The Great Viagra Emergency
Title: The Great Viagra Emergency , By: Itoi, Kay, Newsweek (Atlantic Edition), 01637053, 02/08/99, Vol. 133, Issue 6
Section: ASIA
Japan’s Health Ministry wasted no time approving the potency wonder drug. So why have women been kept waiting for the Pill since 1961?
JAPANESE MEN MAY FEEL LIKE CELEBRATING. TOO BAD IF many of the nation’s women are not in the mood. The government has just announced its decision to let the country’s pharmacists sell Viagra, the male impotence remedy. This certainly is happy news for patients in need of such medicine. Even so, the announcement raises some serious questions about the approval process–especially about the Japanese government’s official handling of another widely known medication: the low-dose birth-control pill, a.k.a. the Pill.
Reviewing a new drug for sale in Japan usually requires a minimum of two years. The manufacturers of Viagra won approval in an unprecedented six months. Meanwhile, despite decades of clinical research, Japan remains the only member of the United Nations where the Pill is banned. The blatancy of the legal double standard is not only frustrating–it’s infuriating. “The situation epitomizes the sexism of our society,'’ says Chieko Nohno, a female member of the Diet. “The Health and Welfare Ministry gives [Viagra for] sexual gratification. But are those men going to use it with their wives, who are not allowed reliable birth control?'’
Private citizens are suggesting all kinds of theories about why Viagra won approval so fast. Some people contend it’s because the country’s mostly male politicians wanted access to the drug for their own use. Others speculate that the aim is to help boost Japan’s birthrate (currently only 1.39 children per woman) and avoid a population crash. The government has its own explanations. Lots of them. The Ministry of Health and Welfare says it’s trying to shorten the review process for all drugs, not just Viagra. And impotence is a medical problem, meaning official action on Viagra is a matter of public urgency. Without cracking a smile, the bureaucrats say the Pill can wait because it’s for healthy women. Furthermore, the country’s health authorities have recorded at least one Viagra-related death. They say unregulated use of gray-market Viagra could place Japan’s men in danger.
Danger? “They have neglected other forms of danger,'’ says Masako Horiguchi, a prominent female gynecologist. Take, for example, the danger of unwanted pregnancy. Every year more than 20 percent of all pregnancies in Japan end in abortionand another. “Once they’ve done it one time,'’ says Kitamura, “they feel it was very easy.'’
Not that Japan has totally ignored the Pill. Japanese clinical tests on oral contraceptives started in 1961, a year after they were first approved in the United States. Research soon stopped amid public worries over “sexual immorality,'’ and serious legalization efforts didn’t resume until the mid-1980s. Japan’s Health minister opined in 1992 that the Pill might increase risk of AIDS infection because people would stop using condoms. Last year the Health Ministry announced yet another concern: the risk of environmental pollution by chemical hormones that are flushed out of Pill takers into waste water. “I don’t know how many times we heard it was getting close,'’ recalls Horiguchi, “but they always came up with some excuse.'’
Anti-Pill propaganda has been so effective that only 7 percent of Japanese women say they even want oral contraceptives. Nearly four fifths of the sexually active population uses condoms. Widespread reliance on condoms in Japan dates back to World War II, when soldiers were required to use them when visiting “comfort women.'’ “Taking the Pill feels kind of scary,'’ says Tomoko Satake, a college student who was recently browsing through colorfully packaged flavored condoms at Condomania, Tokyo’s funky condom shop. “It changes the system of your body, doesn’t it?'’ Many women share that view. More than 70 percent of women polled cited fear of side effects as the reason they wouldn’t use the Pill. Horiguchi blames such attitudes on a lack of public information. “Most women don’t know what the effects are, or what improvements have been made over the years,'’ she says.
Women’s-rights activists haven’t exactly helped their own cause. In the 1970s, one high-profile group focused on contraceptives. Led by Misako Enoki, a pharmacist-turned-radical feminist, they marched and screamed in pink helmets, effectively provoking ridicule instead of respect. Enoki’s celebrity, thankfully, was short-lived, but her protests seem to have exerted a lasting impact. “Feminists who want to be taken seriously have since stayed away from the topic,'’ says literary critic Minako Saito.
If the activists didn’t help, perhaps international pressure will. Hope springs eternal: there are rumors that the ban will be lifted later this year. Neither the Health Ministry nor pharmaceutical firms will comment. In June the United Nations will hold a special session to review progress on the program adopted by the 1994 population conference in Cairo, where Japan was criticized for not approving the Pill. The Japanese government must be eager to report “progress'’ at this year’s meeting.
The experts, meanwhile, are cautious–understandably so. “High-ranking bureaucrats are mostly old men,'’ says gynecologist Horiguchi. “They are probably still not willing [to give women the Pill].'’ By the way, Viagra isn’t the only long-awaited drug recently OK’d for sale on the Japanese market. The Health Ministry has also approved minoxidil, sold as Rogaine in the United States for the treatment of male baldness. Healthy women can wait for the Pill. But the suffering bald men of Japan need relief.
ILLUSTRATION
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By Kay Itoi
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Source: Newsweek (Atlantic Edition), 02/08/99, Vol. 133 Issue 6, p39, 1p
