The Lancet: How should we listen to ECHO?
Lisa Miyako Noguchi, associate in the Department of Epidemiology at Johns Hopkins Bloomberg School of Public Health, and Princess Nothemba Simelela, assistant director general for Family, Women’s and Children’s Health at the WHO

“For many years before the long-awaited results of the study by the Evidence for Contraceptive Options and HIV Outcomes (ECHO) Trial Consortium, observational and laboratory studies suggested that some hormonal contraceptive methods … might increase women’s susceptibility to HIV acquisition. … Notably, ECHO successfully answered some but not all questions about potential interactions between contraception and HIV infection. … In July, 2019, ECHO results will be reviewed in the context of the WHO medical eligibility criteria for contraceptive use … Regardless of the outcome of those deliberations, family planning should remain prioritized as one of public health’s most powerful tools against a range of adverse outcomes, including maternal mortality. … Ultimately, the response to ECHO results must be centered on and informed by women and girls in Africa, where the trial occurred and where substantial burden persists in unmet need for family planning and HIV prevention … Decision makers need to listen to the voices of women and girls — who continue to suffer and die not solely as a result of their unconscionable lack of access to high-quality contraceptive and HIV-related care but also to primary care, cancer prevention, mental health, safe abortion, violence prevention, and maternal health services. Therein lies the message we need to hear and amplify as we listen to results of ECHO” (6/13).