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In many parts of the world, menstrual products like pads are expensive. Activists have filed a lawsuit in Pakistan aimed at lowering the price. But as NPR's Gabrielle Emanuel reports, that strategy has not always worked.
GABRIELLE EMANUEL, BYLINE: Growing up in Pakistan, Bushra Mahnoor dreaded getting her period.
BUSHRA MAHNOOR: I grew up in a family - I have four other sisters, and there were never enough period supplies in our home.
EMANUEL: Her period often meant missing school. Her uniform was all white, and she feared getting blood on it. She had a long list of excuses at the ready - headache, stomachache.
MAHNOOR: Mentioning that you're on period is a big taboo, but mentioning that you're on your period without access to a pad was just even more humiliating.
EMANUEL: A report from the United Nations Children's Fund found that only 12% of girls and women in Pakistan use commercially manufactured sanitary products. Others turn to homemade solutions - a rag wrapped around itself. So when Mahnoor discovered in college that pads were taxed several times, including as luxury goods and not essential items, she became furious.
MAHNOOR: There is almost 40% of tax on pads. They're 40% more expensive, which is being ripped off of that money, and that has gross consequences.
EMANUEL: She's now the executive director at Mahwari Justice, a nonprofit that advocates for menstrual health. Her group has launched a campaign and coordinated with lawyers who sued the government in 2025 for menstrual products to be reclassified as essential goods, with the goal of eliminating the taxes and lowering the price. Pakistani legal officials did not respond to NPR's request for comment. Mahnoor Omer is the petitioner on the case and also a lawyer.
MAHNOOR OMER: I was anticipating a lot of trolling for some reason, but so far, the response - to my surprise - has been very positive.
EMANUEL: She says she's been motivated by what she's seen happen with a lawsuit in nearby Nepal, where the Supreme Court ruled in June of last year that taxes be removed on sanitary pads.
OMER: And they got it alleviated, and the price has gone down considerably.
EMANUEL: But in some cases, eliminating taxes has not lowered the price. Emily Cruz works on menstrual health for the nonprofit Splash. She says look in Malawi in East Africa. That country got rid of all the taxes on menstrual items, only to discover the price to the consumer remained the same. She says it's a bit of a mystery.
EMILY CRUZ: Why haven't we seen the change in price? There's a question there that I feel like really needs to be unpacked.
EMANUEL: Cruz's guess is that the activists likely need another step in their strategy after removing the taxes.
CRUZ: Maybe that's a policy related to subsidizing menstrual health products or perhaps a policy that doesn't allow a retailer to markup essential goods.
EMANUEL: Another idea for how to lower prices - stop relying on international corporations. Umme-Laila Azhar is part of the National Commission on the Status of Women, appointed by the Pakistani government.
UMME-LAILA AZHAR: It's very important that items where the menstrual hygiene is concerned should be locally produced. The raw material is not available in Pakistan. I think that's the main issue.
EMANUEL: Still, she says the commission supports the legal fight to remove the luxury tax. A final hearing in the case is expected in the coming weeks. Gabrielle Emanuel, NPR News. Transcript provided by NPR, Copyright NPR.
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