pharmaceutical giants that manufacture them.

However, a growing body of scientific research — including a new study published by the AIDS medical journal — and a video released last month by the Virginia-based Population Research Institute, reports that the drugs, labeled with black-box health warnings, are also linked to women’s increased risk of acquiring the deadly HIV virus. These drugs are being sent to the very countries where AIDS is epidemic.

 

Black-Box Warning

Injectable contraceptives include Depo-Provera, a shot of synthetic hormones that act for at least three months, mostly by preventing ovulation, and are associated with a number of serious health risks.

In 2004, the Food and Drug Administration attached a “black-box warning,” its highest-level caution, to Depo-Provera because of its significant risk of causing irreversible bone loss in women. It mandates that women be informed of the risk and not use the drug for more than two years.

The three-minute Population Research Institute video describes how Depo-Provera is also documented to weaken women’s immune systems. In addition, it can thin tissue in sexual organs, making it easier for viruses like HIV, linked to AIDS, to enter the bloodstream. “Once there, it is harder for her Depo-weakened immune system to fight off the infection,” the voice-over explains.

More than 40 million people are living with AIDS. And 1 million people die of the disease each year, most of them living in Sub-Saharan Africa, where two-thirds of the Depo-Provera-like drugs are shipped each year, via groups like USAID and the Clinton Health Access Initiative.

“The United States government knows Depo is dangerous,” adds PRI. “It warns American women not to take more than eight doses in a row, but then it turns around and orders massive amounts of the drug and sends them to the very countries gripped by an HIV epidemic. Millions upon millions of doses of Depo to African women, every year.”

 

Increased Concerns

PRI’s video was released the same week the journal AIDS published its new study on drugs containing the Depo-Provera chemical, depot medroxyprogesterone acetate or DMPA. It concludes that “new information increases concerns about DMPA and HIV-acquisition risk in women” and states that if they are causally linked, the drugs have a hazard ratio of 1.5, or raise women’s risk of contracting HIV by 50%.

“This underscores the need to consider next steps on this issue carefully, in terms of clinical guidelines and further research,” said Chelsea Polis, the review’s lead author and senior research scientist at the Guttmacher Institute, the research arm of International Planned Parenthood.

Other documented risks of Depo-Provera include aggressive breast cancer, stroke, blood clots in lungs, limbs and eyes, and loss of fertility or delayed fertility after stopping Depo-Provera, and ectopic pregnancy. Many women complain of side-effects, including weight gain, hair loss, ovarian cysts, acne, suicidal depression, loss of libido, emotional flatness, nervousness, loss of menstruation and mood swings.

 

A ‘Critical Priority’

A 2011 press release from the Gates Foundation stated that there was conflicting evidence “over the past 15 years” on the question of the Depo/HIV connection. “Without a stronger evidence base,” it said, “the [Gates] foundation believes changes in policies and standards may not be warranted before the WHO evaluation of available evidence in early 2012.” It added that the question was a “critical priority.”

Subsequent research, funded in part by the Bill & Melinda Gates Foundation and the National Institutes for Health, published in The Lancet in 2012, confirmed that injectable contraceptives, including Depo-Provera, increase the risk of acquiring and transmitting the HIV-1 AIDS virus.

The Rebecca Project for Justice in Washington, which advocates on behalf of poor women, claimed that the Gates Foundation tried to discredit the research it had funded itself and manipulated regulatory authorities at the World Health Organization (WHO) to circumvent the findings — and the FDA warnings — in its campaign to promote contraceptive injections abroad.

In response to the latest findings, the Gates Foundation released a statement to the Register, similar to its 2011 press release, stating, “While various studies on this issue have shown inconclusive and conflicting results, the Gates Foundation is committed to supporting more research in this area.”

 

Injectables Explosion

Depo-Provera is manufactured by Pfizer Inc. pharmaceuticals company. A number of generic versions of the drug, which has been used as a chemical castrator for male sex offenders, are available as well. Pfizer also manufactures a similar unapproved drug called Sayana Press.

“Injectables” were highlighted as a drug of choice for women in the developing world at the Family Planning Summit in London in 2012 hosted by self-identifying Catholic Melinda Gates. She secured $4 billion from the foundation named for herself and her billionaire husband, Bill Gates, as well as from tax-funded government aid agencies around the world, including USAID, to encourage 120 million additional women globally to use contraceptive drugs by 2020.

The Wall Street Journal’s “Market Watch” at the time predicted her initiative could garner Pfizer additional annual profits of between $15 and $36 billion through increased sales of Depo-Provera.

From 1994-2000, USAID provided 41,967,200 units of Depo-Provera, primarily into African countries, at a cost of more than $40 million.

According to UNFPA External Procurement Support Reports, 2010–2013, USAID spent $116,901,577 on injectable contraceptives in that time frame. USAID-funded UNFPA spent an additional $108,354,606, and IPPF spent $4,579,112 on the drugs.

According to a document procured by PRI from the Reproductive Health Interchange, USAID underwrote shipping of 130 million doses sent to the HIV-endemic region of Sub-Saharan Africa in 2012-13.

And USAID is currently funding an experiment of Sayana Press — the brand name for a medication that uses the same drug as Depo-Provera but which is injected subcutaneously rather than intramuscularly — that encourages women to self-inject the drug in Malawi, although it is not approved or available for use in the United States.

In 2014, Pfizer, the Bill & Melinda Gates Foundation and the Children’s Investment Fund Foundation (CIFF) entered into a partnership supported by a consortium of private-sector donors and aid organizations, which includes PATH, UNFPA and USAID, to sell Sayana Press for $1 per dose to “qualified purchasers” in several countries in Africa, including Burkina Faso, Niger, Senegal, Nigeria and Uganda.

A spokesman for USAID told the Register that the agency’s programs are in line with WHO guidelines and its 2014 statement: “Hormonal Contraceptive Methods for Women at High Risk of HIV and Living With HIV.”

He added, “USAID supports activities to educate health providers and women and men on this issue, to reinforce messages on dual-method use (condoms plus another effective form of contraception) and to improve the availability of a broad range of contraceptives. These interventions enable women to make the best decision for their individual needs and life situation, including their HIV-acquisition risk.”

 

The Clinton Connection

A “Family Planning Market Report” released last week by the Clinton Health Access Initiative — a 2002 initiative of the Clinton Foundation that became a separate but affiliated entity in 2010 — looks at the “global public-sector market” for contraceptives purchased by institutional buyers such as USAID for family-planning-targeted countries. It states: “Injectables represented more than 50% of implied short-acting method users in 10 of the 12 countries: Bangladesh, Nigeria, Uganda, Malawi, Zambia, Madagascar, Myanmar, Ghana, Mozambique and Honduras.”

The Clinton Health Access Initiative received $4,375,028 from the Gates Foundation this July to expand the family-planning “method mix,” including use of injectables, and also to “invest in the long-term sustainability of a healthy [longer-term birth-control] implant market.”

According to the donor list published by the Clinton Health Access Initiative last month, organizations who contributed in excess of $25 million between 2010 and June 2016 included the Gates Foundation and foreign-aid agencies of Canada, Norway, Australia and the U.K. Donors, who gave between $5 million and $10 million during the same time frame, included the Centers for Disease Control, the United Nations Children’s Fund and the World Health Organization. The group’s main priorities are anti-retroviral drug distribution, birth control and vaccines.

 

Targeting the Poor and Blacks

From its inception, Depo-Provera has been mired in charges of eugenics. Early research in 1960s at the Grady Clinic in Atlanta violated FDA informed-consent regulations, and many of the 14,000 predominantly low-income, black and rural women given the drug were not aware it was experimental.

In the 1980s, the Phoenix and Oklahoma City Indian Health Services injected disabled American-Indian women with the drug for “hygienic purposes” — to halt their menstruation. More recent data shows one-third of American users were teens, 84% were black women, and 74% were low-income.

“It is poor women [who are] being given this drug — and black women,” said Rebecca Project’s Elaine Riddick. “They don’t have legal representation, and they are being lied to, so they don’t know. Or it is forced on these people. It’s a form of genocide.”

Register correspondent Celeste McGovern writes from Scotland.