BECAUSE CONTRACEPTIVE information, drugs and devices are now generally available in this country, many Americans have assumed there is little work left to be done in this area. The Population Crisis Committee, a Washington-based organization that supports family planning worldwide, published a report this week that should shake our complacency.
Only about 41 percent of married couples of reproductive age use effective modern contraception. These rates fall to 6 percent in the Mideast and Africa and 26 percent in Asia, outside China. Some couples choose not to practice contraception for personal, religious or cultural reasons, but many more simply do not have access to acceptable means. The perfect contraceptive would be safe, effective, convenient, nonpermanent and inexpensive, but perfection is still a long way off. In some cultures -- such as our own -- safety is more critical than expense. In others, nonpermanence (or reversibility, as it is known) is essential to building trust and assuring couples that a first step should be taken. No single method now being used combines all the desirable features, nor is any method or drug necessarily best for everyone.
In what direction should research be moving? The Population Crisis Committee believes that anti-fertility vaccines effective for periods up to five years would be welcome, especially in rural areas of the Third World where cost and access are critical factors. Male methods of contraception should be developed, particularly drugs and devices that need only be renewed periodically. And, of course, education and the provision of family planning services must be expanded as research continues.
About $175 million is now being spent each year on basic and applied contraceptive research. Experts say triple that amount could be usefully spent. U.S. and international agencies provide much of the funding, but private foundations and drug companies should be encouraged to devote additional resources to this work. There is little doubt that the technology is needed and, when provided, produces dramatic results. Birth rates in Third World countries declined 20 to 30 per- cent within a decade after family planning facilities were made available. Effective programs are absolutely essential to the health, the economy and even the survival of the poorest nations, and we can help.