There is relatively no profitability in contraceptive evolution. Development is governed first by sales potential and only later by public health need. This means that all the pills, patches, and implantable rods that have been created specifically for use by men probably won't reach the market anytime soon. It's not because they don't work. The Population Council has a slew of projects under way, using a synthetic steroid called MENT, that promise to temporarily reduce sperm count. It's because Big Pharma thinks they won't sell, or so one theory goes. Without a new blockbuster, there's little opportunity to gain prominence.
The low profile of contraceptive pioneers also has something to do with opposition to a field of science that "promotes promiscuity." In 1873, 24 U.S. states passed Comstock Laws prohibiting the distribution of "obscene, lewd and/or lascivious" materials—including contraceptives—through the mail. It took almost 100 years to reverse all of these laws. While it may seem like a lot has changed since the days of smuggled birth control, federal funding for this area of research is still an issue.
In 1973, near the peak of reproductive research funding, the field's financial support made up just 2 percent of all U.S. medical research spending. Since then, it has just been a downward slope. The problem with this decline is one of fiscal responsibility: By skimping upfront, we might actually be losing money in the long-term. Proponents argue that if you can increase contraceptive funding and create more effective, reliable, and easy-to-use methods, you can later save millions of dollars in federal health spending on terminations and the costs of raising a child on welfare. Clearly, it's a complicated and deeply polarized balance. But for the researchers involved, it's an issue of livelihood. If the government won't help out and private funding is limited, what's a contraceptive inventor to do?
Just keep plugging along, it would appear. And that's just what Richard Cone has done. Thirty years ago, while teaching physiology to several hundred preppy Johns Hopkins undergraduates, he had a birth-control epiphany. * He asked his pupils to show, by hand, how many were the fruit of "surprise" pregnancies. At least one-quarter of their hands went up. Once Cone realized that everyone had a birth control problem, not just teenagers and poor people, he was sold.
A dozen successful scientific publications and a few setbacks later, he is still in the lab. Microbicides did not work this time: Cone speculates the gel's time-sensitive protection span was to blame. Like a birth control pill taken at the wrong hour of the day, poorly timed gel use could have skewed the results. But there is still hope for a future gel that will kill sperm and HIV alike and not detract from intimacy like a condom or irritating spermicide. It's this hope that keeps contraceptive researchers searching. There might not be much glory in finding the ideal lube, but in bedrooms, the backseats of cars, and everywhere in between, their products make a difference daily.
Correction, March 12, 2010: The article originally and incorrectly referred to John's Hopkins. It is Johns Hopkins. (Return to the corrected sentence.)
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