Reversible sterilization? India fights back against overpopulation

Many view India’s ballooning population –set to overtake China’s by the next decade– as a ticking time-bomb, but a solution is now at hand that, nevertheless, has taken four long decades to see the light of day.

India had only 54 million on its population chart in 1979 when a slight professor in his 40s, Dr Sujoy Kumar Guha, published his first scientific paper on Risug, a molecular drug he had developed as a reversible contraceptive for men.

He pleaded for clinical trials. But the ‘Doctor’ in front of his name was not from a medical degree; it was courtesy of his PhD studies at an American university. No go, said India’s supreme medical body, the ICMR (Indian Council of Medical Research).

Guha chose to circumvent this closed door by opting to sit his medical entrance test and by becoming a qualified medical doctor. The ICMR relented and the clinical trials began, but more than a decade had passed and Guha was now in his 50s, an age when most men tend to get somewhat flaccid of mind.

Phase One of the clinical trials progressed from rats to rabbits to monkeys and then to humans, and proved spectacularly successful in 1993. But then the ICMR brought them to a halt, after someone complained that certain components of Risug are known to cause cancer.

Guha argued that these individual substances become harmless as compounds, just as chlorine, which could melt human flesh, becomes basic everyday salt when mixed with sodium. The ICMR wasn’t convinced.

Dr Guha then knocked on the doors of the Supreme Court; Phase Two was set in motion after a few years and, by 2002, Dr Guha’s dreams were close to being realized, before another spanner was thrown in the works.

This time, it was changes to the international norms for clinical trials. It took the Indian medical authorities another five years to put these required norms in place.

The envy that took its toll

Unsurprisingly, Guha’s work evoked interest and envy in equal measure around the world. Peers began sniffing around his wonder drug, and not always with a sense of appreciation. The National Institutes of Health in the US raised questions, causing more delays.

Dr Guha believes to this day that this was meant to promote a pill-in-the-making which, unlike his one-time injectable hormone-based drug, promised a continual demand and endless profits.

Now, after another dozen years and nearly four decades all told, Dr Guha’s dream is close to becoming a reality. Extended tests on Risug have shown no side-effects. The Indian medical authorities are hopeful of introducing his reversible contraceptive to the market in the next six to seven months. It would be the first injectable male contraceptive in the world. Its competitor, the pill, is nowhere in sight.

Indian men prefer to use condoms rather than invasive vasectomy surgery to sterilize their reproductive systems. But Dr Guha’s invention is external, non-invasive and cheap, and could prompt millions to opt for it, given it’s reversible with just two counter injections. There are no barriers to physical intimacy, as with condoms.

Youth and the shackles of population

There’s a great imbalance in India’s population trajectory, with southern states meeting the global trends of less than two children per household. In contrast, families in the northern states, home to 40 per cent of India’s population, tend to have nearly four children per household.

Education, the economic dependence of women and a rural-urban divide all play roles in India’s population, which is bursting at the seams and poses a great strain on the country’s diminishing resources, such as water and energy. India has more than 600 million young people and needs 12 million jobs for them each year. Population is an issue which can no longer be put off till tomorrow.

In times gone by, around the time when Dr Guha had worked out his invention, Sanjay Gandhi, son of India’s then-reigning prime minister Indira Gandhi, opted for a compulsory sterilization programme to halt the population boom in 1976. Over six million men were sterilized in just a year. Nearly 2,000 men died because of botched operations.

In the ensuing elections, India voted the Gandhis out of power. Nobody in authority has dared to do anything as dramatic as this since those dark days.

Dr Guha, nearing 80 and still sprightly, could finally give India a solution to a problem which has seriously shackled the nation’s future. He won’t meet the tragic fate of Dr Subhas Mukherjee, who was the real architect of ‘test-tube baby’ procedure but lost the rights of invention to Louise Brown only because his work hadn’t appeared in any international journal. In 1981, Dr Mukherjee was found hanged in his Kolkata apartment.

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