1	The Future of QS in Vietnam
2	"In our Lancet paper published..." In our Lancet paper published in July 1993, we announced that we planned to do 6.2 million procedures during the period 1994-1998. (Hieu DT, Tan TT, Tan DN, Nguyet PT, Than P, Vinh DQ. 31 781 cases of non-surgical female sterilisation with quinacrine pellets in Vietnam. Lancet 1993; 342:213-217).
3	"In December 1993 WHO HRP..." In December 1993 WHO HRP sent a letter to Vietnam stating: “WHO experts and FDA officials have said that they would be surprised if quinacrine did not turn out to be carcinogenic.” The Vietnam QS program was immediately brought to a halt for reevaluation.
4	"By February 1994," By February 1994, we had determined that this statement could not be substantiated. The preponderance of scientific evidence suggested that this statement was without merit. We wanted to resume our QS program.
5	"Immediately," Immediately, in the hallways of the Ministry, several threatening rumors from international and UN agencies were heard: If the QS program is resumed, support for family planning in Vietnam could be suspended/ withdrawn.
6	"Ministry officials feared that international..." Ministry officials feared that international and bilateral programs would terminate their financial support to Vietnam (especially when WHO and UNFPA departed). The decision was made not to resume our highly popular QS program.
7	"The number of unnecessary deaths" The number of unnecessary deaths? The impact on our abortion rate? The costs in dollars to our country?
8	"In Vietnam," In Vietnam, there are 10.3 million women ages 30-49. By age 30, 82% of women say they want no more children, or 8.4 million. If the QS program can reach 80% of these women, then 8.4 x 0.80 = 6.7 million QS sterilizations would be required – a number we are confident we can achieve.
9	Total number of maternal deaths in Vietnam annually
10	"Maternal deaths in 30-49 age..." Maternal deaths in 30-49 age group = 190 Total maternal deaths (15-49 age group) = 321
11	No. maternal deaths in 30-49 age group in Vietnam Total No. maternal deaths x proportion of women who are 30-49 2466 x 0.592 = 1460
12	"1460 x 0.82 = 1197" 1460 x 0.82 = 1197
13	"1197 x 0.80 = 958" 1197 x 0.80 = 958
14	"958 x 20 = 19,160" 958 x 20 = 19,160
15	"7/8 x 19,160 = 16,765" 7/8 x 19,160 = 16,765
16	"Someone must take responsibility for..." Someone must take responsibility for these 16,765 deaths of Vietnamese women. They were needless.
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18	"Population of United States" Population of United States 280 million Population of Vietnam 80 million Thus, the abortion rate in Vietnam is 3.5 times the U.S. rate.
19	"To arrive at the total..." To arrive at the total fertility rate of 2.3 reached in Vietnam in 1997 with the following contraceptive method mix required a very high abortion rate.
20	The 1997 contraceptive mix in Vietnam
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22	Savings in costs paid by family for public sector abortions
23	Savings of reducing abortion rate by one-half
24	Annual savings in cost of IUD insertions
25	"Cost savings in abortion and..." Cost savings in abortion and IUD insertions with our QS program alone would make the desired contraceptive mix possible.
26	"These three costs that we..." These three costs that we have discussed are just a few reasons Vietnamese women desire to have QS in their future.
27	"The future of QS in..." The future of QS in Vietnam is in doubt so long as WHO maintains its opinion that QS likely causes cancer. The government is not free to implement the findings of its own risk-benefit assessment. A fully-informed debate by FIGO would be an important first step toward resolving this dilemma.