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ARGENTINA | 30-07-2018 00:56

Argentina's Health Minister: 'I'm not the flag bearer of abortion'

In an interview, Health Minister Adolfo Rubinstein talks about his recent remarks in the Senate over the bill to decriminalise elective abortion.

It was not an easy week for Health Minister Adolfo Rubinstein, a man who would prefer to keep a low profile like other scientists rather than manage the exposure of a public servant. 

It began with Rubinstein being summoned to address the Senate in the ongoing public debate about a bill to decriminalise elective abortion. When he did, the Health Minister took aim at lawmakers from his own political coalition who are against the measure. And it ended with his response to controversial statements made by the pediatrician Abel Albino against the use of condoms. "It was nonsense", Rubinstein said.

Ten days before the historic vote in the Senate, the Health Minister spoke about what went on behind the scenes the day he addressed Congress and what is likely to happen after August 8.

After being summoned, did you ever doubt appearing in the Senate to give your presentation?
No, not for a second. I did not feel good, of course, because it [the summoning] was also completely unfounded. The source of information for the summons, beyond suggesting that I had already taken a stance [on abortion], had to do with a fake news item that was atrocious, claiming that I was being paid by the International Planned Parenthood Federation, something that I learned existed only in the last few days, with my questioning in the Senate.

Were you pressured not to attend?
Absolutely not, never. Since the debate began, with freedom for everyone to express their positions, I have not received any pressure from anyone. I felt free to put the voice of public health in the debate, trying not to express personal positions or convictions but to speak with public health data and about the consequences of abortion in illegal conditions.

The data have been criticized, since first there was talk of 400 to 500 thousand abortions in the country and then, 47 thousand ...

It generated confusion, I don't know if it was intentional. The number of abortions in Argentina is unknown because abortion is illegal, it is clandestine. What data do we know? We know the data about hospital discharges, admissions in public hospitals as a consequence of illegal abortions. We registered 47 thousand hospitalisations and 43 deaths due to abortion in 2016, of which 31 are the result of clandestine abortions. Those are the official data. But there is underreporting, since there are many abortions that are not reported in the public sector. In terms of live births, fertility rates and hospital discharges in the public sector, one can extrapolate the number of estimated abortions in the country. We made this estimate and it came to 350 thousand, which is the data that I presented in the Senate. 

How did you feel when Senator Esteban Bullrich accused you of choosing "the easy way", which is legalising abortion instead of addressing unwanted pregnancies? 

I have spoken at length with Senator Bullrich on other occasions, and what he said is fine. It is true, perhaps the most complex path and the one that takes more time is to work toward the prevention of abortion, with comprehensive sexual education from primary school. Add to that, the counseling and delivery of contraceptives. But until these policies come into effect, we cannot ignore what is happening today with complications and deaths resulting from clandestine abortions. One might say: "This is not the utmost public health problem or the first cause of death among women." It's true, it's not. But it is an avoidable cause of death in young and highly vulnerable women. After five months of debate, among members of a society who are aware and know the data, what do we do? Do we neglect the issue? I agree with Bullrich that we have to work toward prevention. But in the meantime we have to find a a solution to the problem that exists today. 

Do you mind being called the "flag bearer of abortion"?

Nobody is in favour of abortion, neither those who are in favour of legalisation nor those who are against legalisation. This has to be made very clear. Abortion is not a solution, it is a tragedy. And abortion can in no way be considered a contraceptive. I am not the flag bearer of abortion. Perhaps just the first minister of public health to shed light on the problems attributable to abortion in clandestine conditions. This has also emerged as part of the women's rights movements that began decades ago. You have to see it from that perspective.

What will happen the day after August 8?

Regardless of the outcome [of the vote in the Senate], I think that a great deal of progress has been made. Our whole society has been talking about abortion for five months. There are certain topics that are going to be consecrated, such as sex education. Nobody is going to admit now that sex education is not offered in their schools or that contraceptives are not distributed in health centres.

And if it is approved? 
It will fall on me to comply with the law.

And if it is not approved? 
If it doesn't happen now, I am convinced that it will have a second opportunity. Because social movements are unstoppable. Abortion is a reality that one cannot ignore.

 

MORE FUNDING FOR SEXUAL HEALTH

The best way to avoid unwanted pregnancies and, therefore, clandestine abortions is sex education, and health prevention through the distribution of contraceptives (such as condoms, IUDs and sub-dermal implants). 

However, with a budget of 360 million pesos, the National Sexual Health and Responsible Procreation Programme at the Health Ministry has only spent eight percent of its budget, according to La Nacion.

"Last year all the purchases were made and spending this year was going to happen in the second quarter. That's why in the first quarter there was eight percent spent of the budget. Today it is 91 percent", Rubinstein said. 

"In addition, it is the largest budget in history in sexual and reproductive health at constant values. Because we are delivering all the inputs (long-term contraceptives, such as subdermal implants) that are tied to the National Programme for the Prevention of Unintentional Teen Pregnancy", he added.

 

Why are we not seeing public campaigns, for example, about the use of condoms?

It's an excellent question. The use of condoms is a matter of concern. We have already started public campaigns through social media. And we are delivering condoms in health centres and hospitals. Of course, this must be accompanied by sex education and information campaigns for professionals and the general population. It is true that more effort must be made. 

This articled was originally published in Spanish on Perfil.com

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Florencia Ballarino

Florencia Ballarino

Subeditora de Ciencia.

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