Researchers and health advocates say misinformation, restrictive laws and weak implementation are undermining the impact of scientific advances in sexual and reproductive health.
By Bunmi Yekini
Defenders of sexual and reproductive health and rights are confronting growing hostility toward science and evidence, as misinformation, restrictive policies and funding pressures threaten to limit access to healthcare, experts said at a World Health Organization webinar.
Professor Kate Gilmore, co-chair of the Human Reproduction Programme’s Gender and Rights Advisory Panel, said advocates were on the frontline of what she described as a broader attack on science, driven by racism, sexism and homophobia.
“Powerful leaders” were seeking to suppress independent research, undermine academic freedom and reject scientific evidence, while cuts to funding risked restricting the benefits of research to elites, Gilmore, a former U.N. deputy high commissioner for human rights, said.
She was speaking at a webinar marking the start of sexual and reproductive health month, observed each September.
Information platforms that were intended to support the open exchange of evidence and solutions were increasingly being distorted by commercial and political interests, she said, allowing misinformation and myths to spread.
“As equality and diversity and inclusion are targeted by hate, the very notions of our common human family, of our universal rights to equal enjoyment of the fruits of science, are also under attack,” Gilmore said.
Evidence that changed policy
Lianne Gonsalves, a WHO scientist working on sexual health, cited research into contraception and HIV as an example of how scientific evidence can quickly influence healthcare policy.
The Evidence for Contraceptive Options and HIV Outcomes (ECHO) trial compared three contraceptive method, the Depo-Provera injectable, a copper intrauterine device and the levonorgestrel hormonal implant, to determine whether any increased the risk of acquiring HIV.
The three-year study, conducted at 12 sites in four African countries, found no statistically significant difference in HIV acquisition risk among women using the three methods, Gonsalves said.
After the findings were published in The Lancet in 2019, WHO updated its guidance.
Gonsalves said the study demonstrated how identifying an evidence gap, securing funding and conducting rigorous research could lead to changes in guidelines and expand access to contraceptive choices.
Research into gender-based violence has similarly helped turn a long-recognised social problem into a public health priority, she said.
WHO’s landmark 2013 estimates on violence against women, produced with the London School of Hygiene and Tropical Medicine and the South African Medical Research Council, established the widely cited finding that about one in three women experience physical or sexual violence during their lifetime.
The estimates were released alongside WHO clinical and policy guidelines on intimate partner and sexual violence.
The number of countries providing data on gender-based violence has since risen from 80 to 168, Gonsalves said.
As of 2026, just over half of countries have clinical guidelines and protocols for responding to violence against women, while 42% include budgets for the health response, she said.
Pregnant women left out
WHO scientist Mariana Widmer highlighted another example of how research can improve health outcomes, and the consequences when some groups are excluded from clinical studies.
A WHO-led study known as Kesho Bora, conducted in Burkina Faso, Kenya and South Africa and published in 2011, found that starting antiretroviral treatment during pregnancy reduced HIV transmission from mothers to their babies by 43% and more than halved transmission during breastfeeding, Widmer said.
But pregnant women were largely excluded from initial COVID-19 clinical trials despite evidence that they faced a higher risk of severe complications, she said.
“Pregnant women need medicines just like everyone else,” Widmer said, adding that physiological changes during pregnancy can affect how medicines are processed by the body.
WHO has developed a web portal to support the safe and ethical inclusion of pregnant and breastfeeding women in clinical research.
Laws can block access
Scientific evidence alone, however, does not guarantee access to care, said Bertho Makso, community engagement lead for the International Planned Parenthood Federation’s Arab World Regional Office and founder of Proud Lebanon.
Restrictive laws and policies in some countries prevent people from accessing services while reinforcing stigma and fear of being exposed or criminalised, he said.
HIV and mpox illustrate the problem, Makso said, with some people avoiding healthcare because of concerns about judgement, confidentiality or legal consequences.
“People are not hard to reach,” he said. “Too often, our laws, policies, and health systems make services difficult or unsafe to reach.”
From research to reality
Even when policies change, putting new evidence into practice can take years, said Dr Njeri Nyamu, a Kenyan health service provider.
She cited the hormonal IUD as an example. The device entered Kenya’s private sector in 2011 but was not introduced into the government sector until 2022, she said.
Its rollout has since faced service-delivery challenges linked partly to misconceptions and provider bias, which Nyamu attributed to gaps in understanding and training.
Countries need to consider what is required to translate scientific innovation into routine healthcare, including supervision, monitoring performance data and ensuring providers are properly trained, she said.
The examples presented at the webinar point to a common challenge for sexual and reproductive healthcare: generating reliable evidence is only the first step. Turning that evidence into policy, funding and accessible services can take years, and can be undermined by misinformation, discrimination and restrictive laws.