Basis for action

12.10. Research, in particular biomedical research, has been instrumental in giving more and more people access to a greater range of safe and effective modern methods for regulation of fertility. However, not all persons can find a family-planning method that suits them and the range of choices available to men ismore limited than that available to women. The growing incidence of sexually transmitted diseases, including HIV/AIDS, demands substantially higher investments in new methods of prevention,diagnosis and treatment. In spite of greatly reduced funding for reproductive health research, prospects for developing and introducing new methods and products for contraception and regulation of fertility have been promising. Improved collaboration and coordination of activities internationally will increase cost-effectiveness, but a significant increase in support from Governments and industry is needed to bring a number of potential new, safe and affordable methods to fruition, especially barrier methods. This research needs to be guided at all stages by gender perspectives, particularly women's, and the needs of users, and should be carried out in strict conformity with internationally accepted legal, ethical, medical and scientific standards for biomedical research.

Objectives

12.11. The objectives are:

1. To contribute to the understanding of factors affecting universal reproductive health, including sexual health, and to expand reproductive choice;
2. To ensure the initial and continued safety, quality and health aspects of methods for regulation of fertility;
3. To ensure that all people have the opportunity to achieve and maintain sound reproductive and sexual health, the international community should mobilize the full spectrum of basic biomedical, social and behavioural and programme-related researchon reproductive health and sexuality.

Actions

12.12. Governments, assisted by the international community and donor agencies, the private sector, non-governmental organizations and the academic community, should increase support for basic and applied biomedical, technological, clinical, epidemiological and social science research to strengthen reproductive health services,including the improvement of existing and the development of new methods for regulation of fertility that meet users' needs and are acceptable, easy to use, safe, free of long- and short-term side-effects and second-generation effects, effective, affordable and suitable for different age and cultural groups and for different phases of the reproductive cycle. Testing and introduction of all new technologies should be continually monitored to avoid potential abuse. Specifically, areas that need increased attention should include barrier methods, both male andfemale, for fertility control and the prevention of sexually transmitted diseases, including HIV/AIDS, as well as microbicides and virucides, which may or may not prevent pregnancy.

12.13. Research on sexuality and gender roles and relationships indifferent cultural settings is urgently needed, with emphasis on such areas as abuse, discrimination and violence against women;genital mutilation, where practised; sexual behaviour and mores; male attitudes towards sexuality and procreation, fertility, family and gender roles; risk-taking behaviour regarding sexually transmitted diseases and unplanned pregnancies; women's and men's perceived needs for methods for regulation of fertility and sexual health services; and reasons for non-use or ineffective use of existing services and technologies.

12.14. High priority should also be given to the development of new methods for regulation of fertility for men. Special research should be undertaken on factors inhibiting male participation inorder to enhance male involvement and responsibility in family-planning. In conducting sexual and reproductive health research, special attention should be given to the needs of adolescents inorder to develop suitable policies and programmes and appropriate technologies to meet their health needs. Special priority should be given to research on sexually transmitted diseases, including HIV/AIDS, and research on infertility.

12.15. To expedite the availability of improved and new methods for regulation of fertility, efforts must be made to increase the involvement of industry, including industry in developing countries and countries with economies in transition. A new type of partnership between the public and private sectors, including women and consumer groups, is needed to mobilize the experience and resources of industry while protecting the public interest. National drug and device regulatory agencies should be actively involved in all stages of the development process to ensure thatall legal and ethical standards are met. Developed countries should assist research programmes in developing countries and countries with economies in transition with their knowledge, experience and technical expertise and promote the transfer of appropriate technologies to them. The international community should facilitate the establishment of manufacturing capacities for contraceptive commodities in developing countries, particularly the least developed among them, and countries with economies intransition.

12.16. All research on products for regulation of fertility and sexual and reproductive health must be carried out in adherence to internationally accepted ethical and technical standards andcultural conditions for biomedical research. Special attentionneeds to be given to the continuous surveillance of contraceptive safety and side-effects. Users', in particular women's, perspectives and women's organizations should be incorporated into all stages of the research and development process.

12.17. Since unsafe abortion 20/ is a major threat to the health and lives of women, research to understand and better address the determinants and consequences of induced abortion, including its effects on subsequent fertility, reproductive and mental health and contraceptive practice, should be promoted, as well as research ontreatment of complications of abortions and post-abortion care.

12.18. There should be enhanced research on natural methods for regulation of fertility, looking for more effective procedures to detect the moment of ovulation during the menstrual cycle and after childbirth.

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