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Such promising results persuaded both Sweden and Britain to license RU 486; India is testing the drug. China is manufacturing clones that as yet are not widely available. Other countries, most notably Canada, are waiting for the U.S. to take the lead. "The U.S. is the leader in advanced research, the main source of development funds and the heart of worldwide networks that can allow RU 486 to help women everywhere," explains Baulieu.
In 1991 the French began testing the new method of using RU 486 that does not require going to a clinic for a follow-up shot. An oral prostaglandin, commercially marketed as Cytotec by the American manufacturer G.D. Searle, enabled women to abort simply by swallowing a combination of pills. The efficiency rate rose from 95.5% to 96.9%, and the speed of the procedure improved. In 61% of the cases, the uterine contents were expelled within four hours after taking Cytotec, in contrast to 47% in the case of prostaglandin injections. Although there were instances of nausea and diarrhea, which are also common side effects with injections, those who took the pills reported considerably less pain. "Women tolerate it much better," says Dr. Elisabeth Aubeny of the Broussais Hospital in Paris, a testing ground for RU 486 in 1984. For French taxpayers, who foot 80% of the bill for each abortion through their national health-care system, there is also an advantage: a dose of Cytotec costs only 72 cents, vs. $22 for the prostaglandin shot.
Once again, controversy erupted. When Baulieu first began experimenting with RU 486 in combination with an oral prostaglandin, Roussel balked. As a result, Baulieu had to persuade French public health officials to defray insurance costs. After preliminary trials, the government compelled Roussel to participate, arguing that the proposed testing of an oral prostaglandin was important for women. Although Searle raised no objections, its executives remain uncomfortable about being linked to the abortion business. "Searle has never willingly made ((Cytotec)) available for use in abortion," a company official wrote in a letter to the Wall Street Journal in February. "It is not Searle's intention or desire to become embroiled in the abortion issue." Searle's reservations echo that of Hoechst president Wolfgang Hilger, who has been open about his ethical objections to RU 486.
The uses of RU 486 could extend well beyond dealing with some of the 37 million abortions carried out around the globe each year. European studies have shown that it is an effective morning-after pill, inducing less nausea or vomiting than other drugs used for the same purpose. There are also indications that RU 486 can combat endometriosis, a leading cause of female infertility, and fibroid tumors, a condition that often necessitates hysterectomy. Thus the same drug that can help some women end unwanted pregnancies may enable others to bear children. Assorted studies have found that RU 486 may also combat breast cancer and Cushing's syndrome, a life- threatening metabolic disorder.