Over 60 Global leaders Representing 12 Countries Demand WHO act on Critical Concerns Around Depo-provera and Increased HIV risk.

FOR IMMEDIATE RELEASE 26 July 2019

Contact: Dr Tlaleng Mofokeng +27 (0)82 706 8003 (Johannesburg phone & Whatsapp)
Rev. Phumzile Mabizela +27 (0)82648 7354 (Johannesburg phone & Whatsapp)
Yvette Raphael +27(0)76 612 7704 (Washington phone & Whatsapp)

Over 60 Global Leaders Representing 12 Countries Demand WHO act on Critical Concerns Around Depo-Provera and Increased HIV Risk

Over sixty leaders on sexual and reproductive health rights from twelve African countries demand WHO to act on three key concerns about the Trial on HIV risk from the contraceptive Depo-Provera. The leaders include medical doctors, Reverends and Rabi’s, HIV activists, public health educators, and a member of the Evidence for Contraceptive Options and HIV Outcomes, ECHO Trial, Global Community Advisory Group.

The open letter outlines three key requests in advance of the of global health organisation’s Guideline Development Group, GDG meeting Monday-Wednesday next week.

1. That the WHO provide more time to the GDG, African Health authorities, civil society and scholars to consider the relevance of new epidemiological, and biological evidence, including the recently announced findings from the ECHO randomised clinical trial for policy.
2. That the GDG demand transparency from ECHO researchers on their trial. In particular on how a 50% increased risk was determined as an appropriate margin – and by whom. And further that the GDG determine if this margin is still ‘clinically relevant’, and if it ever was?
3. That extensive discussion takes place at the GDG on what is meant by ‘high-risk’ women to determine how, and if the ECHO Trial’s ‘calculated effect size of potential increased risk of 30%’ is valuable enough to inform global guidelines.

“We have come together with a unified demand articulated in our open letter to the WHO (attached). If there is any indication that we could find a more clearer answer to the question about Depo-Provera and HIV acquisition I support that work and believe it must be pursued. The majority of Depo-Provera users are Africans. Policy guidelines from WHO on the increased risk of HIV from hormonal contraceptive use need to carefully consider our health and well-being”. Yvette Raphael, an ECHO Trial Global Community Advisory Group member.

“The limited interrogation of the design of the ECHO study by WHO to date shows a lack of concern for high rates of HIV infection and lack of access to safe contraception. It is clear to us that for African women and girls, it has been decided that pregnancy is worse than an HIV infection. This must end today.” Dr Tlaleng Mofokeng.

“The ECHO consortium designed a study that could only measure a 50% increase in HIV risk from using the contraception Depo-Provera. –Rather than measuring an individual’s risk – and then claims the study findings show no increased risk of HIV. To us, this shows African’s well-being was not considered. The WHO GDG must ensure our need for truthful information, and policy which protects us from a hazard is taken seriously”. Rev Phumzile Mabizela, Executive Director of The International Network of Religious Leaders Living with or Personally Affected by HIV, INERELA+ which operates in 18 countries, and 3 continents.
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2017 Growing Up Asian in America: Letter to the Senator

Commemoration of the Menstrual Health Day on the 28th of May, 2019 at City Carton Slum, Nairobi County.

Every May 28 Menstrual Hygiene Day (MH Day) raises awareness and combats taboos associated with menstrual hygiene with the goal of enabling women and girls to achieve their full potential. The date 28 May has been chosen for its special significance. May is the 5th month of the year, representing five days, or the average number of days (between two to seven) a woman or girl menstruates each month. Twenty-eight represents the average number of days in a menstrual cycle To mark this day INERELA+ Kenya engaged country networks to commemorate the Menstrual Health Day under the theme, “It’s Time for Action!. The day was used to break the silence and raise awareness as well as to change negative social norms around menstrual hygiene management for women and girls. The theme of Menstrual Hygiene Day 2019— “It’s Time for Action” not only emphasized the urgency of this public health issue but also highlighted the transformative power of improved menstrual hygiene to unlock economic and educational opportunities for women and girls.

As part of commemorations, INERELA+ Kenya engaged congregational champions and religious leaders to disseminate key messages and distribute sanitary towels to women in a low-income zone in Nairobi County in City Carton Slum. The slum is home to over 10,000 people, most of whom live below the poverty datum line. Due to the high poverty levels in the area, access to water and sanitation is a huge challenge for women and girls hence the challenges of menstrual hygiene. A total of 100 women (60 adult women above 25 years and 40 women between 12 – 25 years) were reached with key messaging as well as sanitary towels and were overjoyed by the generosity of KENERELA+.

Speaking to the participants, William Sila, the INERELA+ Kenya Communications and Programs Officer noted that in many societies, girls are marginalized and this is exacerbated by lack of proper menstrual hygiene. Approximately 300 million women menstruate every day. For millions of these women, this natural monthly occurrence is disruptive or even dangerous. Lack of adequate facilities and hygiene products coupled with myths and stigma, cause some to skip school or work or go into isolation. Many women lack access to menstrual hygiene products or sanitation facilities either due to limited availability or excessive cost Lack of menstrual hygiene management can have a significant impact on economic and educational opportunities for women and girls. Stigma and shame shroud menstruation around many societies maintain archaic and often harmful ideas and beliefs about menstruation. Such myths often portray women and girls as inferior to men and boys thus promoting gender discrimination, inequality and patriarchal practices. William challenged men to meaningfully participate in addressing menstrual hygiene and not to consider it as a women-only issue but rather a family issue. The persistence of widespread taboo surrounding menstruation results in girls in entering puberty with knowledge gaps and misconceptions about menstruation. Negative talk about periods are damaging girls’ self-esteem and sense of self-worth, putting their physical health at risk. Women and men of all ages must be made aware of the importance of menstrual hygiene through open dialogue and education at home and in school to foster engagement with this often unspoken issue.

Among the speakers was also Jesse Mbugua, a youth champion who noted that many young girls are exposed to dangers due to scanty knowledge of menstrual hygiene and called on parents to disseminate age-appropriate messaging to girls in order to empower them on sexual and reproductive health. This situation also underscores the need to expand health education women and men, young girls and boys no matter where they live must know about their bodies and sexual and reproductive health and rights. Ensuring every women’s and girls’ access to adequate MHM starts with the provision of accurate education on menstruation and menstrual hygiene so that women and girls feel confident and empowered enough to make informed decisions about their body, their health and how they manage their menstruation thus giving them the confidence to live their lives normally.

Janet Macharia, INERELA+ Kenya Legal Officer addressed the need for access to clean water for girls and women to ensure they maintain the highest standards of cleanliness. With accessible water and sanitation facilities that are safe, socially and culturally acceptable and where they can safely dispose of menstrual products within the school premises, women and girls are able to manage menstruation in privacy and with dignity and do not have to miss out on their studies when they menstruate

Apostle Njaramba noted that some of the infections including fungal infections are as a result of uncleanliness. He finalized by calling on the women and men to maintain high standards of cleanliness to ensure they do not get such infections.

Quote: “Periods are not a taboo, we must make our girls and women understand that periods is nothing to be ashamed about” – William Sila, INERELA+ Kenya.