The US Food and Drugs Administration has recently approved the use of Mifepristone (RU-486) to procure abortions up to 49 days gestation (BMJ 2000; 321;851). RU-486 was developed by the French drug company Roussel Uclaf, a subsidiary of Hoechst. Hoechst was itself derived from IG Farben, the chemical giant who made the stabiliser for Zyklon B gas used to kill millions of Jews during the holocaust.
In response to boycotts of Hoechst products by the American pro-life community, Roussel announced in 1994 that it was giving up its patent rights to RU-486 and would cease manufacture even though pressurised by the FDA to apply for a product licence. The FDA broke its own rules repeatedly and facilitated transfer of the patent rights to the strongly anti-natalist Population Council (www.nrlc.org).
RU-486 is not very effective unless used with prostaglandins or analogues such as Misoprostol. Searle Laboratories, the manufacturers of Misoprostol, have objected to its use as an abortifacient and in their literature they advise against its use in pregnancy. There have also been isolated reports of possible teratogenicity. In a series of 2121 women given the Mifepristone/Misoprostol regime, 106 failed to attend follow up (N Eng J Med 1998; 338 (18): 1241-7). It is possible that some of these may have had continuing pregnancies. The population control lobby like Misoprostol because it doesn't have to be refrigerated, a major advantage (to them) in the developing world.
The Population Council could not find a source for RU-486. Recent reports mention a contract with the Hua Lian company in Shanghai. This is a source of much of the Mifepristone used in China where coerced abortion is widespread (www.nrlc.org). Some of the other drugs made at this plant were found to be contaminated with the cytotoxic agent Fluorouracil. Despite this and other serious issues, the FDA rescinded earlier advice on safety and granted the product licence.
In the UK, RU-486 is being promoted by the RCOG in their abortion 'guidelines' but hasn't found favour with the private sector. It is not very profitable because of the need for three visits, placing it in a different category from traditional assembly line abortion. The history of this drug is a long tale of deception and corruption on several continents. We haven't heard the last of it.
