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Viagra OK in Japan Draws Protest

February 10, 1999

TOKYO (AP) _ In a lightning quick six months, the impotence-treatment drug Viagra got the go-ahead from Japan’s notoriously slow Health Ministry. The birth control pill, meanwhile, has been languishing in the approval line for nine years.

Bureaucratic sexism?

Tokyo’s refusal to approve the pill had drawn protests in the past, but Viagra’s fast-track approval has generated an uproar like never before.

Since Viagra was given the OK in January, several major newspapers have carried articles suggesting a double-standard at the Health Ministry. ``Viagra approval rekindles pill debate,″ read a recent headline in the Tokyo Shimbun newspaper.

Women’s groups, not surprisingly, have been outraged.

``When old guys want something, they get it. But when women want something, nothing happens,″ said Midori Ashida, who heads a Tokyo-based grassroots group pushing for the pill’s approval. ``Japan is still a male-dominated society.″

The estimate on Japanese men who suffer from impotence ranges from as low as 8,000, according to the Health Ministry, to as high as 7 million, according to Pfizer, Viagra’s manufacturer.

But supporters of the pill say its approval would serve an even greater social good. And they argue the risks of pregnancy and abortion far outweigh possible side-effects of birth control pills, which the U.S. Food and Drug Administration approved in 1960.

``The fact that Japanese women don’t have the pill, used around the world, is discrimination against women and a violation of their human rights,″ said legislator Akiko Domoto.

Domoto used a major U.N. population forum in The Hague, Netherlands, this week to slam the Japanese government for wasting no time in allowing sales of Viagra, while banning the pill for nearly a decade.

The most widely used contraceptive in Japan is the condom, favored by about 77 percent of women, government figures show.

But unwanted pregnancies are common in Japan. Official statistics show one in five ends in abortion, bringing the total to about 340,000 abortions each year. Japan’s per capita abortion rate is far higher than European nations, although somewhat lower than that of the United States.

Most Japanese women have been kept in the dark about the pill. Traditional culture teaches women to be submissive, and many are still not as eager as their Western counterparts to take control of their sexual choices.

Japan’s Health Ministry says it has not approved the pill because it continues to have reservations about possible side-effects. Officials say they also worry introducing the pill may cut into the use of condoms and contribute to the spread of the AIDS virus.

But the government was less reserved about the possible risks of Viagra _ although 130 Americans who took Viagra have died since the drug began selling last spring, mostly from heart attacks. One Japanese man who used Viagra died last year.

Japan’s position on the pill sets it apart from most of the world.

More than 300 million women worldwide have used the pill, which has long been available in virtually all industrialized and developing countries.

Medical opinion is also generally in favor of the pill. A major study published last month in the British Medical Journal found no long-term ill effects of birth control pills.

``There are no medical reasons why we must wait on the pill,″ said Japanese gynecologist Tomoko Saotome. ``I’m fed up with waiting.″

Takaichi Hirota, spokesman in Tokyo for New York-based Pfizer, said Viagra won quick approval because the company provided solid data on the drug.

Domoto, however, said the quick action on Viagra and foot-dragging on the pill may be more indicative of Japan’s official goal of raising the nation’s plunging birthrate.

Japan’s birth rate is at an all-time low of 1.39 per woman, and officials are worried this will quicken the trend toward a higher percentage of older people than young.

That could create a serious fiscal crunch in the future.

``The decision-makers have no understanding of the issue. All they have is this simple mentality that women should keep having more babies,″ Domoto said.

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