The Japanese government's nine-year deliberation over the birth control pill came to an abrupt end in June, when the pill was approved--ostensibly in response to public outcry over the quick approval of the male impotence drug Viagra early this year. The pill first hit the market in Japan on August 31.

Japan's Ministry of Health (MOH) had been considering the pill since 1990, with little progress. On the other hand, the application for Viagra was approved only six months after submission, much to the chagrin of women's advocates.

Tough Review Process

The MOH's strict standards for foreign medications typically force long review periods and few approvals. Even the pain reliever acetaminophen (Tylenol) has failed to be approved.

For years, the health ministers said more research was needed to determine the pill's safety. They also said they wanted to delay approval until the public becomes better educated about preventing sexually transmitted diseases, fearing increased promiscuity and lowered condom use if given the option of using the pill. The condom, currently the most widely used contraceptive method in Japan, offers protection against pregnancy and sexually transmitted diseases.

Caution or Bias?

While the six-month review of Viagra is atypical of the MOH's timetable, women's groups feel it is characteristic of societal bias. Hitomi Kasai, clinical manager of the Japanese Medical Practice in New York, agrees: "Culture still matters in Japan. People say equality, but...men are still dominant."

According to an article in The New York Times, the Japanese government unofficially maintained that rapid approval of Viagra was necessary to ensure its proper usage. Last year, a Japanese man in his 60s reportedly died two hours after taking Viagra. Though the exact cause of death was not released, the incident did cause alarm.

"If you look at the issue in terms of safety, it's strange that Viagra got approved so fast," said Dr. Tomoko Adachi, according to the Times article. A gynecologist at Tokyo Women's Medical University, Adachi said many of her clients are not happy with their partners' use of Viagra.

An Old Issue Revisited

Critics were quick to connect the disparity in the handling of the two drugs to the MOH's demographics: only six of its 204 members are women.

"This is a gender issue," Hiroko Hara, a member of the Japanese Network for Women and Health, told the Times. "Some Japanese men do not want Japanese women to become empowered."

Naadu Blankson-Seck is a writer and editor at AVSC.