The Supreme Court of the United States, which was to rule yesterday on the legal puzzle surrounding the fate of the abortion pill, postponed its decision for two days, thus temporarily extending full access to the stamp. A Texan judge banned it on April 7, questioning the safety of the molecule used and considering, despite scientific consensus, that it posed risks to women’s health. When the abortion pill was discovered in the 1980s, André Ulmann, then a young doctor, was poached to convince medical and political institutions to authorize chemical abortions. Forty years later, he considers the American legal battle “ridiculous”. By questioning the safety of the molecule used and by agitating about the risks for women, the American judges contradict all the scientific expertise accumulated around this drug. At the risk of destabilizing confidence in medical institutions, according to him.
The Express: How do you judge the latest twists around the American legal battle on this subject?
Andre Ulmann: It is not up to the judges to decide on the reliability of a drug! What will it be next? A judge is going to ban vaccines? This battle goes beyond the abortion pill or the right to abortion. It is the very legitimacy of the American medical regulator that is threatened, and with it, medical institutions in general. Whether we are opposed to abortion, fine. I am not a legislator, or prescriber of morals. But the decision of the Texan judge who relaunched the legal battle in the United States is absurd.
These judges have no medical knowledge. The authorization given to this molecule by the FDA in the 2000s would be illegal, according to them? They would have realized that the abortion pill would actually be dangerous, twenty years later? It’s ridiculous. Five million Americans have already taken it, and many more around the world. All transparency has always been made. As much on the effects as on the risks associated with chemical abortion. Everything else is political.
In 1984 you were recruited by Roussel-Uclaf, the French company that discovered the abortion pill. Your mission: to obtain marketing authorizations. Forty years later, do you fear that the world is going the other way?
Rights, in terms of women’s health and the termination of pregnancy in particular, are never won. But the United States was not sufficiently protected. A simple decision by a judge, the Wade vs. Roe case, prevented federal states from banning abortion. Under Trump’s control, the Supreme Court overthrew this legal framework in June 2022. Since then, pro-abortions have sought to protect this right through a much more protective federal law. But for that, you need the vote of two-thirds of Congress… Paradoxically, the controversy helped to inform American women about abortion, when they were less so than European women. A Streisand effect: conservatives participate in mobilizing around abortion, trying to prevent it.
In Europe, the right to termination of pregnancy is regulated by law, which reinforces it. This does not prevent backtracking: since 2021, Poland has hardly allowed any abortions. But other states, faced with these sporadic setbacks, have increased access to abortion, such as the Netherlands, where the reflection period is no longer mandatory before requesting intervention. A number of French parliamentarians have recently called for the inclusion in the Constitution of a right to abortion. I am in favor of it. It is additional protection.
In France, sporadic shortages of abortion pills have been recorded, in Lille in particular. Health Minister François Braun tried to reassure, citing a very temporary problem. He convinced you?
Molecules allowing medical abortion are the subject of an American monopoly. I am not an economist. I don’t know what’s going on in the supply chain. But leaving an essential product to a single company, in a country where abortion is threatened, is never good. In 1994, the company I worked for, Roussel-Uclaf, had to give up its patent on mifepristone, the main chemical abortion molecule, precisely because it was threatened by American anti-abortion movements, imported from Germany. …
One of the chemical abortion pills? There are several of them ?
If the American debate focuses on mifepristone, it is almost systematically associated with another, misoprostol. The first, also called RU486, was invented in the 1980s by two scientists from Roussel-Uclaf. Very quickly, the company realizes that it blocks the action of progesterone, which has the effect of aborting. She recruits a first person in charge of getting marketing… who turned out to be anti-abortion! That’s when they recruited me.
In parallel, another molecule emerged, and was added to the protocol. 24 to 48 hours after taking the first pill, take the other, a prostaglandin (misoprostol). This was developed for gastric ulcers. It was for digestive purposes but we realized that it caused an evacuation of the embryo. Taken alone, it is very painful. One does not go without the other. And both are now produced by a single American company, Nordic Pharma.
In Japan, only surgical abortion is allowed. It’s usual ?
No. Usually both are offered when the law authorizes abortion. I am also in favor of women being able to have a choice, it is important. Japan is a very conservative country when it comes to women’s health, and remains an exception, even in Asia. We approached him very early with Roussel-Uclaf, without success. Imagine that China was one of the first countries to say yes, even before France, and hasn’t turned back since!
In my career, I also developed another product called Norlevo. A morning after pill. We took ten years to bring it to the Japanese market. At the same time, viagra took six months! In Japan, last-resort contraception still cannot be obtained without a doctor’s approval, while it is self-service in the West and other Asian countries. And it costs up to 140 euros, not reimbursed.
A question of manners then…
And money! Abortion is legal in Japan, but only through surgery. It is practiced in small city pharmacies. The act makes a lot of money for gynecologists. The cost ? 1,000 to 2,000 euros, which women take out of their pockets. Doctors make a good living with it. They therefore take a dim view of the abortion pill, and do nothing to change the legislation. It should still happen. The Ministry of Health would now be in favor of it. But he is also very attentive to what is happening in the United States. However, I remain optimistic.
Abortion, the morning after pill… You have made your career in the field of women’s health. If certain rights are declining, at the same time, is the market driven by the ongoing feminist revolutions?
It is indeed a booming sector, even if there is still too little talk about women’s health. Much remains to be done. Just in terms of the ergonomics of the products, which often turn out to be designed and tested by men. With Cemag Care, my current company, we have just put on the market an IUD which is inserted painlessly, to remove certain obstacles to this contraception, which is sometimes shunned even though it has many advantages. We will soon be marketing a product that reduces menstrual bleeding. It is a taboo condition, and yet common and disabling! We are also developing a tool to help women know when they are at risk of becoming pregnant, in relation to their hormonal cycle. A kind of self-test.