A Chinese Pill to which many medical effects have been attributed in Uganda and other countries, became more popular in the country after its ban, according to the drugs regulators.

The authority warned against using the Contraceptive Pill in October last year upon realising that it was being sold on the black market. It is dubbed the ‘Chinese pill’ because its packaging has no name either for the manufacturer or for the drug itself. But it has two words that are not written in Chinese; Levonorgestrel and Quinestrol.

A search of the labels reveals that the pill contains Levonorgestrel Fast Estradiol Tablets, according to the first line. The second line describes it as a long-acting oral contraceptive tablet, while the manufacturer is shown as Zizhu Pharmaceutical Co Ltd in the lower line.

A company with a similar name, Beijing Zizhu Pharmaceutical Co. Ltd. was founded in 1980, and deals in the “manufacturing, fabricating, or processing of drugs in pharmaceutical preparations for human or veterinary use”. it is not clear whether the two are related.

Medical records show that Levonorgestrel, also known as the morning-after pill, is a first-line oral emergency contraceptive pill with approval from the World Health Organization to prevent pregnancy.

It is effective if used within 72 hours of unprotected sexual intercourse or when a presumed contraceptive failure has occurred. It is usually applied as a once-a-month dose tablet.

Quinestrol, the second ingredient that is sometimes stated as ethinylestradiol cyclopentyl and sold under the brand name Estrovis, has been used in menopausal hormone therapy, hormonal birth control, and treatment against breast and prostate cancers.

According to NDA, the pill was found to contain high doses of hormones above the recommended dosage. The risks associated with the use of this product include prolonged bleeding, irregular menstrual periods, palpitations, the possibility of blood clots and heart disease. It can also lead to cancer in the uterine area and infertility.

Since the October warning, NDA says it has been on surveillance of the market to ensure the pill is not anywhere on the Ugandan market. National Drug Authority Public Relations Manager Abiaz Rwamwiri, however, says that the pill is sold on the black market, by a complex racket.

“We even arrested one person, a boda-boda rider, but it was found that this was someone who was just delivering the pill, perhaps to a person unknown to him, and not even knowing where it came from.” He says the drug can go through 40 different hands before it gets to the final user and one cannot just walk into a pharmacy and get it, yet it’s being sold.

One pill costs between 10,000 and 15,000 Shillings each, compared to other available alternatives that cost around 5,000 shillings for a month’s dose.

Asked why one would go through all that trouble and expense to get the pill instead of using the legally acceptable ones, he said that its main advantage is because it can be taken once for a whole month, unlike the other available oral options that require daily consumption.

He is however concerned that the ban seems to have made the drug even more popular since more people started looking for it and its demand went up. He adds that unfortunately, its adverse effects are far worse than what it gives.

The regulator says that when used, the hormones from the pill take longer than should be in the body and this poses high risks to the baby born of a user mother, including secondary sexual characteristics like premature puberty.

“For example, there was a baby which got pubic hair at three years and because the mother had used this pill, it was most likely to be the cause,” Rwamwiri said.

By the time Uganda banned the pill, it had been banned in other countries long before. In Kenya, the ban came as long ago as 10 years after authorities realized that the levonorgestrel levels were “more than 40 times the recommended levels,” according to a report by BBC.

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