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USAID was fully aware that informed consent was not provided to women prior to Depo Provera injections (the Rebecca Project provided details to the DHHS, DOJ, and USAID) and that violates US ethical research IRB procedures and international law. U.S. drug companies and U.S. researchers have conducted nonconsensual and unethical research in Africa and the developing world. Pfizer v. Abdullahi directly confronted the issue. In a July 2009 ruling, a U.S. Court of Appeals found that the prohibition of non-consensual medical experimentation on humans is binding under customary international law, thereby allowing Trovan victims in Nigeria the right to seek relief against Pfizer in U.S. courts.In June 2010, the U.S. Supreme Court rejected Pfizer's appeal after the U.S. Acting Solicitor General, Neal Katyal, submitted his brief urging the court to deny Pfizer's petition.
Melinda and Bill Gates Foundation, UNFPA and USAID have taken advantage of political disorganization in Pakistan to administer Depo Provera to Muslim women; and are collaborating to expand a “self-inject” Depo Provera system in Pakistan. The In Israel, Netanyahu administration moved to act ethically and banned its doctors from renewing all Depo Provera prescriptions without full disclosure and consent to protect African Jews in Israel after the story of mandated Depo Provera injections was exposed in the spring of 2013.
European countries have provided full information about risks for women to consent to use Depo Provera for decades and use of Depo Provera is negligible. All U.S. allies in the Middle-East: Bahrain, Israel, Jordan, Kuwait, Qatar, and Saudi Arabia restrict the use of Depo Provera on their nationals.. India, a permanent target of US population control policy, banned Depo Provera from its social welfare programs in 2012
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