Injecting debate

Contraception in Brazil, like elsewhere, centres around the pill, implants and injections. If you don't have health insurance and wish to get any of these via a doctor, you will either have to pay for an expensive appointment or take your chances with the dreadful public health system. Unsurprisingly, a popular third alternative is to go to your local chemist and, in classic Brazilian fashion, get the pill or an injection under the counter. Some sort of technical loophole means they can provide these services if you ask for the brand name specifically rather than for what the drug is meant to do.

Apparently, the use of pharmacy-administered injections is on the rise. But for the past year or so, and certainly over the nine months that I've been here, the three-month injection has been "out of stock", leaving only the one-month alternative. Multiple times at multiple pharmacies we've asked why the three-month is "out of stock" and when will it be back in stock ? And of course, this being Brazil, the answer is always a pleasant but impossibly incurious "I don't know". But aren't other people also trying to find out what's going on, you inquire ? No, they aren't. Or at least that's what the pharmacies assume from their customers' silence.

Today we managed to find out a little more. The manufacturer of the three-month injection is, or rather was, Pfizer. Its drug had apparently been in use and widely available for about a decade before suddenly disappearing. A local branch of Droga Raia, one of the big pharmacy chains, told us there had been problems with the injection: women were having too many adverse side-effects. The injection was withdrawn and then briefly reinstated before being withdrawn again. The reason given on the second occasion was that Pfizer had problems getting access to the necessary raw materials with which to manufacture the product.

Yet a quick Google search doesn't seem to indicate problems with the supply of this Pfizer contraceptive in any other countries. For example, this website has mainly positive things to say about it.

So once again we are left with a deafening silence as to why things in Brazil have to be the way they are. The issue here is not so much about contraception but about the perennial passivity of Brazil's masses. There will never be any accountability in this country until people start holding others to account and stop behaving as if everything they get is some kind of gift from on high, no matter how much they are charged for it.

Update, September 9, 2011, Oxford, UK: We went to a sexual health and family planning clinic today to get the injection today here in the UK. Told them P is a Brazilian visitor and prepared to pay. Were given a three-month injection of a drug made by Pharmacia and told "there is no charge, it is a free service." Unreal contrast. PS: Never heard back from Pfizer.