Two North Carolina companies hope that a new method of sterilization will provide safe and cheap birth control for women around the world, but shadows from the era of eugenic sterilization have complicated the discussion.

Quinacrine was originally developed as an antimalarial drug, and it comes in the form of small pellets. When inserted into a woman's uterus, the pellets cause inflammation and then scarring of the fallopian tubes that block the passage of eggs. The cost is about $5 for each treatment.

The U.S. Food and Drug Administration has not approved the method for domestic use, but more than 100,000 women have used quinacrine overseas. Phase One clinical trials are under way here.

Quinacrine is in the testing stage but last month the FDA approved Essure , another sterilization method that doesn't require an operation. Essure is a flexible device that a gynecologist inserts into the fallopian tubes that forms a block. Essure was approved without controversy.

Dr. David Sokal of Family Health International in Durham said that his company hopes to get FDA approval for quinacrine, but that might take 10 years. "If such a method is ever approved by the FDA you'd want to be very careful in the marketing and distribution. And make sure women knew what they were getting into," Sokal said.

Family Health International is a major player in international birth-control programs. The company won a five-year, $87 million contract from the U.S. Agency for International Development in 1999.

But two former employees of the company who believed that quinacrine was ready for widespread human use ran into trouble when a series of media reports said that women in the Third World were being given quinacrine before proper tests had been finished.

Dr. Elton Kessel and Dr. Stephen Mumford, the head of the Center for Research on Population and Security in Research Triangle Park, started to ship quinacrine for birth-control use in the mid-1980s, but the FDA eventually said that they were violating U.S. law by shipping abroad from a storehouse in Mumford's home in Chapel Hill.

India and Chile have banned the use of quinacrine pellets, and the World Health Organization called for further tests before it is used anywhere as a birth-control method.

"The potential for abuse of quinacrine has been grossly overplayed," Mumford told the Winston-Salem Journal recently. But though Mumford's and Kessel's Web site contains a wealth of data about the product, it also shows why some critics are uneasy about the rush to distribute the product before full clinical tests are finished.

A paper on the site about the benefits of quinacrine was written by Sarah G. Epstein -the daughter of Dr. Clarence Gamble. Gamble helped found the Human Betterment League of North Carolina in 1947 to promote eugenic sterilization, and Journal research shows a long history of abuses in the N.C. sterilization program - abuses that Gamble consistently glossed over.

Epstein herself makes the link to her father's work, writing that "his battles ... with birth control opponents remind me today of what we are facing with (quinacrine)."

Both sides in the debate over quinacrine are being somewhat dishonest, said Johanna Schoen, an assistant professor of women's history at the University of Iowa.

"Sarah Epstein's rousing endorsement ... ignores the fact that any easy contraceptive method - and particularly one as inexpensive as quinacrine and as easy to administer - carries with it a higher likelihood of abuse," said Schoen, who has done extensive research on birth-control methods.

"The realities of family planning politics around the world are likely to lead to a situation in which especially poor women get pushed towards the use of quinacrine - or even worse, are given quinacrine without their knowledge."

But Schoen pointed out that quinacrine itself isn't good or evil.

"The one problem is that the safeguards that you have to have in order to assure that it isn't abused might have to be higher," she said.

Still, Schoen said that quinacrine supporters are correct in pointing out that there are plenty of poor women who don't have access to cheap and effective family planning methods and that quinacrine might be a godsend for them, as well as for women who want sterilization without surgery. The key, she said, is for any birth-control program in the world to offer women a variety of options, instead of pushing them toward one solution - especially a permanent solution.

Sokal, of Family Health International, agreed with that point. "Absolutely. It's something we've been talking with women's groups to prevent abuse if it (quinacrine) ever does get approved," he said. "With all contraceptive methods you need good options."