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Quarterly Newsletter
Dear Friends,
Since the 1994 International Conference on Population and Development in Cairo, the international community has struggled to reach the looming goal to eradicate extreme poverty and hunger, reduce preventable diseases and reduce infant and maternal mortality around the globe. As we approach the year 2015 - the target set by world leaders at the UN Millennium Summit in 2000 - we are challenged to make more headway on that ambitious yet bold declaration detailed in the Millennium Development Goals (MDGs).
Over the last few months PIWH reached out to several community-based organizations throughout Latin America, Africa and Asia that are leading the way with innovative partnerships and programs that address these challenges. Yet, no matter where we were, be it Guatemala or South Africa, I was struck by the reoccurring themes in lessons learned, best practices and evidence-based research that emerged from advocates.
As an invited presenter at the recent XIX World Congress of Obstetrics and Gynecology in Cape Town, South Africa, a mostly clinical gathering of clinicians and researchers from around the world, I was told that this year's conference marked one of the first such conferences that women's health advocates like me were invited to speak. I presented on pharmacy access to hormonal contraception - a model with the potential for improving access to birth control for millions of women in the U.S. Timely to both the current U.S. healthcare reform debate and the urgent need for improved global health, I was proud that PIWH could offer a sustainable option to broaden access sexual and reproductive healthcare services and supplies.
If the international community is to be successful in achieving a global health strategy that strengthens health systems, improves women's sexual and reproductive health, involves men as partners and elevates women as decision makers, then we have no choice but to forge a bold vision where human rights and sexual and reproductive rights are inextricably linked. PIWH is committed to that vision.
Belle Taylor-McGhee
President and CEO, Pacific Institute for Women's Health
  
Power Breakfast Forum for Women’s Health
“Action Towards Women’s Health”
As we advocate for full access to women’s reproductive health options in the U.S. healthcare reform debate, we are mindful of the millions of women worldwide who do not have access to basic healthcare.
At the first Power Breakfast Forum on Women’s Health (PIWH) hosted by the Pacific Institute for Women’s Health, journalist and author Michelle Goldberg described these challenges as the global battle over women’s sexual and reproductive freedom. Michelle’s poignant remarks were echoed by an enthusiastic and insightful audience of advocates, policy makers, researchers and funders – topping off an inspirational morning at the beautiful City Club of San Francisco.
Guests gathered over a wholesome breakfast to discuss practical strategies that U.S. and global leaders can take to improve and protect women’s health and rights worldwide – from greater awareness and public education to policy work that improves access to reproductive health technologies.
We were so honored to have convened leaders from myriad organizations foundations, including The Wohlford Foundation; IBIS Reproductive Health; Association of Reproductive Health Professionals, Physicians for Reproductive Choice and Health; Beacon Program at Mission Neighborhood Center; EngenderHealth; and the University of California San Francisco - organizations committed to elevating the status of women’s health in the U.S. and abroad.
We were especially thrilled to present the first PIWH Visionary Partner Award to Francine Coeytaux and Daniel Grossman. The Visionary Partner Award is presented to individuals who work to improve women’s sexual reproductive health worldwide and who promote women’s access to the full range of reproductive health options, including access to new reproductive health technologies.
Highlighting her new book, The Means of Reproduction: Sex, Power, and The Future of the World, Michelle Goldberg’s keynote address reminded us about the complexities of female oppression around the world and the various fronts on which advocates must battle to ensure reproductive freedom. Michelle told the story of “Rosita”, the 9-year old Nicaraguan girl, who was prohibited by the Church and government to receive an abortion, even though carrying the pregnancy to term would endanger her life.
While the ultimate life-saving medical procedure was obtained for “Rosita”, the international pressure mobilized the Catholic Church, with support from Nicaragua’s president – to pass a draconian law that outlawed abortion even when the life of the mother is in danger.
“Rosita’s” story, like many women’s stories, embodies the need to work with allies on different fronts to address women’s health and rights.
PIWH President and CEO, Belle Taylor McGhee, said “We believe women need support so that they can manage their reproductive lives – free from violence and intimidation.” PIWH is committed to leading this discussion with our myriad allies and partners.
Pharmacist Leaders Moving Pharmacy Forward
Pharmacy Access Partnership, a center of The Pacific Institute for Women’s Health, is proud to present the inaugural class of Pharmacy Forward, the nation’s first leadership training program for pharmacists around sexual and reproductive health.
Pharmacy Forward kicked off in Los Angeles October 2-4, 2009.
This first retreat gathered many well-recognized experts from various fields to train fellows in key policy and advocacy areas of reproductive health. Rocio Cordoba and Gabriela Valle of California Latinas for Reproductive Justice led an interactive session on applying the reproductive justice frame to the pharmacist’s role in advancing reproductive health.
Edward O’Neil, Director of the Center for the Health Professions challenged participates to formulate their own vision and goals to advance reproductive health in a changing – and challenging – healthcare landscape.
Participants also enhanced their communication skills through live on-camera media advocacy training facilitated by Berkeley Media Studies Group. Tom Riley, Principal of Cal Capitol Group ended the training reviewing critical advocacy strategies to for fellows to use on the local, state and national levels.
Pharmacy Forward fellows were also officially recognized and welcomed as first time attendees at Reproductive Health 2009, Association of Reproductive Health Professional’s national clinical conference. As pharmacists are traditionally underrepresented at this conference, Pharmacy Forward represented a new opportunity for other health professionals to network with pharmacists around a common goal of promoting reproductive health.
Over the course of this year-long program, fellows will be setting individual leadership goals and participating in webinars and conference calls. And through PAP’s colleagues and networks, fellows will be introduced to myriad reproductive health and justice organizations throughout the U.S.
PAP also extends its most sincere appreciation to its co-collaborators, University of California, San Francisco, School of Pharmacy and Center for the Health Profession’s Pharmacist Leadership Institute.
Meet the Inaugural Class of 2009-2010
This year’s Inaugural class is comprised of nine pharmacists from around the country representing various practice settings. These outstanding fellows were selected by our multi-disciplinary steering committee from a pool of 40 applicants from 25 states.
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Amy Bachyrycz
Assistant Professor of Community Pharmacy, University of New Mexico; Patient Care Center Pharmacist, Walgreens, NM
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Teresa Dunsworth
Pharmacist and Adjunct Clinical Professor of Clinical Pharmacy, West Virginia University Hospitals, Pharmaceutical Services, WV
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Sonya Frausto
Assistant Professor, California Northstate College of Pharmacy, CA
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Adrienne Matthews
Pharmacy Director, Anthem Blue Cross and UniCare WellPoint, Integrated Pharmacy Management, CA
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Khanh Pham
President, Nevada Pharmacists Association; Pharmacist, Vons; Preceptor at USN, College of Pharmacy, NV
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Joanna Preker
Pharmacy Student, University of Washington School of Pharmacy; Intern, Seattle Children’s Hospital Pharmacy, WA
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Craig Richard
Associate Professor, Shenandoah University School of Pharmacy, Biopharmaceutical Sciences, VA
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Calita Richards
Director of Pharmacy, Tennessee Department of Health, TN
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Becky Twamley
Pharmacist, Brainerd Lakes Health-Clinic Pharmacy, MN
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Program Mentor Kathy Besinque
Associate Professor of Clinical Pharmacy, Director of the Professional Experience Programs and Office for Teaching and Learning Resources, University of Southern California School of Pharmacy
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Program Mentor Don Downing
Clinical Professor, University of Washington, Institute for Innovative Pharmacy Practice, WA
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Youth-Friendly Pharmacy Initiative Gaining National Recognition
 The Youth-Friendly Pharmacy Initiative (YFPI) has received overwhelmingly positive responses from members of the pharmacy community, youth, youth-serving organizations, foundations and reproductive rights and justice advocates since initiating its first live trainings in May 2009.
To date, more than 110 pharmacists, pharmacy technicians and pharmacy store managers have completed the YFPI training to enhance their capacity in attracting, serving and retaining youth clients.
The positive feedback and interest received underscores the importance of making pharmacies more accessible to youth clients, as well as the importance of reducing barriers young people experience in accessing sexual and reproductive health information, resources and services.
The YFPI has recently been featured in various publications, websites, blogs and conferences, including:
- Grantee Magazine, Fall edition of The California Wellness Foundation’s quarterly magazine
- Contraceptive Technology Update, A Monthly Update on Contraception and Sexually Transmitted Disease
- TeenSource.org, an educational website on healthy and responsible sexual lifestyles for teens and young adults
- AllBusiness.com
- The California Wellness Foundation’s website
- 2009 teenNow California Conference and
- 2008 California Adolescent Health Collaborative Conference
 The YFPI continues to advance its goal of expanding youth access to sexual and reproductive health services in pharmacy settings. Pharmacists are enthusiastic about this training opportunity. A Bay Area training participant said, “Definitely making this training available to pharmacists is educational and practical. Addressing the needs of youth is important, and should not be ignored.”
Through collaborations with the California Pharmacists Association (CPhA) and Walgreens Pharmacies, YFPI extended its reach to community pharmacies and Kaiser Pharmacies throughout the Bay Area, San Diego and Stockton. In San Diego, nearly 50 people attended the training!
Another component of the YFPI is the community partnerships formed with local, youth-serving and youth-led organizations. One such partnership is with this year’s Female Leadership Academy class at ACT for Women and Girls (Advocacy Coalition of Tulare County for Women and Girls). These young women will lead a community initiative to improve access to sexual and reproductive health services and products in pharmacies throughout Tulare County. Over the next year, we are also partnering with UCSD School of Pharmacy students.
 In spring 2010, we plan to collaborate with Advocates for Youth to bring this live pharmacist training and community-involvement initiative to New Jersey. Additionally, we anticipate a spring 2010 launch of the online YFPI continuing-education training for pharmacists nationally.
Learn more about the Youth Friendly Pharmacy Initiative and it various components, such as the video and factsheet.
For more information about the Youth Friendly Pharmacy Initiative including training participation or opportunities for collaboration, please contact Nicole Monastersky Maderas, MPH, at nmaderas@piwh.org.
Confused about EC Access?
For providers and consumers alike, confusion abounds about the availability of and accessibility to emergency contraception (EC). On April 22, 2009, the FDA decreased its previous age limitation from 18 to 17 and now allows consumers ages 17 and older to purchase Plan B over the counter (OTC).
There are now three FDA approved EC products available in the U.S. These products are “dual-labeled”-- they are available by both prescription and OTC with the same restrictions: women 16 years and younger need a prior a prescription from a doctor or clinic and consumers (women and men) 17 and older can get it OTC.
Plan B® One Step (Teva Pharmaceuticals, Inc.) is delivered as one tablet containing 1.5 mg levonorgestrel.
Next Choice™ (Watson Pharmaceuticals, Inc.) is a generic EC delivered in two tablets containing 1.5 mg levonorgestrel.
Plan B® (Teva Pharmaceuticals, Inc.) delivered in two tablets. also contains 1.5 mg levonorgestrel. Teva is no longer manufacturing or shipping Plan B and when existing supplies sell out, it will be replaced by Plan B® One Step.
The Reproductive Health Technologies Project has created a useful chart to compare the three EC products currently sold in the U.S. The chart is available at: www.rhtp.org/documents/PlanB-NextChoice-OneStepChart.pdf. According to Teva’s report at the American Society for Emergency Contraception meeting in September 2009, current sales for EC products are estimated at about 70,000 units per week, 90% of which is sold OTC. This can be compared with sales of 17,000 units per week before the OTC change.
Although, we are excited that EC sales are up and there are more product options for women, we remain disappointed about the FDA’s continued unnecessary restrictions on young women’s EC access. Pharmacist-initiated prescriptions for EC that are currently available in nine states (AK, CA, HI, MA, ME, WA, VT, NH, NM) continue to be especially crucial to facilitate timely access for younger women, undocumented women, women without proof of age, or those needing a prescription for insurance coverage.
Through our programs, such as the Youth-Friendly Pharmacy Initiative, we will continue to educate about and promote pharmacies as a culturally-relevant access points for teens, women and men for sexual and reproductive health care.
Keep an eye out for another EC product. A new compound has been developed for EC use – ulipristal acetate – and is now commercially available in France, Germany and the United Kingdom, in anticipation of the forthcoming launch throughout the E.U. ellaOne® (HRA Pharma) maintains efficacy for five days after unprotected intercourse. ellaOne’s® safety and tolerability profile has been demonstrated to be comparable to that of levonorgestrel. Submission to the U.S. FDA is underway. In Singapore and Malaysia, HRA Pharma and Hyphens entered into a license and supply agreement to commercialize ella®.
Circle of Advisors Celebrate PAP’s 10 Year Anniversary
On November 3, 2009, in Oakland, Pharmacy Access Partnership’s Circle of Advisors convened to discuss emerging reproductive health issues and celebrate ten years of promoting community health through pharmacies.
We were pleased to welcome our newest members including: Adrienne R. Matthews, Pharmacy Director, Anthem Blue Cross and UniCare WellPoint nextRx; Diana Greene Foster, Demographer, Assistant Professor, Bixby Center for Global Reproductive Health University of California, San Francisco and Director of Research, Advancing New Standards in Reproductive Health; and Liseli Mulala-simpson, Pharmacy Manager, Walgreens.
 Special guest presentations included new research on understanding what drives pharmacist’s ethical decision-making by Liz Chiarello, PhD candidate in Sociology, UC Irvine. Advisors also discussed condom access in pharmacies, specifically condoms being “locked up” and strategized some common ground solutions.
New topics in pharmacy education was also highlighted, with updates on multi-disciplinary national curriculum reform efforts around reproductive health as well as emerging opportunities for pharmacists on the domestic violence intervention team.
Expanding access to hormonal contraception through both an OTC and pharmacy access model was discussed, including new research on physician/clinician attitudes toward pharmacy access to hormonal contraception and upcoming legislative strategies.
Regarding international opportunities, the Circle of Advisors discussed medication abortion access via pharmacies in Latin America.
“How Can a Pharmacist Help Me?”
Pharmacy Access Partnership Eases the
Contraceptive Communication Gap for Teens
PIWH is proud to announce that the Youth Friendly Pharmacy Initiative has been featured in the Fall issue of Grantee Magazine, a quarterly publication of the California Wellness Foundation.
The article highlights the important of providing youth and young women with culturally relevant and easily accessible reproductive health services in their community, such as their local pharmacy.
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