furthermore, the costs of that failure are high, for societies, for families, and for individuals. The committee also found that an agenda for contraceptive research and development that is "woman-centered" to be reasonable, just, and also market-worthy. The challenge is to find creative ways to elicit the best response from the scientific and industrial communities in a conducive climate that protects the integrity of inquiry and the safety of consumers.

The issue of climate is central. The aspects of context that press on every effort to provide safe and effective contraceptive technologies are complex and reflective of deeply rooted differences and deeply held beliefs. In addition, there is the current atmosphere of fiscal austerity in so much of the world, an atmosphere that cannot be ignored. At the same time, what is to be done about real, urgent, and unmet needs that affect public health and well-being everywhere? The committee opted for a set of recommendations that are neither glamorous nor sweeping. They are, instead, unified by their practicality, located in the middle ground of policy, and intended to respond to what seem to be the needs of a significant majority.

Finally, the committee chose to use this closing chapter to simply list its recommendations, without elaboration and divided into two main sections: first, the criteria for and the prospects of the science and, second, the elements of context that will need to be affected if the science is to advance significantly and the needs and demands of individuals and families are to be met. The reader is referred to the summary at the very outset of this report which frames each recommendation in the larger setting to which it corresponds. Each presentation serves a slightly different policy objective for different audiences, while the report as a whole is meant as a review of the various key dimensions of this very complicated but very essential topic.

The Prospects of the Science

Recommendation 1. The committee recommends that priorities for new research be assessed against the preference criteria presented in a new "womancentered agenda" and that existing public sector contraceptive research and development portfolios be reassessed similarly. Such an approach highlights the need for improvements and new advances in contraceptives for women, and in areas where there are few or inadequate options, namely:

  • Methods that act as chemical or physical barriers to conception and to transmission of sexually transmitted diseases, including the human immunodeficiency virus (HIV);
  • Menses-inducers and once-a-month methods targeted at different points in the menstrual cycle;
  • Methods for males that would expand their contraceptive choices and responsibility.


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