Gardasil versus GAVI versus Public Health and Safety

[SaneVax: A recent article in The Stanford Journal of Public Health fails to address multiple public health issues regarding the introduction of HPV vaccines in developing countries. What are the future consequences to public health when introducing HPV vaccines into the adolescent population of countries that do not currently have cervical cancer screening programs, particularly when these vaccines do not eliminate the need for screening? What are the future health consequences when introducing HPV vaccines into a population with no way to test for prior exposure to to the purported pathogen? What are the potential consequences of introducing a vaccine to a population with no means of establishing an individual’s medical history?

These are but a few of the questions left unanswered in this ‘journal of public health.’ It appears this journal is more interested in HPV vaccine uptake, than any real public health issues. Once again, medical consumers are on their own. This is not acceptable in any country – much less developing countries without access to adequate healthcare. Would it not make more sense to establish adequate medical facilities first?]

Gardasil versus GAVI: Challenges to Implementing HPV Vaccines in Developing Countries

By Christina Averhoff

Cervical cancer, caused by human papillomavirus (HPV), is one of few preventable cancers. In the developed world, this cancer is relatively easy to manage with preventative surgery or HPV vaccines such as Gardasil. However, in the developing world, cervical cancer is a virulent threat consistently ranking among the leading causes of death in women.¹ HPV causes approximately 275,000 deaths due to cervical cancer each year, 88% of which occur in developing countries.² If available around the world, the HPV vaccine could decrease rates of cervical cancer by 70%.²

The Global Alliance for Vaccines and Immunizations (GAVI) was launched in early 2000 to support the implementation of vaccination programs to reduce child mortality rates in 70 of the world’s poorest countries.³ GAVI gathers funds from donors worldwide, and decides which vaccines would be the most efficacious and cost-effective to introduce to these countries. Recently, GAVI has agreed to fund the HPV vaccine. This decision will likely protect two million women in nine countries from cervical cancer by 2015.²Although GAVI has agreed to fund this vaccine, impediments to introduction of the vaccine may still exist, says Dr. Lauri Markowitz, an expert on HPV and STIs at the Center for Disease Control and Prevention (CDC).⁴GAVI may cover the costs for vaccines and some operational costs, but the states are responsible for delivering them in the most effective and efficient way. Introduction of vaccine requires capacity for storage, transport, and personnel, which might be lacking in the country, adds Markowitz, further complicating the launch of the vaccine program. Due to infrastructure and capacity issues, many GAVI countries may delay the introduction of this vaccine.

Read the entire article here.