Intended for healthcare professionals


Depot contraception and HIV: an exercise in obfuscation

BMJ 2019; 367 doi: (Published 07 October 2019) Cite this as: BMJ 2019;367:l5768

Re: Depot contraception and HIV: an exercise in obfuscation

In my view this is an apposite and well-crafted piece by a respected medical doctor of many years outstanding practice, and one of the world's most persistent and careful analysts of the impact of depot medroxyprogesterone (known as "DEPO" across Southern Africa), specifically, on the health of women in India. Even if you do not agree with her analysis I think you can agree with the overarching point made by Dr Sathyamala here -- that the way the ECHO trial results are being used and reported is flawed. In the view of many of us working in historical/ anthropological / sociological and philosophical fields, who support science, and work to build confidence in science into our teaching and work, while maintaining a critical attitude to the many perverting forms of power around the scientific endeavour, and who are following ECHO very closely, the outflow from this trial could lead to suspicion about the way in which scientific knowledge gets used, especially in the fields of clinical research vitally important to women on the African continent. By over stating results and indulging in hyperbolic result-launches -- in the style of business marketing events -- and by exaggerating the strength of trial findings, or aiding and abetting news organisations doing the same, the suspicions of many social scientists, civic organisations and the interested public, are once again raised concerning the power of money and status and unstated objectives surrounding many clinical trials. Even as we know that complex and important trials, like this one, involve so many dedicated and ethical scientists and researchers, we also know they cannot always control the use of their work after its completion. I urge scientists and clinical researchers to take a very close look at the trial and the claims being made from it.

Competing interests: No competing interests

09 October 2019
Catherine E Burns
academic historian working in the field of women's health
In my own capacity
Sociology Department, University of Pretoria, South Africa