Diane Summers
Senior Specialist Advocacy and Public Policy, GAVI Alliance
World Cancer Day 2012: Together it is possible
In many countries, cancer is no longer considered a death sentence.
But for the world’s poorest people it remains a stark reality.
A
startling statistic underpins this situation. Of the more than seven
million people who die from cancer every year, about 70% lived in low-
and middle-income countries. Preventive technology like vaccines, and
effective screening and treatment programmes that we take for granted in
industrialised countries, are simply unavailable to the poor.
This year’s World Cancer Day
calls on everyone to do their part to reduce cancer deaths. GAVI is a
member of the Union for International Cancer Control and supporter of
World Cancer Day. On this day, I want to highlight how GAVI contributes
to the fight against cancer through accelerating the reach of vaccines
that prevent cancer-causing infections.
One in five cancers is
caused by chronic infections. For example, viral hepatitis infections
contribute to liver cancer, one of the top three causes of cancer deaths
worldwide. Cervical cancer, the third most common cause of cancer
deaths among women, is primarily caused by human papillomavirus (HPV). The bacterium Helicobacter pylori contributes to stomach cancer.
Two
vaccines now exist that prevent the viruses that are the primary causes
of liver and cervical cancers. GAVI works to accelerate the reach of
those vaccines to people living in low-income countries.
Hepatitis B vaccine
was the world’s first anti-cancer vaccine. The vaccine prevents
infection with hepatitis B virus, a primary cause of liver cancer and
cirrhosis. When the vaccine became first available in 1981 it was too
expensive for low-income countries to introduce, despite their high
burden of disease.
However, price reductions achieved with GAVI
support spurred a spectacular acceleration of hepatitis B vaccine
introduction in low-income countries. Between 2000 and 2010, the vaccine price dropped by 68% from US $ 0.59 cents to US $0.18 cents.
Consequently, by 2006 more low-income countries than high-income
countries had introduced the vaccine into routine immunisation.
GAVI’s support to developing countries for hepatitis B vaccine has now prevented over three million deaths.
China is a well-documented success story.
Following the introduction of hepatitis B vaccines into national
routine immunisation programme, the percentage of immunised newborns has
risen to 90% and the prevalence of hepatitis B virus carriers is
markedly reduced. Less than 1% of children under five are now chronic
carriers of hepatitis B.
Now, the World Health Organization identifies hepatitis B vaccines as a ‘best buy’
on a population-wide basis – that is, an immediate action that can
accelerate lives saved, diseases prevented and heavy costs avoided.
Vaccines against the human papillomavirus infection that causes cervical cancer in women offer a similar potential.
Cervical
cancer kills 275,000 women every year. Over 85% of those deaths are in
developing countries. Safe and effective human papillomavirus (HPV)
vaccines can prevent around 70% of cervical cancer cases.
HPV
vaccines have been available since 2007. Although HPV vaccines quickly
became part of routine immunisation of girls and young women in many
industrialised countries, they are still largely unavailable in
low-income countries. The high price of the new vaccines remains a
barrier to introduction.
GAVI is working with the two
WHO-prequalified vaccine manufacturers on strategies to lower the price
of the vaccines to make them more affordable. A milestone was reached in
June 2011 when one manufacturer offered to provide its HPV vaccine at
$US 5 per dose to GAVI-eligible countries, a 67% reduction in the
current lowest public price. This was the first-ever public offer of an indicative price for HPV vaccines for low-income countries.
A second milestone was achieved in November 2011, when GAVI took first steps towards introducing HPV vaccines in GAVI-eligible countries.
GAVI will invite countries to apply for funding for HPV vaccines
provided that further price reductions from manufacturers can be secured
to ensure affordability. Funding proposals will have to demonstrate
country’s ability to deliver the vaccines successfully or deploy pilot
projects. By 2015, nine countries are expected to apply and an estimated
1.6 million young women and girls immunised.
The power of
vaccines to prevent the infections that cause cancers has yet to be
fully harnessed. Research continues to better understand the role of
infections in cancer. With this work comes the promise of dramatic new
developments of vaccines to reduce cancer deaths, and the need to roll
out these vaccines in low-income countries.
GAVI is committed to
accelerating the reach of life-saving vaccines, a mission aligned with
the UN General Assembly’s declaration to increase access to
cost-effective vaccinations to prevent infections associated with
cancers.
No one should die because of where they are born.
