Why Depo Provera’s Popularity in Africa Defies Health Warnings and Lawsuits

Shene Gurling has no recollection of her wedding day. The 39-year-old mother from Cape Town was diagnosed with meningioma, a slow-growing brain tumor. In 2023, it pressed against her optic nerve, causing vision loss in her left eye. Pressing against her optic nerve, the tumor caused her to lose vision in her left eye in 2023. Searching for answers, Gurling approached the South African Health Products Regulatory Authority (SAHPRA) over her concerns about her contraceptive injection.

She believes Depo Provera was responsible for her meningioma diagnosis. Gurling had been on the shot since age 17. For decades, Depo-Provera had been the popular birth control choice for millions of women in Africa. Manufactured by Pfizer, the active hormone depot medroxyprogesterone acetate (DMPA) recently became the focus of countless lawsuits and studies.

Insufficient Warnings

In October 2024, Kristina Schmidt filed the first Depo-Provera lawsuit in the U.S. Like Gurling, she developed meningioma. Pfizer, Viatris, Greenstone, Prasco, and Pharmacia & Upjohn were sued for failing to warn consumers about the risks of long-term contraceptive use. In use since the FDA’s approval in 1992, the Depo Provera injection is taken by millions of women every three months. Now that investigations have revealed a concerning link between the method of birth control and serious health issues, the Depo-Provera lawsuit is being watched across the globe. TruLaw says research has shown patterns of adverse effects, particularly in women who used Depo Provera for extended periods.

Medical Colonization

For decades, Africa has been used as the testing ground for pharmaceuticals. A French doctor made a controversial comment at the height of the pandemic. He suggested that COVID-19 vaccines be tested on Africans due to the lack of masks and personal protective equipment (PPE). Al Jazeera described his remarks as “part of a trend that for generations has seen the dehumanizing of some people because of the superiority complex of others”. The Global South has been and remains ripe for medical colonization. 

Apartheid-Era Practices

Several years ago, HEALTH-E reported on the controversial practice of medical staff injecting women with Depo Provera without their consent in South African public health hospitals. The article reopened old wounds as many more came forward and disclosed that they were given the contraceptive without knowing what it was soon after giving birth. Despite only receiving FDA approval decades later, the injection was introduced in South Africa in the 1970s. It was primarily given to Black women under the apartheid government’s population control policy. Concerns were raised in the early 1990s. Criticism of the evidence led to the ECHO trial, a randomized study comparing Depo Provera with two other female contraceptives for HIV risk.

A Mainstay of Family Planning

Depo Provera remains a popular choice for women in Africa where HIV runs rampant. In many clinics, it’s the only option that’s given. The reason for the contraceptive’s wide use? Many African men refuse to use condoms. The injectable is also easier to conceal than the Pill. When viewed from a cultural lens, women are expected to bear children. They face humiliation or physical violence if caught avoiding pregnancy. The irony is that scientists warned for years that Depo Provera increased the risk of contracting HIV by 40%. Since then, other studies have refuted the findings, claiming that the drug doesn’t increase the risk of HIV infection.

What the Studies Say

The associated known risks of the contraceptive are osteoporosis, its impact on bone health, and increased likelihood of breast cancer. A 2024 study explored the brain tumor hypothesis. French researchers studied 18,061 women (average age 58) who had surgery for intracranial meningiomas from 2009 to 2018. They found that oral pills (medrogestone and promegestone) increased the risk of meningioma by 4.1-fold and 2.7-fold, respectively. The contraceptive injection Depo Provera (medroxyprogesterone acetate) was linked to a 5.6-fold increased risk. The study urged further research on the safety of these hormones, especially injectable medroxyprogesterone acetate. Pfizer acknowledged the risk of long-term progesterone use and is working with regulators to update labels and patient information. Nothing was mentioned of medroxyprogesterone acetate.

Depo Provera Lawsuits to Increase

New Depo Provera meningioma lawsuits continue to be filed worldwide. The plaintiffs have filed a motion to consolidate them into the Depo Provera MDL. According to Consumer Notice, the U.S. Judicial Panel on Multidistrict Litigation has set a hearing for the end of January 2025. In the meantime, plaintiffs and their lawyers advocate for greater awareness of Depo Provera’s risks. Women are urged to seek medical advice for adverse symptoms and consider legal action if a brain tumor develops following prolonged Depo Provera use.