A shortage of birth control makes life tough for Egyptians

WHEN they got married a year ago, Hassan and his wife were not ready to have children. So she began using Yasmin, a popular birth-control pill made by Bayer, a German company. But last summer, Yasmin disappeared from pharmacies. So she switched to another brand, until it also disappeared. The newly-weds were careful, but in October Hassan’s wife found out that she was pregnant. He went looking for abortion pills. But they, too, were unavailable.

The ordeal of Hassan (not his real name) and his wife is not unusual. During the past year, many Egyptians have struggled to find contraceptives, especially birth-control pills. This is symptomatic of a broader shortage of medicines that has caused widespread suffering. Access to contraception is rarely a matter of life and death—unlike, say, cancer treatment, which is also limited. But Egypt’s population is growing at 2.4% a year, much faster than most other developing countries. Water and food are in short supply. The government can hardly serve the 92m Egyptians alive today.

Egypt was once at the forefront of contraception. In ancient times women inserted a paste made with crocodile dung into their vaginas to prevent pregnancy. Now more reliable prophylactics are imported, or made locally with foreign ingredients. The same is true of other medicines, so Egyptian drug companies need foreign currency, which was in short supply last year. Most had to buy dollars at a premium on the black market, adding to their costs. After Egypt floated its currency in November, leading to a precipitous drop in its value, the cost of imports spiked.

Since 1955 the government has fixed the price of medicine, which once made Egypt a destination for medical tourists. Now the policy hinders drug firms, which cannot pass on higher costs to consumers, most of whom pay for contraceptives themselves. Since last year firms have pleaded with the government to raise prices and, say critics, hoarded their stocks. Anxious consumers have aggravated the shortages by buying more than they need.

Hassan turned to the black market to get birth-control pills, until those disappeared. Others adapted in different ways. Egyptian couples tend to shun condoms, but some have resorted to them. There is a shortage of sex education, too. A pharmacist in Cairo claims one woman tried to swallow the condoms she bought.

By the time the government agreed to raise the price of medicines in January, 95% of the local factories that make drugs had stopped production, says Ali Ouf of the Federation of Egyptian Chambers of Commerce. For now, shortages are easing. “Most missing medicine is now available, but in very small quantities,” says another pharmacist. “For contraceptives, one person cannot buy more than one pack.”

There has been talk of the government playing a larger role in the drugs market. (When there was a shortage of baby formula last year, the army intervened.) But its bureaucracy is already part of the problem. Several ministries regulate the import, manufacture and sale of drugs. The IMF has urged Egypt to abandon fixed prices. Locals want the government to widen and improve coverage.

The government claimed a victory for its family-planning policies when population growth slowed slightly in 2015. The numbers for 2016 are not yet available, but they will not tell the whole story. Last year Hassan paid a doctor 8,000 Egyptian pounds ($440) to perform an illegal abortion. “The government is, of course, responsible for that,” he says.