By Agnes Rogo and Estefanny Molina, Women’s Link Worldwide
Photo credit: Courtesy of Jonathan Torgovnik/Getty Images/Images of Empowerment. Some rights reserved.
Defective contraceptives have become a silent weapon in the systemic neglect of women’s health, disproportionately harming communities particularly in low-income countries. While access to family planning is a fundamental human right, racialized disparities in pharmaceutical quality control and regulatory oversight have turned contraceptives into sources of trauma rather than empowerment. From Africa to Latin America, the consequences of this injustice—unplanned and forced pregnancies, economic destabilization, and shattered life plans—reveal a pattern of corporate negligence and governmental failure that demands urgent redress.
In East Africa: High Contraceptive Failure and Systemic Neglect
Uganda’s struggle with defective contraceptives epitomizes the broader crisis. Despite the government’s commitment to reducing unmet contraceptive needs, studies reveal alarming gaps. The 2023 Uganda Demographic and Health Survey found a 5.6% contraceptive failure rate, with many women facing stockouts of preferred methods and resorting to less effective alternatives. Stockouts force women into cycles of method-switching, increasing health risks and unintended pregnancies. For example, 26% of married Ugandan women report unmet family planning needs, contributing to unsafe abortions and maternal mortality rates that remain among the highest globally. Uganda’s reliance on donated contraceptives—often sourced from cost-cutting pharmaceutical suppliers—exposes women to substandard products. A 2023 study linked inconsistent bleeding, dizziness, and unintended pregnancies to poorly regulated injectables and implants. Yet, the government’s focus on “human capital development” often sidelines investments in contraceptive quality. As Dr. Dinah Amongin of Makerere University notes: “When women cannot access their preferred methods due to stockouts, it reflects a failure in our legislative and budgeting processes. This is not acceptable.”
The crisis extends across borders. In Kenya, banned Chinese contraceptives like Sofia—packaged with dangerously high hormone levels—circulate illegally, causing severe side effects and unplanned pregnancies. Despite a 2012 ban, these pills remain accessible in informal markets, disproportionately affecting low-income women. Similarly, Rwanda reports a 36.5% post-abortion contraception uptake failure rate, driven by stockouts and inadequate counselling. Even as Rwanda’s contraceptive use rose to 64%, systemic issues like provider bias and misinformation persist, trapping women in cycles of unintended pregnancies. In Tanzania, cultural stigma and supply chain gaps mirror Uganda’s challenges. While data is sparse, regional studies show that 40% of contraceptive discontinuations in East Africa stem from side effects or method failure. These “user-related failures” often reflect poor-quality products, not individual choices.
Latin America’s Legal Battles: A Blueprint For Accountability
In Chile, a 2020 scandal exposed 276,890 defective contraceptive packets distributed through public health systems. This means that in the blister pack of pills, the pills that had the active hormone were placed in place of the placebo. That is, women took placebo believing that they were taking the pills with the active hormone. Women like Melanie Riffo, faced unplanned pregnancies after taking pills impacting their education and livelihoods.
Having identified the seriousness of the situation, Corporación Miles and Women’s Link Worldwide, led a comprehensive strategy of international complaint before the Special Mechanisms of the United Nations such as the Special Rapporteur on the Right to Health, the Working Group on Business and Human Rights and the Working Group on Discrimination against Women and Girls. With the media coverage at a national and international level, these UN mechanisms recognized -for the first time- the severity of the situation and the responsibility of the State of Chile and several pharmaceutical companies involved. They called for reparations to be offered to the affected women and for measures to be taken to prevent this from happening again as well as to consider the decriminalization of abortion in order to prevent such cases like and to compensate women for unwanted and unplanned pregnancies.
Despite state pledges to correct this failure and to comply with the recommendations of the UN, affected women waited years for justice. Corporación Miles and Women’s Link Worldwide stepped in, accompanied by a strong communications and advocacy strategy filing a landmark lawsuit against the Chilean government and manufacturers. In this case, Women’s Link argued that: “The State must implement measures to ensure this never happens again. Affected women deserve reparations and systemic change.”
Thanks to the impact that the strategies have had both nationally and internationally, the Chilean congress is currently discussing a bill to specifically monitor contraceptive pills from the moment they leave the pharmaceutical companies until they are distributed to health services. Additionally, due to this situation with defective contraceptives and the coverage that the case has had, the government has promised to introduce a bill proposing the decriminalization of abortion to guarantee their right to reproductive autonomy.
Global North-south Divide in Pharmaceutical Accountability
Pharmaceutical companies routinely prioritize cost-cutting over quality in low-income countries, exploiting lax regulations. Profits outrides safety. These practices contrast sharply with stricter oversight in wealthier nations. When Qualitest Pharmaceuticals mispackaged pills in the U.S., a recall was issued within weeks. Yet, similar errors in Chile or Uganda languish for years without redress. This double standard perpetuates a form of biocolonialism, where women of color bear the brunt of corporate negligence.
Defective contraceptives violate reproductive autonomy and deepen gender inequality.
Legal battles and transnational solidarity is needed to combat corporate impunity and hold governments and pharmaceutical companies to account. Additionally, there is an urgent need to strengthen regulatory frameworks, invest in national health systems, and center the voices of women in policymaking.
At Women’s Link, we believe reproductive justice cannot exist without racial and economic justice. The fight against defective contraceptives is not just about healthcare—it’s about dismantling systems that devalue women of color worldwide.
*Name has been changed to protect her identify.