New EC guidelines in Portugal

In July 2015, the Portuguese Society of Contraception released Recomendações sobre Contraceção de Emergência, a guide for emergency contraception provision. The recommendations are based on WHO guidelines as well as ECEC’s guidelines. The guide will officially be presented at the Society’s annual meeting in September 2015. The Society is already working closely with pharmacists to strengthen their capacity to provide high-quality EC counselling and services. Read the guidelines here (in Portuguese) and learn more about access to EC in Portugal´s in the country profile.

Unaware of EC’s mechanism of action, Spanish Constitutional Court protects a pharmacist’s right to refuse to sell EC

In 2008, a pharmacy in Seville, (in the southern Spain’s Andalusia region) was fined for refusing to sell emergency contraceptive pills (EC). The pharmacy challenged this, however, and the case was brought up to the Constitutional Court. In July 2015 this Court found that the pharmacist’s right to “ideological freedom” was violated by the sanction, because the owners of the pharmacy in question were officially registered as “conscientious objectors”.

In Spain, conscientious objectors can refuse to perform abortions but cannot refuse to provide contraceptives. Furthermore, conscientious objection is a mechanism foreseen for reproductive health care providers, but not for pharmacists. Ignoring all available scientific evidence and even the technical criteria of the Spanish Medicine Agency, the highest national authority on this issue –  the Constitutional Court decision equates EC with pregnancy termination.

The Spanish Society of Contraception, has publicly expressed its disagreement with the Court’s ruling. The European Consortium for Emergency Contraception supports the Spanish Society statement and also regrets this decision.

The right to receive timely information on EC and to be able to access this postcoital method, is a reproductive right, and part of the body of Human Rights. A number of treaties and conventions, such as those monitored by the Committee on the Rights of the Child (CRC), the Committee on the Elimination of Discrimination against Women (CEDAW), the Committee on Economic, Social and Cultural Rights (ESCR), and the Human Rights Committee, have found that EC should be available as part of the range of modern contraceptive services offered in a country. Restrictions on free distribution of EC may violate a number of rights, including the rights to health, non-discrimination, gender equality, and to be free from ill-treatment. 

We hope that the decision is amended, upon review of the most recent evidence of EC’s mechanism of action and that efforts are made to ensure that Spanish women are able to exercise their reproductive rights, protected under the national law.

For more information, click here (in Spanish) and here (in English).

New Federal Pharmacy Chamber recommendations for EC in Germany

In January 2015, the Federal Union of German Associations of Pharmacists (Bundesapothekerkammer, or BAK) issued Rezeptfreie Abgabe von Notfallkontrazeptiva („Pille danach“), a tool to guide pharmacists when providing emergency contraception without prescription. This tool includes recommendations for action, documents for consultation and  a curricula, which can be accessed here (available in German, only).

Since April 2015 women can buy emergency contraceptive pills directly from pharmacies, without prescription.  For further information, see Germany´s country profile in our website.

New EC guideline in Spain

The Spanish Society of Contraception (SEC) just launched the Spanish edition of Emergency Contraception: A guideline for service provision in Europe, published by ECEC in December 2013.

Anticoncepción de Urgencia. Guía para la provisión de servicios en Europa, can be downloaded from the SEC´s website, here.

ECEC thanks the SEC for this collaboration and for their efforts to provide tools to foster and strengthen an evidence-based approach to EC recommendations.

Sexual health, human rights and the law. New report of the World Health Organization

States have obligations to bring their laws and regulations that affect sexual health into alignment with human rights laws and standards.

Drawing from a review of public health evidence and research into human rights law, the report Sexual health, human rights and the law shows how states can support sexual health through mechanisms that are consistent with human rights standards.

The report includes ensuring access to emergency contraception as a factor that contributes to the promotion and protection of sexual health.

Evidence shows that for adolescents, increased access to modern contraception, and particularly emergency contraception, protects them from negative health outcomes, and does not lead to unwanted sexual intercourse, unprotected intercourse, decreases in condom use, increased STIs or increased pregnancy rates (24–26).  Page 14

(…) medicines needed for the promotion of sexual health, such as antiretrovirals for HIV, emergency contraception, or mifepristone and misoprostol for medical abortion – all of which are included on the WHO Model List of Essential Medicines (46) – are often either not available (due to intellectual property laws) or are restricted or prohibited by law. Page16

Read the full report here. 

 

Update on UPA in European Union countries – May 2015

In January 2015 the European Commission issued an implementing decision, amending the marketing authorisation granted in 2009 for UPA ECPs. Sine then, the decision has started to be implemented. In most European Union countries the decision is being followed and UPA ECPs are available directly in the pharmacies or will be very soon. At the end of April 2015, the situation was the following:

  • UPA ECPs are available without prescription in Austria, Belgium, Bulgaria, Croatia, Cyprus, Czech Republic, Denmark, Finland, France, Germany, Greece, Ireland, Italy, Luxembourg, Poland, Portugal, Romania, Slovakia, Slovenia, Spain, Sweden, Netherlands, and the United Kingdom.
  • Age restrictions have been set at least in 3 countries: Croatia and Italy (for women younger than 18); and Poland (for women younger than 15).
  • In the Baltic subregion, the new marketing authorisation is being processed in Latvia, Lithuania and Estonia and UPA EC is expected to be available before the end of the year, if not sooner.
  • In Hungary, the government informed, on January 16 that, based on patient safety considerations, it will continue to require prescriptions for all emergency contraceptives.
  • In Malta no provisions have been taken to make UPA available in the islands.

 

Renewed commitment to reduce inequalities in sexual and reproductive health in Eastern Europe and Central Asia

Over a 140 participants from 19 countries, representing governments, parliaments, civil society, young people and academia, gathered in Sofia, Bulgaria in May 27-29, 2015,  to participate in the Regional Conference “Promoting Health and Rights, Reducing Inequalities: Towards Better Sexual and Reproductive Health Outcomes in Eastern Europe and Central Asia”.

Participants in the Conference, conveyed by UNFPA, reviewed the progress made and identified priorities to advance sexual and reproductive health and reproductive rights, and reduce inequalities in Eastern Europe and Central Asia. Priorities and pledges to accelerate progress are listed in the  Sofia Declaration of Commitment.

The European Consortium for Emergency Contraception hopes to contribute to the implementation of the Sofia Declaration, making emergency contraceptives more accessible in Easter Europe and Central Asai (EECA), and reducing inequalities in access within the Europe region.

 

UPA EC available without prescription in Italy

The Italian Medicines Agency (AIFA) has decreed, as of April 21, 2015, that UPA EC will now be available without a prescription in Italy for women who are 18 years of age or older. AIFA has also announced that women will not need to take a pregnancy test before being able to access UPA EC. UPA EC will remain prescription-only for women and girls under 18 years old, and LNG EC will remain prescription-only for all women. For more information, please read the official notice (in Italian) here.

Continued inequalities in access to contraceptive choice in Europe

On March 24, 2015, the International Planned Parenthood Federation European Network (IPPF EN) launched a new Barometer of Women’s Access to Modern Contraceptive Choice in 16 EU Countries (Extended). This report analyses how easily women in 16 EU countries (Bulgaria, Cyprus, Czech Republic, Denmark, Finland, France, Germany, Ireland, Italy, Latvia, Lithuania, The Netherlands, Poland, Romania, Spain, and Sweden) can access modern contraceptives. Similarly to the previous Barometer report, this new edition finds that, overall, the situation in most countries has stagnated or worsened in recent years. Although women’s access to modern contraceptives varies significantly from one EU country to the next, overall, there are growing obstacles to women getting the contraception they need due to austerity measures, financial constraints, and political and economic instability, among others. IPPF EN calls on decision-makers at all levels to implement a comprehensive approach to contraceptive choice in Europe to ensure the wellbeing of women and adolescent girls.

As IPPF EN states, “There is a major gap in research and data collection in Europe on SRHR, including access to modern contraception. This hampers evidence-based policy making that could improve the health and wellbeing of women and girls. We strongly urge EU decision-makers to boost investment in research and data collection.” ECEC works hard to fill this gap on EC-related issues and to increase knowledge on EC access across the European region.