During an unexpected and often dangerous situation, a person is required to take immediate action, the same applies to the prevention of an unwanted pregnancy. The ever-increasing access to birth control for Rwandan women is a sign of progress in supporting them to take more control of their bodies. According to the World Health Organisation (WHO), emergency contraceptive pills prevent up to over 95% of pregnancies when taken within 5 days after intercourse. And, when taken within 24 hours of sexual intercourse, the pills are even more effective. Access to contraception allows women to put off having children until they are ready as well as reduce the need for abortion. However, one issue that continues to compromise their use, is the affordability of these pills, especially for low-income earners. Since emergency contraception pills are considered essential drugs, they ought to be affordable for all women and more especially for the vulnerable low-income earners The drugs are exonerated from paying taxes (tax-free) which means that the difference in the wholesale price and the price on the market should be minimal. However, since there is a high demand for the morning-after- pill - as it is commonly known - pharmacists take advantage and inflate the price up to 5 times, an act I would refer to as economic violence towards women and their exploitation. In a recent interview with The New Times, Dr. Blaise Uhagaze, the Executive Secretary of RHIA (the Rwanda Health Insurance Association) explained how the high cost of the emergency pills have hindered access to these particular drugs. RHIA serves as a platform for insurance companies and the Ministry of Health to regulate drug prices, The most expensive emergency contraceptive pill is NorLevo. It is is an oral pill prescribed for use within 72 hours of unprotected intercourse to prevent unwanted pregnancy. It is supposed to be sold at Rwf 4,200. However, some pharmacies price the pill at Rwf 10,000, Rwf 15,000, or even Rwf 25,000. There is, therefore, a need to urgently review these prices as well as monitoring that the pharmacies are respecting the regulators recommended prices. Additionally, the set prices for the different emergency contraception pills should be publicly available and displayed for all citizens. Contraceptive pills should be available and affordable, whether it is a case of emergency or for purchase in advance to be used as and if needed. Equitable access and use of emergency contraception could reduce the considerable medical and social costs of unintended pregnancies as well as significantly contribute to the prevention of unsafe abortions. The writer is a physician and Human Rights Activist & Executive Director, HDI- Rwanda.
