Thankfully, this may be possible because Gavi, an organisation which funds vaccines for children in the world’s 73 poorest countries, has set the target of supporting the vaccination of 30 million girls against HPV by 2020. If a country can demonstrate its ability to deliver the vaccine, it will eligible for a full rollout of funding, and this year, Gavi-funded pilot projects are due to start Ghana, Kenya, Laos, Madagascar, Malawi, Niger, Sierra Leone, whilst Tanzania is planning to start in 2014.
According to Dr Kimberley Fox of the Expanded Programme on Immunisation at the World Health Organisation’s (WHO) Western Pacific regional office in Manila, ‘In terms of access, WHO pre-qualification is required for any UN agency funding to be used to purchase a vaccine and Gavi also requires it.’ This WHO-recommended approach involves prevention through education and vaccination, screening for early detection and early treatment of precancerous lesions and cervical cancer, as well as cancer treatment and palliative care.
So far, the wellness of young women in 38 countries has been potentially improved with a national immunisation schedule, but few girls in low-income countries have had access to the vaccine. Seth Berkley, Gavi chief executive, says, ‘There is a triple whammy for women in the developing world: they have a higher incidence of HPV infection, there is usually no good screening programme in place, and if they do get cervical cancer they don’t have good treatment options.’
Fox adds, ‘This vaccine has been a sensitive issue in many countries, because it relates to reproductive health. Communications with communities, schools, teachers, parents and girls are really crucial to ensure acceptance of vaccine. They have to understand what the vaccine is, that it’s about preventing cancer.’