By: Ennety Munshya
The banned Chinese contraceptive pill, known as the “Sophia pill,” has re-emerged on the Zambian market, despite its dangerous hormone levels causing health issues like excessive bleeding and irregular menstrual cycles. It is allegedly being sold through Chinese-run clinics.
The sale of the once-a-month pill was prohibited by Zambia’s authorities six years ago because of high levels of levonorgestrel – more than 40 times the recommended levels. Levonorgestrel is a hormonal medication used in a number of birth control methods.
The Zambia Medicines and Regulatory Authority (ZAMRA) banned the pill in 2018, citing serious safety concerns. However, its continued availability and use by many women across the country raise critical questions about the enforcement of drug regulations and the protection of public health.
The pill packaged and labelled primarily in Chinese, adds to the danger, as users cannot fully understand the potential health implications.
The use of Chinese on the packaging indicates that the pill has not been approved, as one of the requirements for registering and approving medicine is that the name and instructions must be in English.
MakanDay investigations reveal that despite the risks and the official ban, the pill is easily accessible and sold discreetly in some Chinese-operated clinics.
MakanDay has visited several Chinese-run clinics in the capital, Lusaka, to make inquiries about Sofia – most said the drug was on sale. A Chinese man at Dr. Wu’s Surgery in Lusaka’s Libala area clinic reached into his pocket, retrieved a small plastic bag containing pills, and handed one to the reporter.
When asked about potential side effects, especially for a first-time user, he hastily dismissed any concerns, stating there were no side effects. During the short time the reporter was at the clinic, two other women also came in to buy the pill. At this location, the pill is sold for K50 (US$ 1.8 at the current exchange rate).
On November 18, 2024, this reporter visited WHB Medical Centre, operated by Dr. Li, in Lusaka’s Olympia area. Here, the pill was sold for K60 (US$ 2.2). When asked about possible side effects, the response was, “Usually not—maybe you will just have nausea.”
He further explained that taking the pill might cause menstruation-like bleeding but reassured her it was merely the body reacting to the medication.
The price of the Chinese pill ranges from K50 (US$ 1.8) to K100 (US$ 3.7), depending on the clinic.
While at WHB Medical Centre, the reporter also observed other medications labelled in Chinese being dispensed to clients.
This troubling trend underscores the urgent need for stricter regulatory oversight and increased public awareness about the risks of unapproved medications.
The investigation by MakanDay into the banned Chinese pill revealed inconsistencies in the responses from clinics allegedly distributing it.
In a phone conversation with Dr. Wu’s clinic, the initial confirmation of the pill’s availability at K50 was later denied when informed of its prohibition. A similar situation unfolded at Dr. Li’s clinic, where the pill was reportedly available for K60.
Upon questioning about the ban, the clinic shifted its stance, claiming the product was not the Chinese pill but Mycrogynon, a different emergency contraceptive.
These interactions suggest potential non-compliance with the regulation banning the pill, raising concerns about enforcement and public health risks.
Testimonies from users
Many women continue using the pill, unaware of its potential side effects, drawn by its perceived convenience. Among them is a 36-year-old Lusaka resident, who spoke to MakanDay on condition of anonymity. Like many Zambian women, she was initially attracted to the pill for its affordability and the ease of taking it just once a month.
At first, the pill appeared effective. However, within a few months, she began experiencing complications.
In her fifth month of use, she developed severe headaches—an early warning sign. After a short break, she resumed taking the pill, only to suffer heavy bleeding. A hospital visit confirmed that the pill was the cause of her distressing symptoms.
“It was convenient to use once a month, so I didn’t think it could cause such problems,” she explained, adding that a friend had recommended the pill.
MakanDay also discovered mixed reactions on social media. While some women praised the pill for its effectiveness, others detailed similar adverse effects, ranging from headaches to more severe health issues.
ZAMRA’s response
The Zambia Medicines Regulatory Authority is a statutory body established under the Medicines and Allied Substances Act No. 3 of 2013. Its mandate is to regulate and control the manufacture, importation, storage, distribution, supply, sale, and use of medicines and allied substances. ZAMRA ensures that all medicines and allied substances available to the Zambian population consistently meet standards of quality, safety, and efficacy.
Responding to an inquiry from MakanDay, ZAMRA’s Senior Public Relations Officer, Ludovic Mwape, acknowledged reports of the continued availability of the banned Sophia contraceptive pill on the Zambian market. Mwape attributed the challenge of removing the pill from circulation to porous borders that facilitate smuggling, inadequate resources (both human and financial), and the complexity of supply chains.
Expert analysis
Dr. Bright Makenzie, a consultant obstetrician and gynecologist at Levy Mwanawasa University Teaching Hospital, raised concerns about the pill’s safety. He explained that studies have revealed the Chinese contraceptive pill contains an excessively high dosage of hormones, posing significant health risks to women.
Dr. Makenzie highlighted that prolonged bleeding is the most common issue among his patients who have used the pill. He urged women to avoid harmful health-seeking behaviours and cautioned against making contraceptive choices based solely on anecdotal advice from friends. He emphasised that contraceptives affect individuals differently and recommended consulting qualified healthcare professionals to determine the most suitable option.
Phone Conversation with Dr. Wu’s clinic
Reporter: Hello, Am I through to Dr. Wu’s clinic?
Dr. Wu’s clinic: yes you are.
Reporter: I wanted to find out whether the Chinese pill is available at your clinic?
Dr. Wu’s clinic: Yes it is available.
Reporter: How much is it?
Dr. Wu’s clinic: k50
Reporter: Are you aware that the pill was banned for sell and use in Zambia?
Dr. Wu’s clinic: Aaaaah! What are you saying?
Reporter: Are you aware that the pill was banned for sell and use in Zambia?
Dr. Wu’s clinic: laughs……Actually we don’t have, we stopped selling.
Reporter: But you earlier confirmed that you have the pill
Dr. Wu’s clinic: No I did not hear properly, we don’t sell.
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