MOH: Abortion Pills Not Needed Despite WHO Recommendation

The WHO Essential Medicines List is only a guide, says a health official.

PETALING JAYA, Jan 21 — Abortion drugs are not included in Malaysia’s clinical guidelines, a health official said today, despite the World Health Organization (WHO) listing it as an essential medicine.

Speaking to reporters during a media engagement session here, Dr Ramli Zainal, senior director of the Ministry of Health’s (MOH) pharmaceutical services programme said today that the WHO’s Essential Medicines List is only a guide.

“Countries, any countries, including Malaysia, can actually decide which medicines to consider as essential…in the country. The question is to satisfy the priority (of) health within the country. That’s the concept.”

Dr Ramli said it is not necessary for MOH to follow everything the WHO Essential Medicines List outlines, adding that the ministry also has to base its decisions on the standard clinical practice guidelines for the country.

“Our national clinical guidelines do not list misoprostol as one of the drugs to be used for abortion,” he said at the National Pharmaceutical Regulatory Agency here.

He added that a panel of expert physicians have long determined that there is no need for misoprostol use in the country, and said this was unlikely to change anytime soon.

Last July, the WHO moved mifepristone and misoprostol from the complementary list to the core list of the 21st WHO Essential Medicines List, besides deleting a note that said the abortion pill required “close medical supervision”, as evidence showed this was not necessary for safe and effective use of the drug.

The WHO, however, retained a note for the mifepristone-misoprostol combination pack (mifepristone 200mg tablet and misoprostol 200 microgram tablet) that said: “where permitted under national law and where culturally acceptable”.

Abortion is only permitted in Malaysia if it endangers the mother, but abortion services in public health facilities are not available for unmarried women. Government clinics also do not provide birth control pills and other modern contraceptives to single women, leading many unwed teenage girls to dump their babies to avoid ostracisation from their families.

Dr Ramli added that anyone buying misoprostol in Malaysia was violating the law as the drug is not registered here.

He also spoke of efforts by his department to request social media platforms such as Facebook and e-commerce sites like Lazada and Shopee to bring down advertisements or listings that sell abortion pills online, which it does in collaboration with the Malaysian Communications and Multimedia Commission and Interpol.

Earlier this month, gynaecologist Dr John Teo pointed out that unsafe abortion kills women and threatens maternal health, and questioned why misoprostol and mifepristone are still not available in Malaysia.

According to United States health care provider Planned Parenthood, the abortion pill process requires taking the mifepristone pill first, and then the second medicine, misoprostol. Planned Parenthood also said the abortion pill is “really safe and effective”, but told women to first meet with their doctor or nurse to prepare for their medication abortion.

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