Health Canada is being urged to approve a drug that is considered the “gold standard” of medical abortion and is already available in most other developed countries.

The drug mifepristone, commonly known as RU-486, is not available in Canada despite being the best known option for abortion, says a commentary published in the Canadian Medical Association Journal.

“This is the choice that many women actually want to have,” said one of the authors, Dr. Sheila Dunn of Women’s College Hospital in Toronto. “Canadian women don’t have it, and it’s unacceptable that we don’t.”

Medical abortion uses drugs rather than surgery to induce an early abortion, similar to a miscarriage. Mifepristone is taken orally and ends a pregnancy within one or two days.

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Women in 57 countries have access to the drug, according to Dunn. It has been available in France since 1988, in Britain since 1991 and in the United States since 2000.

A manufacturer must apply to bring the drug to market in Canada. Health Canada, citing confidentiality laws, would not confirm whether it is currently studying such an application.

However, Dunn said an application had been made within the last year. She said it may have taken time for a manufacturer to apply, owing to the expense and Canada’s relatively small population.

“There would be different reasons that different companies have for bringing new drugs to Canada. Some of the decision-making would likely be economic,” she said.

There were clinical trials of the drug in Canada early in the last decade. But one was stopped after a woman who received the drug died of a bacterial infection.

Dunn said that several other such deaths were reported in the United States and Europe. Investigations could find no explanation for the cluster of what are normally rare infections and there have been none in recent years, she added.

Millions of women have used mifepristone safely and effectively, wrote Dunn and co-author Rebecca Cook, a lawyer and expert in reproductive law at the University of Toronto.

Currently, they write, the only option for Canadian women seeking a medical abortion is a longer, less predictable method not recommended by the World Health Organization (WHO).

The method involves taking a combination of two drugs, methotrexate and misoprostol, which are injected five to seven days apart. However, some abortions can be delayed by several weeks, and infants can be born with serious deformities if the procedure fails.

Vicki Saporta, president of the National Abortion Federation of Canada, said her organization had encouraged a number of manufacturers over the years to apply to Health Canada to have mifepristone approved.

“We represent abortion providers in the country, and they would like to be able to offer it. Their patients request it,” she said.

Approval of the drug would improve access to abortion in rural areas and in Atlantic Canada, where women currently have to travel long distances and experience long wait times for a surgical procedure, she said.

In the commentary, Dunn wrote that the Society of Obstetricians and Gynaecologists of Canada urged Health Canada in 2009 to work with industry to make the drug available.

“Is the Canadian government shirking its responsibility to facilitate availability of mifepristone, as some have suggested?” she asked.

Health Canada did not respond to a question about why the only medical abortion option currently available in Canada is one not recommended by the WHO.

In Parliament, Prime Minister Stephen Harper has refused to reopen the abortion debate despite attempts to do so by members of his caucus. Conservative MP Stephen Woodworth introduced a new motion last week calling for legal recognition of “the equal worth and dignity of every human being.”

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NDP health critic Libby Davies said the government could have been more aggressive in bringing mifepristone to the market.

“This is a proven medical pill that is available in many other places. It has enormous implications for women in terms of access to safe abortion,” she said.