World Contraception Day (WCD) is an important family planning event that takes place on September 26 each year. Launched in 2007, WCD’s mission is to help drive awareness around the need for contraception, and to enable young people to make informed choices on their sexual and reproductive health.
The worldwide campaign was the brainchild of two visionary thinkers, Jan Kreutzberg, Executive Director of DSW, and Klaus Brill, Former Vice President of Bayer Healthcare Pharmaceuticals. In celebration of WCD this year, and the 60th anniversary of the birth control pill, we interviewed the two drivers of WCD to find out more about how this day came about, their thoughts on its progress so far, and their expectations for the future.
DSW: Thank you, Mr. Brill and Mr. Kreutzberg, Klaus and Jan, for taking the time to join us today. I’d like to start by asking you about those early days that led to the creation of WCD. What was it specifically that kicked off the idea?
Klaus: Going 15 or 20 years back, we felt that knowledge about sexual and reproductive health (SRH) around the world had to be improved. There was not much information available to people wanting to know about contraceptive methods. That gave us the idea to think about how we could spur interest and spread knowledge.
From early on, there was the idea to have a special day celebrating SRH. We did a lot of work on what might be a good name, what might be a good date, but we were in for a surprise: almost every day in the year was already dedicated to a special topic. We settled on September 26. It was clear from the beginning that this day should be an unbranded campaign aimed at improving awareness of contraception and enabling young people to make informed choices about their SRH. This was the starting point for WCD in 2007.
Jan: Klaus and I were both in the same global group, the therapeutic leadership team, at Schering AG. From 2004 to 2009, I was located in Singapore, leading the woman’s health care business unit there. Schering AG, which merged with Bayer in 2006, was the research-based manufacturer for contraception worldwide. In the Asia Pacific region, in particular where I was located, various myths, misconceptions, and misinformation about contraception were omnipresent within consumer groups as well as the gynaecologist community. It was surprising how little gynaecologists knew about contraception.
We established the Asia Pacific Council on Contraception (APCOC) to enhance doctors’ knowledge about contraception, including side effect management and the benefits of hormonal contraception. We established a biannual congress to share the most recent medical information and studies about family planning and female contraception. We also provided contraception information and contraception itself to young men and women.
APCOC established a system of young ambassadors for sex education; school programs for basic, youth-friendly sexual education; and a video contest for contraception that was then published throughout Asia. Because of the success of the contest, I suggested an Asia-specific contraception day to the therapeutic leadership team, which we did in 2004 or 2005. Speaking with colleagues in Latin America and Europe, I realised that similar events were already established there. Because of this, in 2005, we suggested establishing a global day to garner global attention and recognition for this topic. WCD was born based on these ideas.
DSW: Were there any obstacles or resistance to the idea during those early days?
Klaus: For many people, the idea of celebrating WCD was very new, and there is always scepticism when you come up with new ideas. NGOs, governmental organisations, and even medical or scientific associations expressed doubts over whether WCD, coming from a company such as Schering, was really a good idea or if it was a marketing scheme. That was the first big hurdle. The resistance from those organisations was quite high at the beginning. For the first celebration of WCD in 2007, we only had two or three NGOs on board. The main organisation to be open to the idea was IPPF.
Jan: And then DSW, very soon after.
Klaus: Today we have a coalition of 14 NGOs, governmental organisations, and scientific and medical societies with an interest in SRH, sponsored by Bayer. This is a kind of sponsorship where the company is open to listen and to learn. It is Bayer’s goal not to influence any of the organisations but to inspire the organisations to work together.
Jan: Exactly. We also had several internal conflicts, for instance with country directors who associated contraception with specific branded products, and that was not the idea at all! They came to understand that WCD, as a neutral and independent institution, contributes to increased knowledge of contraception and family planning. Yes, the company might benefit, but that was never the intention; rather, the goal was to raise awareness about contraception and particularly to reduce unintended teenage pregnancies.
DSW: I’d like to bring us back to the present and talk about WCD as it stands now. What is going well and what opportunity is there to grow further from here?
Jan: WCD became a global movement, accepted by many NGOs. DKT, where I worked before DSW, established WCD in Africa, in the Congo, Nigeria, and other countries. But contraception is still a taboo topic in many societies in Africa today. Because of this, it is even more important to understand that it remains a key topic for family planning.
There has been significant progress since the launch of WCD, but there is still a lot of work to do if you consider that every second girl between the age of 15 and 19 who would like to use contraception does not have the opportunity to do so in Africa. We made many inroads in spreading information, but, to provide the other 50% of women in need with contraception – this is still a demanding task to do in the future.
Klaus: One main goal that was achieved is that a special day every year is dedicated to the topic. That has never been done before. People all over the world come together on that day to celebrate WCD. About 70-80 countries in South America, in Asia, in Europe, and especially in Africa actively celebrate WCD. It brings together the main drivers of SRH. They not only raise awareness about contraceptive methods but also talk about SRH basics, the supply chain, and even about combining services. That gives you an idea of how interactive WCD is. It empowers people to stand up.
As for what we can do better – I think there are always things you can do better. We took an important step forward three or four years ago, when we discussed how to use social media. Much energy went into creating a social media campaign, which was a big success.
“Our vision is as clear today as it was when we first conceived of WCD – to create a world where every pregnancy is wanted!” Jan Kreutzberg, Executive Director, DSW.
DSW: This year is also important in that it’s the 60th anniversary of the birth control pill. Many would say that the development of this pill sparked feminism and the sexual revolution. Do you have any thoughts about that?
Jan: It was absolutely a revolution. It revolutionised women’s quality of life across the globe and had a very positive impact on society. It was hugely beneficial for women’s health as well as their economic freedom. The pill enabled women to obtain higher education so they could pursue more lucrative jobs, resulting in an increase in the global economy, and increased productivity. One of the top reasons that women miss work and school is due to painful periods. The birth control pill is often used to treat this. Families were able to space their children better and wait at least 8-24 months between pregnancies to allow the woman’s body to recover. At the end of the day, there were fewer abortions as the pill enabled women to decide when to have a child and how many to have – what we call SRHR. It has wide implications for society.
Klaus: One aspect concerns the medical benefits and risks of hormonal methods, which have improved significantly over the last 60 years. When you look at the composition of the first pill, there has been a big step forward in lowering the dose and offering a variety of choices. Alternatives to the pill, such as IUDs, patches and rings, offer a broad variety of different methods to choose from. Over the last 60 years, experts have learned more about how to minimise risks when prescribing contraceptive methods. I think the overall risk in taking contraceptives is low in comparison to many other medical therapies.
The other aspect is that the introduction of the birth control pill is directly connected to the self-determination of women. It empowers women and gives them, as Jan rightly mentioned, freedom to decide how to plan their life and when they want to have a child. There is a lot of data on how this has positively impacted the lives of women around the world. It is very difficult for young girls who are forced into early marriage and have children at 14-16 to finish school. This is one of the major obstacles in developing countries in ensuring access to education for women.
Jan: Being able to decide for yourself when you want to have a child is something that oral contraception and the pill certainly contributed to. In accounts of the 10 most important social revolutions of the 20th century, the pill is always mentioned, with good reason. With the pill, it was understood that sex is also for pleasure, and with contraception comes a certain liberty and freedom.
DSW: The pill was definitely a major invention and a major revolution: enabling self-choice for couples but for women especially. Unfortunately, WCD has been criticised. There was an article in Der Spiegel last year that heavily criticised the whole event and the role that Bayer, as a big pharmaceutical company, played in it. How would you respond to that?
Klaus: I think, in general, criticism is an advantage. Criticism makes you consider if everything has been done in the best way. There is always room for improvement. Der Spiegel questioned whether information coming from pharmaceutical companies gives a complete overview about the benefits and the risks. Maybe pharmaceutical companies have to learn to talk more about the risks and to balance risk against benefit. That was one takeaway from the article.
It is easy for a journalist to say that companies only care about making money, but many companies have changed their philosophies regarding doing good for society. People believe that any information coming from professional companies smells of a marketing scheme, but it is risky for companies to minimize adverse effects or events because there will be pushback or it will come back in a different way.
I have read the article in Der Spiegel. Some of the arguments brought forward have some legitimacy, but it is not all true. We have to put it into the right perspective. With so many internationally recognised organisations on the board, it would be difficult to manipulate them all to say that only what Bayer says is good. As I said in the beginning, the advantage for Bayer is to listen to those organisations and learn from them to do better.
Jan: I agree. I think both sides learned from each other. Yes, the article in Der Spiegel has certain relevance, but I wouldn’t cast the roles in black and white. At the end of the day, it is a win-win situation for both sides and a win for men and women worldwide, providing access to balanced information about contraception and family planning. But of course the line can be very thin.
Jan: You need to have certain principles when establishing something like WCD, to come in as a sponsor as Bayer has and draw this fine line when it comes to the content and integrity of the program itself, making sure to avoid talking about products and grants so that it is not seen as an opportunistic approach to help the pharmaceutical industry. This was never the case with WCD. The focus was to provide independent information and to learn from each other. Yes, money is provided by an industry partner but that partner is kept at an arms’ length from the topics to be discussed on WCD. I can’t remember any attempts on the part of Bayer to influence WCD in a certain direction.
DSW: Thank you. That brings me to my last question, which ties the other questions together. There is a phrase in English, ‘hindsight is 20/20’. If you could revisit those early days, knowing what you know now, is there anything that you would do differently?
Jan: That’s a good question. From the perspective of today, I would have sped up the process of implementing it in the countries. I would have looked more closely at local family planning and SRHR advocacy groups to include as well as more independent institutional donors. Coming back to the criticism we discussed, we could have looked for more industry partners in those days. That would have been one way to avoid the criticism that WCD is only linked to one industry partner. If you bring other industry partners on board, the discussion becomes more complex, but it guarantees that you do not discuss any branded products. That would be my suggestion if I reflect.
Klaus: I agree.
DSW: That concludes our interview. I would like to thank you again for taking part. It’s been an absolute pleasure talking to both of you.
Featured image by Yagazie Emezi.