The performance of National Research Institute of Fertility Care (NRIFC), Karachi, the only public-sector institute in Pakistan carrying out testing and res earch on contraceptives and studying their side-effects, has been marred by stoppage of funds and a lack of interest in its activities by the federal government.
Established in 1962, the institute was shifted in 1990 from Saddar to Clifton, for want of space. Located on prime land in Clifton Karachi, the purpose-built health facility on 4000 square yards has 17 rooms, including a clinical trial room, a contraceptive testing lab, a biochemistry lab, a radioactive lab and a chemical storage space.
The function of this institute is to conduct research studies on reproductive health, with special emphasis on matters related to family planning. It also covers other components of reproductive health like comprehensive family planning for both females and males, safe motherhood, post-abortion care, infant health care, puberty/adolescent sexual health, management of infertility, male reproductive health and postmenopausal health.
“The centre had been doing research studies on reproductive health since its establishment in 1962, which stopped in 2010,” said an official of the centre on condition of anonymity.
This was a federal research body but after the 18th amendment, which devolved the health ministry to the provinces, the Sindh government claimed the NRIFC was under its domain. The federal government still insists it falls under the authority of Islamabad. “It is still effectively under the control of the federal government, which also releases salaries for the employees. But right now, neither of the two governments is ready to release funds for this institute, which means no testing or research is being conducted there,” says an official of the Federal Ministry for National Health Services Regulation and Coordination on condition of anonymity. “Consequently, those who are provided contraceptives face a big risk,” he adds.
Independent institutions and several other sources working for family planning centres and bodies also corroborate this official’s version. According to sources, one of the tasks of this institute was to work on new products of family planning medicines, produced both by local and foreign companies, but they are not doing it any longer.
“After devolution, the centre was not handed over to the Sindh government. Now the federal government does not have funding for it while the Sindh government is embroiled in its own problems and lack of resources,” says Dr Xaher Shah of Marie Stopes Society that works for family planning and keeps an eye on research reports and works related to family planning in Pakistan.
In order to investigate whether the centre is carrying out research on family planning medicines, studying their side effects, conducting clinical trials, testing contraceptives and doing comparative studies of new contraceptives or not, I visited the centre recently. I had tried to go there a week ago but was not allowed in. However, later Dr Intisaar Burney, Director of NRIFC, told me over the phone that their research on comparative study of contraceptives, side effects of contraceptives, clinical trials and testing of new contraceptives was still going on.
The director claimed the research was being carried out without the availability of funds but could not back his claims with evidence. The centre is supposed to send reports to the federal government detailing the number of research or tests that they have carried out in a certain year. He declined to show any such report.
On my second visit, which was managed with great difficulty, I requested the staff to let me have a look at the centre. An officer of the centre showed me around. Explaining the position of the administration of the centre, he said, “It is true the funding has stopped but we are managing the funds and still carrying out research and testing. In fact Pakistan Medical and Dental Council (PMDC) is eying the valuable land of our centre and that is why they are propagating rumours against us. They want the only state-run institute doing research in this important field in Pakistan to be shut down. The testing, clinical trials and research are still being carried out though they are confined to Sindh only because we do not have enough funds to do it for the whole of Pakistan as we used to do in the past.”
However, the officer failed to explain as to how the centre was arranging funds for research. The condition of the centre testified that its activities had been badly affected. It wore a deserted look with a few people sitting here and there. “This year some of its rooms have been handed over to the PMDC and now they are demanding eight more rooms. I don’t know who gave these rooms to them because I have not seen any written order for that,” said the officer. Legally and effectively the NRIFC is with the Federal Government.
Aamer Mehmood Kiani, Federal Minister for National Health Services, Regulations and Coordination, admits while talking to TNS that the funding for the centre had been stopped. “This is the only public-sector institute in Pakistan that carries out research on contraceptives, analysing better options, studying the side effects and carrying out tests and clinical trials. But our research was stopped because of the unavailability of funds which we are trying to restore.”
Another officer of the centre told TNS on condition of anonymity: “Before the devolution, we were being given funds regularly. We would visit universities and other institutions across the country, doing research and compiling studies in this field. But funding was first reduced to Rs2.5 million annually and then was completely stopped. So, since 2010 we have not been carrying out clinical trials, test new contraceptives for effectiveness or side-effects or carry out comparative studies on contraceptives and other matters of fertility.”
This he implied could have severe complications for those using contraceptives across the country.
There is already severe propaganda against contraceptive and family planning in the country. Many feel that lack of research and testing will further undermine the campaign for family planning, besides it will also pose serious health complications for those who are using contraceptives. Medical experts believe that studying the effects of any medicine is important to avoiding damage and harm to users.
Dr. Samina Khalid, Director of Reproductive Health Research Centre, Islamabad, told TNS that to ensure the safety of those who use it, “medicines should be tested and clinical trials should be conducted to assess whether a certain contraceptive is beneficial or not as well as its side-effects.”
TNS attempted to call Sindh Health Minister Azra Pechuho for comments over the issue but she did not take the calls nor did she respond to written questions sent to her via SMS.