Abortion

Overview

Abortion is a common part of women’s reproductive lives, regardless of the legal context in which they live. When properly administered, it is one of the safest medical procedures available. However,  nearly half of all abortions are unsafe, with the potential to cause severe complications such as life-threatening blood loss, infection, organ damage, and even death (8% of maternal deaths annually). If left untreated, complications from unsafe abortion can lead to anaemia, chronic pelvic pain, and fertility issues such as ectopic pregnancy (pregnancy outside the uterus), a higher risk of miscarriage in future pregnancies, and ultimately infertility.  Ninety-seven per cent of unsafe abortions occur in LMICs where persistent political, cultural and health system barriers restrict access to safe abortion and post-abortion care. Every instance of maternal injury or death due to an unsafe abortion represents a failure to provide women with the care that is known to be both effective and safe​. Expanding access to safe abortion services is critical to reducing maternal morbidity and mortality and improving reproductive health outcomes worldwide.

Unmet needs

Addressing the risks associated with unsafe abortion is a major challenge in LMICs, where restrictive policies alongside social, political and gender-related inequities limit women’s ability to access existing products and services to manage their reproductive lives, such as modern contraception, effective home pregnancy tests, and safe medical or surgical abortion. Removing these barriers would go a long way to improving women’s health in LMICs, where just under half of all pregnancies – 111 million each year – are unintended. While current abortion care is highly effective and safe, gaps also exist for additional products to safely manage unintended and unwanted pregnancy, including novel drugs or drug regimens for very early abortion or menstrual regulation (within the first month of suspected pregnancy) and drugs and devices to improve later abortion care. Current investigations include different regimens of existing drugs, such as misoprostol and letrozole, as well as the potential discovery of novel molecules in traditional herbal decoctions.

Funding

Abortion received only $1.1m in R&D funding, all of it for drug R&D. There was no funding at all for either diagnostics or devices – the other two areas now in-scope for abortion R&D.

Essentially all of this funding (99.8%) came from Grand Challenges Canada, with the remaining 0.2% (just $2k) coming from industry for early menstrual induction drugs – funding which has been ongoing at a similarly low level since 2019, before the inclusion of abortion R&D in the G-FINDER survey.

This abysmally low total was the lowest amount of any of the areas included in our scope, probably partly due to the politicised environment of abortion in general, and possibly a perceived lack of R&D opportunity.

Closing the funding gap for safe abortion is both a moral imperative and a strategic opportunity. Every dollar invested in safe abortion access yields powerful returns: lives saved, injuries prevented, and women empowered to participate fully in society. It also makes economic sense—treating complications from unsafe procedures is far more costly to health systems than providing safe care.

Funding for abortion