Birth control too expensive in developing nations


WASHINGTON -- The first effort to compare the cost of modern birth control methods in a wide range of developing nations has found that, unless heavily subsidized, costs often run five times higher than couples can afford, the Population Crisis Committee said Sunday.

In some of the nations studied, the new report said, the cost of year's worth of birth control pills or condoms is higher than one-third of the annual per capita gross national product -- the measure used to compare income levels.


'This study debunks the idea, now current in U.S. foreign aid circles, that the private-for-private sector alone can provide contraception at affordable prices to the hundreds of millions of low- income couples who seek it,' said Sharon Camp, senior vice president of the committee.

'In the poorest countries, where many families struggle to pay for food, effective modern contraceptives are a luxury item,' she added.


The study looked at costs for condoms, birth control pills, IUDs and female contraceptive sterilization.

The study found that in three-fourths of the developing countries studied -- some 60 nations -- contraceptive costs in the private commercial sector exceed 1 percent of income, the level experts regard as affordable. In the United States, which has some of the highest contraceptive costs in the industrialized world, a year's supply of birth control pills cost $216 -- 1.1 percent of per capita income. A year's supply of condoms -- 100 -- cost about $92 in the United States.

In some African countries, on the other hand, a year's supply of condoms costs from one-quarter to almost one-half of annual per capita GNP. In Ethiopia, where per capita GNP is $120, a year's supply of condoms costs $36, or 30 percent of GNP.

'Paying a price of $38 for an IUD may not sound like much,' Camp said, 'but the typical Egyptian government employee -- a member of the middle class -- supports a family on less than $400 annually. An IUD represents nearly 10 percent of family income.'

The study found that, relative to per cpaita income, couples pay the lowest commercial prices for contraception in Belgium, France, Norway, Singapore and Sri Lanka. In the latter two nations, governments heavily subsidize family planning services.


Costs were highest in Burundi, the Central African Republic, Ethiopia, Lebanon, Madagascar and Burma.

Typically, the study said, less than half the population of developing countries have ready access to a range of affordable contraceptive methods through either the public or private sector while in the the developed nations, more than 90 percent of couples have such access.

'The situation is most serious in Africa, where the population is growing the fastest and where condoms are urgently needed to protect the sexually active from AIDS,' it said.

Of the sub-Saharan countries studied, only eight of 24 provide at least one-third of the population access to a range of affordable contraception methods.

It said that in Uganda, where one out of 10 adults (over the age 15) are estimated to be infected with the AIDS virus, public sector condom distribution reaches just 6 percent of the population.

Among the various methods of contraception, the study found:

--Condoms: In six countries -- Burundi, Burma, Togo, Ethiopia, Mali and Madagascar -- the price of a year's supply of condoms was 25 percent or more of per capita income.

--Birth control: The annual commerical cost of birth control pills (13 monthly cycles) is 20 percent or more of per capita income in six countries -- Kenya, Burundi, Ethiopia, Chad, Rwanda and the Central African Republic.


--IUD: The up-front cost of an IUD is more than 20 percent of per capita income in five nations -- Chad, Lebanon, Iran, Burma and the Central African Republic.

--Female Contraceptive sterilization: The study said sterilization was the most commonly used birth control method in the world and the least expensive when its cost is pro-rated over 15 years. But like the IUD, paying the cost of procedure all at one time is often expensive. In four countries, the cost is above 50 percent of per capita income -- Lebanon, Kenya, Zaire and Peru and in another 10 countries is more than 20 percent of per capita income.

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