Human papillomavirus vaccine support

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In response to country demand, GAVI decided to support the introduction of HPV vaccines

A woman dies every two minutes from cervical cancer

Over 85% of the 275,000 women who die every year from cervical cancer lived in the developing world. If left unchecked, by 2030 cervical cancer will kill as many as 430,000 women, virtually all in low-income countries.

The third most common cancer in women worldwide1, cervical cancer usually kills women at the prime of their lives. For a family, cervical cancer is a tragedy. For a nation, the disease is a serious health and economic burden.

Safe and effective human papillomavirus (HPV) vaccines protect against HPV types 16 and 18 which cause about 70% of cervical cancer cases.

HPV vaccines are critically important to developing countries as cancer screening and treatment services are often unavailable. 

GAVI is delivering on the promise for girls and women in developing countries

In response to country demand, the GAVI decided to support the introduction of HPV vaccines if negotiations to secure an acceptable price from manufacturers are successful and countries can demonstrate their ability to deliver the vaccines to girls. By 2020, more than 28 million girls can be immunised.

GAVI’s decision leads the way for girls in developing countries to enjoy the same access to HPV vaccines as girls in developed nations. It supports the UN Secretary-General’s Global Strategy on Women’s and Children’s Health to address key global health priorities by increasing access to life-saving vaccines.

More affordable HPV vaccines

GAVI is working with vaccine manufacturers to ensure that HPV vaccines are affordable. Last year, a vaccine manufacturer offered an indicative price for HPV vaccines to GAVI countries at US$ 5 per dose, a 67% reduction on the lowest public price. GAVI continues to work with manufacturers to reduce prices.

Working with partners

HPV vaccines will be delivered to girls in the ten to 13 year age group. GAVI will partner with cancer, reproductive health and women’s organisations to help countries deliver HPV vaccines cost-effectively, integrated with other important interventions for girls such as adolescent reproductive health, HIV prevention, nutrition, family planning and safe motherhood.

Initial experience in offering HPV vaccination in Africa, Asia and Latin America has been encouraging. Lessons learnt documents are available through the Reproductive Health Outlook Cervical Cancer library.

"GAVI’s decision to include the HPV vaccine is a visionary investment that will improve the health of girls and women, equity and development," Julio Frenk, Dean, Harvard School of Public Health.

1http://globocan.iarc.fr/factsheet.asp

Partners

Many organisations are actively involved with clinical and operational research, policy analysis, and advocacy related to HPV vaccine. Collaborating partners and their main roles include:

World Health Organization (WHO) offer technical information, standards and guidelines;

United Nations Population Fund (UNFPA) brings expertise in reproductive health;

International Agency for Research on Cancer (IARC) carry out epidemiological studies assessing HPV type-specific prevalence among various populations;

The Cervical Cancer Action coalition for advocacy and education;

Alliance for Cervical Cancer Prevention provides news, resources, advocacy and information;

PATH supports operational research in India, Peru, Uganda and Vietnam to inform decisions about how to introduce HPV vaccines;

Vaccine manufacturers and academia conduct clinical research;

GAVI Alliance offers financial support for the introduction of vaccines into the routine immunisation of eligible countries.


Approximately 275,000 women die every year from cervical cancer with 88% occurring in developing countries, but HPV vaccines offer protection against 70% of all cervical cancer cases

Increasing cervical cancer cases and deaths in GAVI-eligible countries. Source: based on GLOBOCAN database and GAVI-eligible countries.

Increasing cervical cancer cases and deaths in GAVI-eligible countries. Source: based on GLOBOCAN database and GAVI-eligible countries.

Disease burden

Human papillomavirus (HPV) is the key cause of cervical cancer, a large and growing issue in developing countries, where women often lack access to effective screening and treatment.

Cervical cancer killed 275,000 women in 2008, but could kill as many as 430,000 women by 2030, if appropriate interventions are not taken.

More than 85 percent of cervical cancer deaths occur in developing countries. Sub-Saharan Africa has the highest incidence of cervical cancer, which accounts for more than 50 percent of cancers in countries such as Comoros and Tanzania.

Cervical cancer tends to kill women in the prime of their lives when their contribution to families and child-raising is critical. Children whose mothers die prematurely, have a lower chance of getting a good education and receiving adequate health care.

The vaccine

Existing vaccines against HPV can prevent as many as 70 percent of all cervical cancer cases.

But high prices have been a major barrier to using these vaccines in developing countries where the cervical cancer burden is highest.

WHO, the Alliance for Cervical Cancer Prevention, the Cervical Cancer Action coalition and the UNFPA have called for comprehensive cervical cancer prevention plans that include both vaccination of young girls and screening and treatment of women. 

This joint approach could virtually eliminate all cervical cancer.

Licensed HPV vaccines

Two human papillomavirus (HPV) vaccines have been licensed in over 100 countries many of which are GAVI-eligible. Both have been prequalified by WHO for purchase by UN agencies. In clinical trials, the vaccines were found to be safe and highly effective in preventing persistent HPV infection caused by types 16 and 18.

Both vaccines require three doses given over six months.

The vaccines have been proven to remain effective for at least five years when three vaccine doses are given, but the protective period is likely to increase as further data are analysed.

Research is ongoing to determine if fewer doses will provide adequate levels of protection.

Feedback

3.9 million

GAVI’s support for hepatitis B vaccine has averted 3,896,000 future deaths from 2000 to 2011

WHO Department of Immunisation, Vaccines and Biologicals’ estimates and projections, November 2011

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