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WHO expands recommended contraceptive options, backs longer-lasting methods

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The World Health Organisation (WHO) has recommended an expanded range of contraceptive options, including longer use of some existing methods, mifepristone for emergency contraception and the development of new contraceptives for men.

The recommendations are contained in a new publication, “WHO guidelines on expanding contraceptive options”, aimed at helping countries broaden access to contraceptive methods supported by available scientific evidence.

WHO said the expansion was necessary to give people more options when deciding whether to use contraception, which method to use, and when to change or stop a method.

The global health body estimates that 164 million women who want to delay or avoid pregnancy are not currently using contraception.

Longer use of existing methods

Under the new guidance, WHO recommends that combined oral contraceptive pills may be taken for extended periods of up to six months or continuously for up to one year, instead of the conventional cyclical use.

The organisation also supports the use of contraceptive implants for up to five years, saying this could reduce the frequency of replacement procedures, clinic visits and associated costs.

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WHO also recommends mifepristone as an additional emergency contraceptive option.

It said mifepristone should be taken as soon as possible and within five days of unprotected sex.

According to the organisation, available evidence indicates that mifepristone at doses of 10 to 50 milligrams is likely to be as safe and effective as other emergency contraceptive methods.

Speaking on the need to expand contraceptive choices, Pascale Allotey, Director of WHO’s Department of Sexual, Reproductive, Maternal, Child and Adolescent Health and Ageing, said contraception should reflect people’s different needs and circumstances.

She said the choice of a contraceptive method should take into account factors including convenience, invasiveness, behaviour, reliability and accessibility.

“Choice is a gender equality issue,” Ms Allotey said, adding that contraception was not “one-size-fits-all”.

She noted that people should have the confidence and control to choose a contraceptive method, change it or stop using it.

WHO cautions against some contraceptive methods

While expanding the range of recommended methods, WHO said there was insufficient evidence to support some contraceptives for inclusion in family planning programmes.

The organisation called for further research into ormeloxifene before it is included in family planning programmes, citing limited evidence on its safety.

It also recommended against adding quinestrol-containing contraceptive pills to national contraceptive programmes because of limited evidence and reports of serious adverse events.

Push for male contraceptives

WHO said expanding contraceptive choices should also include methods that allow men to take greater responsibility for preventing pregnancy.

Currently, the main contraceptive methods under men’s direct control are condoms, withdrawal and vasectomy.

Despite the limited options, WHO said about 30 per cent of couples rely on a male method of contraception.

The organisation said its research challenges the longstanding assumption that men would not use new contraceptive methods.

More than 75 per cent of couples surveyed said they would be willing to use a new male contraceptive, while more than 85 per cent of women said they would trust their male partners to take responsibility for contraception.

To support the development of new methods, WHO has developed its first Target Product Profile for male contraceptives.

The profile outlines characteristics that future male contraceptive methods should aim to meet, including safety, effectiveness, acceptability and affordability.

READ ALSO: WHO urges safer care for people living with noncommunicable diseases

WHO said the profile is intended to provide researchers, funders and developers with clearer direction while helping to shape a contraceptive market that reflects users’ needs.

New male contraceptives in development

Several hormonal and non-hormonal male contraceptive methods are currently being researched, with some candidates in advanced clinical trials.

WHO said this suggests that new reversible male contraceptives could reach the market within the next five to 10 years.

The organisation said it would continue supporting countries to update their policies and family planning programmes in line with the best available scientific evidence.


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Health

DRC Ebola outbreak remains active as death toll reaches 3,779 – Africa CDC

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The Africa Centres for Disease Control and Prevention (Africa CDC) says the Ebola outbreak in the Democratic Republic of the Congo (DRC) remains active, with 7,820 cases and 3,779 deaths recorded nationwide.

Wessam Mankoula, regional director at the Northern Africa Regional Coordinating Centre, Africa CDC, said this during a Thursday webinar on the Ebola outbreak in the DRC and ongoing response efforts.

Mr Mankoula said the outbreak had affected 63 health zones across seven provinces, with 49 health zones still in the active phase and continuing to report cases across the DRC during response operations.

He said eight health zones had entered the sustained controlled phase, while six others were in the controlled phase after reporting no cases for specified periods under routine monitoring.

According to him, the outbreak has plateaued over the past five weeks, partly driven by declining cases in Ituri, the epicentre of the outbreak in DRC, and surrounding areas.

He, however, cautioned against interpreting the decline as evidence that the outbreak was under control, noting that some provinces were still recording upward trends in several affected provinces.

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Mr Mankoula said cases in Ituri declined by 25 per cent during the latest three-week period, while deaths dropped by 31 per cent compared with the previous three weeks overall, as recently reported.

He said North Kivu recorded a different trend, with cases increasing by 56 per cent and deaths rising by 19 per cent during the same three-week period there, in recent weeks.

The official said North Kivu also recorded the highest case-fatality ratio of about 60.5 per cent, compared with the national average of approximately 48 per cent during the outbreak period.

He attributed the situation partly to insecurity and limited access to affected communities, which were making active case searches and contact tracing increasingly difficult for health workers in affected areas.

Mr Mankoula said children below five years were among the most affected groups, prompting collaboration with UNICEF to strengthen case management for paediatric patients in affected areas in the region as needed.

He said community transmission remained a major concern, with about 65 per cent of reported cases occurring within communities, requiring stronger engagement and deployment of community health workers across affected communities.

Mr Mankoula said the contact listing had improved from about 10 contacts per case at the beginning of the outbreak to approximately 20 per case in affected areas currently.

He said the figure remained below the target of 60 contacts per case, emphasising the need to strengthen contact tracing and community-based surveillance in affected communities nationwide.

READ ALSO: Ebola spread in DRC linked to delayed detection, insecurity — Africa CDC

The Africa CDC official said the response had also expanded laboratory capacity, with 24 laboratories now able to conduct more than 3,400 tests daily across affected areas in the affected region.

He said additional laboratory equipment and more than 100,000 test kits had been provided to strengthen testing in affected and neighbouring areas across the region, supporting response efforts. (NAN)


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Ebola spread in DRC linked to delayed detection, insecurity — Africa CDC

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The Africa Centres for Disease Control and Prevention (Africa CDC) says delayed detection, diagnostic challenges, insecurity and community mistrust contributed to Ebola’s rapid spread in eastern Democratic Republic of the Congo (DRC).

Yap Boum II, head of emergency preparedness and response, Africa CDC, said this on Thursday during a webinar on the ongoing Ebola outbreak in DRC.

Mr Boum said the outbreak involved Bundibugyo virus, a less commonly detected Ebola species, unlike the Zaire strain previously associated with most Ebola outbreaks in the DRC.

He said existing diagnostic test kits in eastern DRC could not initially detect Bundibugyo virus, allowing the disease to spread undetected before laboratory confirmation and response measures.

According to him, the outbreak was detected and officially declared on 15 May, almost five months after the disease had begun spreading in the region.

Mr Boum said delayed detection contributed to the rapid escalation from eight cases in three health zones to more than 2,000 cases across 46 health zones.

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He said the outbreak had subsequently expanded to 63 health zones across seven provinces, making it the largest Ebola outbreak recorded in the DRC.

The official identified insecurity and limited accessibility in eastern DRC as major operational challenges affecting active case searches, contact tracing and access for response teams.

He said community mistrust had further complicated efforts to control transmission, requiring stronger engagement with affected communities and increased community-based response activities.

READ ALSO: Ebola: Nigeria on high alert as cases rise in DRC

Mr Boum said the current outbreak differed from previous Ebola outbreaks in the DRC because of the virus type, insecurity, accessibility challenges and community concerns.

He said the situation demonstrated the need for stronger diagnostic preparedness for less common pathogens, particularly in regions where outbreaks could spread before laboratory confirmation.

The Africa CDC official called for increased resources and political support to enable responders to access affected communities and strengthen disease-control operations safely.

He said the response required not only financial resources but also political support to improve security, community cooperation and access to affected areas.

(NAN)


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