Special Programme on Human Reproduction

Last updated

The Human Reproduction Program -UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP) is a WHO co-sponsored research programme on human reproduction. HRP is based at the WHO headquarters in Geneva, Switzerland. [1] Its goal is to support and coordinate research on a global scale. It is part of the Sexual and Reproductive Health and Research (SRH) department of the WHO. [2] [3] [4]

Contents

It resulted in the following marketed combined injectable contraceptives: [3] [4] [5] [6] [7] [8] [9] [10]

And in the following never-marketed progestogen injectable contraceptives: [2] [5]

Creation of the Human Reproduction Unit

Since the first United Nations World Population Conference, held in Rome in 1954, the United Nations had a growing interest in the issue of demography and associated it with the economic difficulties of developing countries. following a request of the UN General Assembly, [11] the Secretary-General conducted an inquiry among the member-States and concluded there were indeed concerns among the developing countries about the growth of their populations. These findings were taken into account by the General Assembly in the resolution 1048 (XXXVII). [12]

As the Second World Population Conference was meeting in Belgrade in 1965, the WHO was wondering how it could contribute. [13] For the Director-General, as he said in a report demanded by the WHO Executive Council, "the importance of many medical, biological, social, cultural and economic factors in human reproduction makes it a major public health problem", [12] which justified the decision to work on the demographic question, especially via the subject of human reproduction. The report was approved by the World Health Assembly, and it was decided to study sterility, the regulation of fertility, and the health aspect of demography. [14] This mark the beginning of the Human Reproduction Unit. Its mission was to give technical advice on human reproduction aspects that were involved in public health.

Development of the Unit and creation of a global program of research

The Human Reproduction Unit continued its mission and expanded its research not to only take into account strictly the medical aspect of human reproduction, but also economic, sociological, cultural, and psychological factors. The Unit was organizing meetings of experts and began to create a centre of documentation on human reproduction. In 1970, the WHO designated the Reproductive Endocrinology Research Unit of the Karolinska Institute of Stockholm as research and training centre on human reproduction. [15]

Pleased by the progress made, the World Health Assembly requested the Director-General to consider a way to develop family planning services. [16] In 1970, the WHO launched a feasibility study about a global program of research on human reproduction. A report was thus presented in 1971 and advocated for a five ways action plan. [17] First, the designation of four Research and Training Centres, which would have to be leaders on the research on human reproduction in their respective region. Second, the collaboration with Clinical Research Centres to facilitate the clinical evaluation of new fertility regulating agents. Third, the creation of task Forces to conduct the research projects. Fourth, the creation of an international documentation centre on biomedical aspects of human reproduction (this point was not executed due to limited funding at the time). The fifth point was about secondary objectives and miscellaneous recommendations.

The Human Reproduction Unit was charged with the creation and administration of the new "Expanded Programme of Research, Development, and Research Training in Human Reproduction". In 1972, the World Health Assembly voted the WHA25.60 resolution "on WHO's role in the development and coordination of biomedical research", which requested the Director-General to "prepare proposals for the development of long-term WHO activities in biomedical research within the framework of the programmes being carried out by the Organization". [18] He presented a report on this matter in December of the same year, including human reproduction and especially the Expanded Programme in the researches to fund. [19] According to previous directors of the Programme, it is the date which formally established the HRP. [20]

Expanded Programme of Research, Development, and Research Training in Human Reproduction

The Expanded Programme was directed by an Advisory Group of 12 to 15 people designated by the Director-general. Their role was to advise the WHO on the policies, the strategies, the research priorities, and the resource affectation. [21] The technical details of the scientific projects, the control of the publications and works of the Task Forces were delegated to a Review Group, which also designated the Clinical Research Centres.

In 1977, the Expanded Programme became the Special Programme.

Evolution to a Co-sponsored Special Programme

In 1986, the structure of the Programme changed. [22] The advisory Group was replaced by the Policy and Coordination Advisory Committee (PCAC), a consultative organ to the Director-General which made recommendations on issues linked to the policies, funding and general organization of the programme. It was composed of 30 members, twelve being the countries that contributed the most, twelve elected by the regional committees, three elected by the PCAC itself and the UNFPA, World Bank and IPPF as permanent members. The new structure also included the Scientific and Technical Advisory Group (STAG): [23] composed of 10 to 15 members (experts and scientists) it designated the Programme research priorities, the creation or end of a task Force, and gave an independent evaluation of all scientific and technical aspect of the Programme.

In 1988, the co-sponsorship of the Programme began: [23] the UNDP, UNFPA, World Bank and the WHO were co-sponsors of the "UNDP/UNFPA/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction", commonly referred to as "the HRP". This had to objective to obtain consequent and stable funding for the Programme. The PCAC became the Policy and Coordination Committee (PCC), in charge of the administration, the approval of the budget, and the general orientation of the work of the Programme and included the co-sponsors as permanent members. A Standing Committee, composed of representatives of the co-sponsors meets thrice a year, monitors the Programme situation and formulates recommendations to the PCC. As the executive agency, the WHO nominates the director of the Programme and other non-elected members of the HRP after consulting the Standing Committee. The STAG had also now to report to the Standing Committee while the Review Group is replaced by the Research Project Review Panel which had similar attributions, but includes also the control of the financial aspect of the research projects.

Finally, in 1996, the Gender Advisory Panel was created in order to keep particular attention to issues linked to gender inequities, mutilations and violence based on sex and rights based on sexual practice and orientation. [24] It became the Gender and Rights Advisory Panel in 2007.

The HRP was still part of the Human Reproduction Unit, but other WHO organs were working on demography-linked subjects. Thus, in 1998, to avoid duplicate efforts, the Unit merged with the Reproductive Health Division into the Department of Reproductive Health and Research (RHR). [20] The RHR was composed of the HRP, which was focused on research and training but without operational activities and the Programme Development in Reproductive Health (PDRH), which was tasked to translate the HRP's work into policies and operational actions. The STAG extended its attribution to also supervise the PDRH. Ultimately, following a global reform of the WHO structure in 2019, the RHR was placed under the responsibility of the UHC/Life Course Division and became the Department of Sexual and Reproductive Health and Research (SRH). [25]

In 2012, UNICEF joined the co-sponsors.

See also

Related Research Articles

<span class="mw-page-title-main">Levonorgestrel</span> Hormonal medication used for birth control

Levonorgestrel is a hormonal medication which is used in a number of birth control methods. It is combined with an estrogen to make combination birth control pills. As an emergency birth control, sold under the brand names Plan B One-Step and Julie, among others, it is useful within 72 hours of unprotected sex. The more time that has passed since sex, the less effective the medication becomes, and it does not work after pregnancy (implantation) has occurred. Levonorgestrel works by preventing ovulation or fertilization from occurring. It decreases the chances of pregnancy by 57 to 93%. In an intrauterine device (IUD), such as Mirena among others, it is effective for the long-term prevention of pregnancy. A levonorgestrel-releasing implant is also available in some countries.

Male contraceptives, also known as male birth control, are methods of preventing pregnancy by leveraging male physiology. Globally, the most common forms of male contraceptives include condoms, vasectomy, and withdrawal. Men are largely limited to these forms of contraception, and combined, male contraceptives make up less than one-third of total contraceptive use today. The most commonly used method is the male condom.

<span class="mw-page-title-main">Hormonal intrauterine device</span> Intrauterine device

A hormonal intrauterine device (IUD), also known as an intrauterine system (IUS) with progestogen and sold under the brand name Mirena among others, is an intrauterine device that releases a progestogenic hormonal agent such as levonorgestrel into the uterus. It is used for birth control, heavy menstrual periods, and to prevent excessive build of the lining of the uterus in those on estrogen replacement therapy. It is one of the most effective forms of birth control with a one-year failure rate around 0.2%. The device is placed in the uterus and lasts three to eight years. Fertility often returns quickly following removal.

<span class="mw-page-title-main">Hormonal contraception</span> Birth control methods that act on the endocrine system

Hormonal contraception refers to birth control methods that act on the endocrine system. Almost all methods are composed of steroid hormones, although in India one selective estrogen receptor modulator is marketed as a contraceptive. The original hormonal method—the combined oral contraceptive pill—was first marketed as a contraceptive in 1960. In the ensuing decades many other delivery methods have been developed, although the oral and injectable methods are by far the most popular. Hormonal contraception is highly effective: when taken on the prescribed schedule, users of steroid hormone methods experience pregnancy rates of less than 1% per year. Perfect-use pregnancy rates for most hormonal contraceptives are usually around the 0.3% rate or less. Currently available methods can only be used by women; the development of a male hormonal contraceptive is an active research area.

<span class="mw-page-title-main">Concept Foundation</span>

The Concept Foundation is a non-profit foundation which was established by the UNDP/UNFPA/WHO/WB Special program in Reproductive Health (WHO/HRP), PATH, the World Bank in 1989 in Bangkok, Thailand, "as a mechanism through which WHO’s rights associated with an injectable contraceptive, Cyclofem, could be licensed to potential producers in developing countries". Estradiol cypionate/medroxyprogesterone acetate, is a once-a-month combined injectable contraceptive which contains 25 mg of medroxyprogesterone acetate—the same ingredient in Depo Provera—and 5 mg of estradiol cypionate.

Combined injectable contraceptives (CICs) are a form of hormonal birth control for women. They consist of monthly injections of combined formulations containing an estrogen and a progestin to prevent pregnancy.

<span class="mw-page-title-main">Algestone acetophenide</span> Chemical compound

Algestone acetophenide, also known more commonly as dihydroxyprogesterone acetophenide (DHPA) and sold under the brand names Perlutal and Topasel among others, is a progestin medication which is used in combination with an estrogen as a form of long-lasting injectable birth control. It has also been used alone, but is no longer available as a standalone medication. DHPA is not active by mouth and is given once a month by injection into muscle.

<span class="mw-page-title-main">Norethisterone enanthate</span> Chemical compound

Norethisterone enanthate (NETE), also known as norethindrone enanthate, is a form of hormonal birth control which is used to prevent pregnancy in women. It is used both as a form of progestogen-only injectable birth control and in combined injectable birth control formulations. It may be used following childbirth, miscarriage, or abortion. The failure rate per year in preventing pregnancy for the progestogen-only formulation is 2 per 100 women. Each dose of this form lasts two months with only up to two doses typically recommended.

<span class="mw-page-title-main">Estradiol enantate</span> Chemical compound

Estradiol enantate, also spelled estradiol enanthate and sold under the brand names Perlutal and Topasel among others, is an estrogen medication which is used in hormonal birth control for women. It is formulated in combination with dihydroxyprogesterone acetophenide, a progestin, and is used specifically as a combined injectable contraceptive. Estradiol enantate is not available for medical use alone. The medication, in combination with DHPA, is given by injection into muscle once a month.

<span class="mw-page-title-main">Levonorgestrel butanoate</span> Chemical compound

Levonorgestrel butanoate (LNG-B), or levonorgestrel 17β-butanoate, is a steroidal progestin of the 19-nortestosterone group which was developed by the World Health Organization (WHO) in collaboration with the Contraceptive Development Branch (CDB) of the National Institute of Child Health and Human Development as a long-acting injectable contraceptive. It is the C17β butanoate ester of levonorgestrel, and acts as a prodrug of levonorgestrel in the body. The drug is at or beyond the phase III stage of clinical development, but has not been marketed at this time. It was first described in the literature, by the WHO, in 1983, and has been under investigation for potential clinical use since then.

<span class="mw-page-title-main">Estradiol cypionate/medroxyprogesterone acetate</span> Pharmaceutical combination

Estradiol cypionate/medroxyprogesterone acetate (EC/MPA), sold under the brand name Cyclofem among others, is a form of combined injectable birth control. It contains estradiol cypionate (EC), an estrogen, and medroxyprogesterone acetate (MPA), a progestin. It is recommended for short-term use and is given once a month by injection into a muscle.

<span class="mw-page-title-main">Estradiol valerate/norethisterone enantate</span> Combination drug

Estradiol valerate/norethisterone enantate (EV/NETE), sold under the brand name Mesigyna among others, is a form of combined injectable birth control which is used to prevent pregnancy in women. It contains estradiol valerate (EV), an estrogen, and norethisterone enantate (NETE), a progestin. The medication is given once a month by injection into muscle.

<span class="mw-page-title-main">Estradiol enantate/algestone acetophenide</span> Pharmaceutical combination

Estradiol enantate/algestone acetophenide, also known as estradiol enantate/dihydroxyprogesterone acetophenide (E2-EN/DHPA) and sold under the brand names Perlutal and Topasel among others, is a form of combined injectable birth control which is used to prevent pregnancy. It contains estradiol enantate (E2-EN), an estrogen, and algestone acetophenide, a progestin. The medication is given once a month by injection into muscle.

<span class="mw-page-title-main">Estradiol benzoate butyrate/algestone acetophenide</span> Combination drug

Estradiol benzoate butyrate/algestone acetophenide, also known as estradiol benzoate butyrate/dihydroxyprogesterone acetophenide (EBB/DHPA) and sold under the brand names Neolutin N, Redimen, Soluna, and Unijab, is a form of combined injectable birth control which is used in Peru and Singapore. It contains estradiol benzoate butyrate (EBB), an estrogen, and algestone acetophenide, a progestin. The medication is given once per month by injection into muscle.

<span class="mw-page-title-main">Chlormadinone caproate</span> Chemical compound

Chlormadinone caproate (CMC) is a progestin and a progestogen ester which was studied for potential use in combined injectable contraceptives but was never marketed. It was assessed in combination with estradiol valerate at doses of 80 mg and 3 mg, respectively. In addition to chlormadinone acetate (CMA), analogues of CMC include gestonorone caproate, hydroxyprogesterone caproate, medroxyprogesterone caproate, megestrol caproate, and methenmadinone caproate.

<span class="mw-page-title-main">Levonorgestrel cyclobutylcarboxylate</span> Chemical compound

Levonorgestrel cyclobutylcarboxylate is a progestin and a progestogen ester which was studied for potential use as an injectable hormonal contraceptive but was never marketed. It was developed by the World Health Organization's Special Programme on Human Reproduction in the 1980s. Analogues of levonorgestrel cyclobutylcarboxylate include levonorgestrel butanoate (HRP-002) and levonorgestrel cyclopropylcarboxylate (HRP-003).

<span class="mw-page-title-main">Levonorgestrel cyclopropylcarboxylate</span> Chemical compound

Levonorgestrel cyclopropylcarboxylate, or levonorgestrel 17β-cyclopropylcarboxylate, is a progestin and a progestogen ester which was studied for potential use as an injectable hormonal contraceptive but was never marketed. It was developed by the World Health Organization's Special Programme on Human Reproduction in the 1980s. Analogues of levonorgestrel cyclopropylcarboxylate include levonorgestrel cyclobutylcarboxylate (HRP-001) and levonorgestrel butanoate (HRP-002).

The Human Reproduction Program -UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP) is a WHO co-sponsored research programme on human reproduction. HRP is based at the WHO headquarters in Geneva, Switzerland. Its goal is to support and coordinate research on a global scale. It is part of the Sexual and Reproductive Health and Research (SRH) department of the WHO.

<span class="mw-page-title-main">Katayun Virkar</span> Indian scientist

Katayun Dattatraya Virkar was an Indian physician and medical researcher, head of the contraception division at India's National Institute of Research on Reproductive Health (NIRRH).

References

  1. ↑ "sexual and reproductive health and research-SHR" . Retrieved 9 March 2023.
  2. 1 2 Benagiano, G., & Merialdi, M. (2011). Carl Djerassi and the World Health Organisation special programme of research in human reproduction. Journal für Reproduktionsmedizin und Endokrinologie-Journal of Reproductive Medicine and Endocrinology, 8(1), 10-13. http://www.kup.at/kup/pdf/10163.pdf
  3. 1 2 Toppozada MK (April 1994). "Existing once-a-month combined injectable contraceptives". Contraception. 49 (4): 293–301. doi:10.1016/0010-7824(94)90029-9. PMID   8013216.
  4. 1 2 Koetsawang S (1991). "The injectable contraceptive: present and future trends". Ann. N. Y. Acad. Sci. 626 (1): 30–42. Bibcode:1991NYASA.626...30K. doi:10.1111/j.1749-6632.1991.tb37897.x. PMID   1829341. S2CID   27008012.
  5. 1 2 Garza-Flores J, Hall PE, Perez-Palacios G (1991). "Long-acting hormonal contraceptives for women". J. Steroid Biochem. Mol. Biol. 40 (4–6): 697–704. doi:10.1016/0960-0760(91)90293-E. PMID   1958567. S2CID   26021562.
  6. ↑ Koetsawang S (April 1994). "Once-a-month injectable contraceptives: efficacy and reasons for discontinuation". Contraception. 49 (4): 387–98. doi:10.1016/0010-7824(94)90034-5. PMID   8013221.
  7. ↑ Garza-Flores J (April 1994). "Pharmacokinetics of once-a-month injectable contraceptives". Contraception. 49 (4): 347–59. doi:10.1016/0010-7824(94)90032-9. PMID   8013219.
  8. ↑ Fraser IS (April 1994). "Vaginal bleeding patterns in women using once-a-month injectable contraceptives". Contraception. 49 (4): 399–420. doi:10.1016/0010-7824(94)90035-3. PMID   8013222.
  9. ↑ Hassan EO, el-Nahal N, el-Hussinie M (August 1999). "Once-a-month injectable contraceptives, Cyclofem and Mesigyna, in Egypt. Efficacy, causes of discontinuation, and side effects". Contraception. 60 (2): 87–92. doi:10.1016/S0010-7824(99)00064-5. PMID   10592855.
  10. ↑ Giwa-Osagie OF (May 1994). "Metabolic effects of once-a-month combined injectable contraceptives. The World Health Organization Task Force on Long-Acting Systemic Agents for Fertility Regulation, Geneva, Switzerland". Contraception. 49 (5): 421–33. doi:10.1016/0010-7824(94)90001-9. PMID   8045129.
  11. ↑ "Population growth and economic development". United Nations. March 9, 1963.
  12. 1 2 "Decisions of the United Nations, specialized agencies and the International Atomic Energy Agency affecting WHO's activities (programme matters): programme activities in the health aspects of world population which might be developed by WHO: report by the Director-General". March 9, 1965. hdl:10665/136768.
  13. ↑ "Decisions of the United Nations affecting WHO's activities: resolution 1048 (XXXVII) of the Economic and Social Council". March 9, 1965. hdl:10665/88958.
  14. ↑ "Programme activities in the health aspects of world population which might be developed by WHO". March 9, 1965. hdl:10665/89329.
  15. ↑ Candau, Marcolino Gomes (March 9, 1971). The work of WHO, 1970: annual report of the Director-General to the World Health Assembly and to the United Nations. World Health Organization. hdl: 10665/85828 . ISBN   9241601884.
  16. ↑ "Health aspects of population dynamics". March 9, 1969. hdl:10665/91257.
  17. ↑ "World Health Organization: Expanded Programme of Research, Development and Research Training in Human Reproduction: Report of a Feasibility Project, May 1971; HR/71.4 (1971) part 1" (PDF). hdl:10665/361192.
  18. ↑ "World Health Organization: Resolution WHA25.60 on WHO's role in the development and coordination of biomedical research, Twenty-fifth World Health Assembly, Geneva, 9-26 May 1972 - Part I: resolutions and decisions pp.32-33". 26 May 1972. Retrieved 13 March 2023.
  19. ↑ "World Health Organization: EB51/6 - WHO's role in the development and coordination of biomedical research: interim report by the Director-General, December 1972" (PDF). 20 December 1972. Retrieved 13 March 2023.
  20. 1 2 Mbizvo, Michael T.; d'Arcangues, Catherine; Van Look, Paul FA; Benagiano, Giuseppe (2012). "40 years of innovation in sexual and reproductive health". The Lancet. 380 (9843): 705–706. doi:10.1016/S0140-6736(12)61025-3. PMID   22920740. S2CID   205966657.
  21. ↑ "Expanded Programme of Research, Development and Research Training in Human Reproduction: report of a feasibility project: supplementary information". March 9, 1971. hdl:10665/361193.
  22. ↑ "World Health Organization: EM/RC33/13 - Nomination of a member state to the Policy and Coordination advisory committee (PCAC) of the Special programme of research, development, and research training in human reproduction (HRP), July 1986" (PDF). hdl:10665/120636.
  23. 1 2 "RECENT DEVELOPMENTS IN HUMAN REPRODUCTION RESEARCH - Progress report by the Director-General" (PDF). hdl:10665/162389.
  24. ↑ Khosla, Rajat; Amin, Avni; Allotey, Pascale; Barroso, Carmen; George, Asha; Hardon, Anita; Askew, Ian (January 1, 2019). ""Righting the wrongs": addressing human rights and gender equality through research since Cairo". Sexual and Reproductive Health Matters. 27 (1): 329–332. doi:10.1080/26410397.2019.1676529. PMC   7887975 . PMID   31746277.
  25. ↑ "Special Programmes: UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP): Policy and Coordination Committee (PCC) – Report on attendance at PCC in 2020 and nomination of a Member in place of Bhutan whose term expires on 31 December 2020". March 9, 2020. hdl:10665/333620.
This page is based on this Wikipedia article
Text is available under the CC BY-SA 4.0 license; additional terms may apply.
Images, videos and audio are available under their respective licenses.