Concerned about reproductive health? Strengthen the HRP

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Based at the World Health Organization in Geneva and co-sponsored by the UN Population Fund (UNFPA) the UN Development Program and the World Bank the Special Program of Research Development and Research Training in Human Reproduction (HRP) is the worlds foremost multilateral program devoted to reproductive health. The HRP was launched in 1972 to build reproductive research capacity in developing countries and to advance contraceptive research and development. Support over the first two decades came largely from Sweden the UNFPA the UK Norway and other governments. Income over recent years however has declined from $23 million in 1990 to a projected $20 million for 1994. Pledged support is also down and fears that estimated income will not be forthcoming have led to sweeping budget cuts. Waning support may reflect donor fatigue but it also stems from debate among donors and lobbyists over the focus of HRP research. Womens health activists argue that the programs current research agenda is too traditional overly focused upon contraceptive research and development and insensitive to health and human rights. These critics instead want the HRP to incorporate feminist concerns over sexual health and guard against coercive or abusive contraceptive delivery in family planning programs. Research into contraceptive vaccines and other long-acting methods should be scaled back in favor of accelerated research on barrier methods and microbicides. While some of these recommendations should be welcomed by the research community the suggestion that HRP make such radical changes risks trivializing the scientific demands of addressing sexual health and the specialized research capacities of the existing program. It would be a serious mistake to withdraw support for continuing research on long-acting methods to fund new initiatives and objectives. Barrier methods and microbicides may be needed but so are long-acting contraceptive methods and the fruits of other ongoing HRP research. Current HRP research must therefore continue and additional objectives be incorporated only pending the pledge and receipt of necessary supplementary funding. Constructive evolution of HRP may require systematic review and the targeting of future growth the outmoded names of some HRP task forces need to be updated and the participation and leadership of women scientists should be increased at HRP. Moreover stronger scientific literacy and better understanding of the research and development process among skeptics would make criticism more constructive.