In Brazil’s northeastern state of Bahia, Dr. Elsimar Coutinho is on a mission to discover the perfect birth control method and bring down Brazil’s high birth rate. For over 30 years, he’s waged a one-man crusade to bring birth control to Bahia, in direct confrontation with the powerful Catholic Church.

With funding from the Rockefeller Foundation, the UN-funded Population Council, and the World Health Organization, Dr. Coutinho is internationally known for his pioneering research in hormonal birth control technologies. In Bahia, government officials and many health care experts credit Dr. Coutinho for single-handedly lowering the state’s birth rate.

Coutinho is beloved by hundreds of thousands of poor Brazilians who flock to him for advice about birth control. But he is vehemently criticized by women’s health advocates who say he is a sexist and a megalomaniac, more concerned with being an international star than with the well-being of his patients. Critics, including doctors and other health care professionals, say Dr. Coutinho is taking advantage of lax government regulations and using patients as guinea pigs for his research.