NEW DELHI: The reproductive Health Department of the Indian Council of Medical Research (IGMR) and the Department of Family Welfare has locked horns ‘overuse of quanancrine (a quinine variant) used successfully as a suppository for blocking the tubes of women in Vietnam and Chile. ‘The secretary of the Family Welfare, V.K. Shunglu, who heard about the quinine suppository during a discussion at the Cairo Conference on Population and Development, was eager that the ICMR should conduct trials on quanancrine and get its own insights. With a large number of women activists clamoring for noninvasive, nonsurgical contraceptives in India, quanancrine seemed a good alternative. Tetracycline, it was claimed, was equally effective as a suppository. But the ICMR’s reproductive unit does not share its parent body’s enthusiasm for the quanancrine suppository and has not exactly been supportive.

While some 40,000 women have tried quanancrine successfully in Chile, in Vietnam even more women hay used this suppository to limit their family size. Some six tablets are placed near the tubes and in 10 to 15 days fibroids develop blocking them. The Family Welfare officials maintain that there has not been a single case of the fibroids turning cancerous. Further, it is a onetime insertion and recanalization of the tubes is said to be easier if the mother changes her mind and wants to have a baby.

However, the ICMR did the trial of quanancrine on just eight women and claimed it was a failure. Dr. Badri Saxena of the ICMR said “at the dose of the regimen tried by us, it did not close the tubes. Since it did not work on eight we have stopped the trials.”

‘The suppository has to be used just once, It cannot be tried again with a higher regimen of quinine, ‘said Dr, Saxena. But the Ministry is pecked about the small sample. For trying out some rings on the tubes there is a sample of 3000 women. But for trying out the quinine suppository just eight women were called, the official stated.

Internationally, quanancrine has already been caught in controversy with lobbies championing it and others opposing it. According to a UNFPA (United Nations Fund for Population Activities) official, in India it is still on the backburners.

Normally, if a drug is cleared for treatment of a disease (like quinine formal aria), it does not require toxicology clearance for other uses, Butin the case of quanancrine, since it is not to be used internally but as a suppository this clearance it being sought. While the Family Health International in the US favor quanancrine since it is free of surgical intervention and is a comparatively easy method, another US group Association for Voluntary Safe Contraception ‘wants more trials and better documentation of the effects of the supposition of the effects of the suppository. ‘They maintain that it causes cramps, pain and scars the tissue. In short, they feel it is not a tidy way of ligation. Ann GO, based in Howrah, has been rooting for extensive use of quanancrine and there is talk of trials in Kamataka.

But the ministry has refused to be getting drawn into the controversy. After the unsatisfactory response of the ICMR, the ministry has got in touch with Health officials in Vietnam. Two Indian gynecologists are being sent to Hanoi in mid-January for detailed investigation of quanancrine in family planning. At least some of the 50,000 women, who have tried it, can be interviewed.

Article extracted from this publication >>  December 23, 1994