Discussion Of Pregnancy Termination Drug RU-486

If the Government adopts a similar course, there's little doubt that a move by the Australian Democrats to lift the effective ban on RU-486, which has been known in some quarters as the abortion pill, will gain majority support, at least in the Senate. What Health Minister Tony Abbott does then remains to be seen.

Adding weight to the campaign, the Australian Medical Association says it now supports the use of RU-486 in appropriate cases. And Dr Mukesh Haikerwal is President of the AMA and he joins us now. Doctor, good morning.

DR HAIKERWAL: Good morning, Fran, how are you?

KELLY: I'm all right, thank you. Let's go back to the beginning here. This RU-486, it's a drug used to terminate pregnancies without the need for surgery. Is it safe?

DR HAIKERWAL: The drug certainly is safe and has been used overseas for many years now with over a million women having been treated with this process.

It's something that gives choice and what we've said at our weekend conference is that people who have the need to have this procedure, and where it's legally available, this is another choice that should be given to women as it is in many countries in the rest of the world, where it has been proven to be safe, effective and a choice that women would like to make.

KELLY: If it's proven to be safe and effective elsewhere, why has Health Minister Tony Abbott said recently there are still health concerns?

DR HAIKERWAL: Well, with any medical procedure and any medication that you may use you'll find problems for anybody, depending on where you look for the data. But, overall, when you compare it with surgical terminations, this is a very safe and effective way to perform this procedure, where it's clinically indicated.

KELLY: From your point of view as a doctor, is it a preferable way than a surgical procedure?

DR HAIKERWAL: Well, it's always preferable to avoid surgery, is the short answer. In the past we used to do major gastric surgery for people who had ulcers. Then they invented a wonderful drug, you know, which actually stopped people needing to have ulcer surgery. And people prefer tablets to having ulcer surgery and this is very similar to that.

KELLY: It's not illegal to use RU-486 here at the moment, is it? I mean it has been certified as safe by the TGA, but to import it you need Ministerial approval, is that right?

DR HAIKERWAL: To import it you need to go through several hoops and hurdles which are really fairly draconian in many ways and that's why people haven't actually made the attempt to get the drug in. And it very much is subject to Ministerial approval for every single application.

KELLY: And this was a move that was brought into the Parliament in 1996?

DR HAIKERWAL: This came in in 1996 and it's something that in 1996…it was fairly early in the evolution of this drug. Now, nearly 10 years later there are women and many years worth of trials on this now, and people have used it successfully with very minimal problems.

Obviously any intervention can have problems, but they're very minimal compared to surgical problems and certainly it's an option people are very keen to pursue.

KELLY: Is there an equity element to this argument. I know some government female MPs have been arguing that women in rural areas don't have the same access to surgical terminations and this could be useful for them?

DR HAIKERWAL: The health of people in rural and remote areas is certainly quite behind the rest of the country because of access problems. And, indeed, this sort of service where people who find themselves pregnant and have made a very difficult decision that they may need to end their pregnancy have great difficulty accessing these services locally.

With properly trained doctors and support people nearer home, this certainly could be used. But it doesn't remove the need for proper review and watching people after they've had this tablet. And also after having the tablet they actually need to have some medicines inserted vaginally to make sure that they complete the process.

KELLY: So it does need medical oversight to be safe?

DR HAIKERWAL: Absolutely. I mean it's not a case of taking a pill and walking away. It's something that does need- you need to take medication. You need to have review occasionally like with any other form of evacuation of the uterus. There may well be products left behind which need to be removed later on. So it's important to check for those things and to check for infections, which may have occurred as well, of course.

KELLY: This was a very politically contentious debate back in 1996. Why has the AMA chosen to come out in support of this drug again right now?

DR HAIKERWAL: Well, I think the situation has changed because in 1996 we didn't have so much information. Now we do, and I think that the debate's opened up again with other alternative uses for Mifepristone having been identified, although still very much in the early trial phases, but there may be other uses for it other than simply abortion.

And these other uses have kind of been stymied by the lack of access, whilst the choice for women who require abortion, who are legally entitled to it and it's actually something that's been recommended, this method is not available for them.

KELLY: Well, as I said Tony Abbott, the Health Minister, hasn't been all that receptive to calls for the laws to be changed to make it easier to import RU-486. He said 'the Government's position is unchanged, although obviously we're always prepared to listen to someone who wants to make an intelligent case to us'. Has the AMA, or will the AMA be seeking a meeting with the Health Minister on this?

DR HAIKERWAL: We'll certainly be discussing this with the Minister and his office and the Government. I think the other people who are key players here are colleagues in the Royal Australian and NZ College of Obstetricians and Gynaecologists who also have some very good information evidence we hope to take forward as well.

It's really a case of increasing choice, introducing a safer alternative to what currently exists for a procedure, which is legal in most States.

KELLY: Mukesh Haikerwal, thanks very much for joining us.

DR HAIKERWAL: Thank you, good morning.

KELLY: That's Dr Mukesh Haikerwal, President of the AMA.