Protecting against cervical cancer

A new immunization campaign gets underway soon to protect 180,000 girls in developing countries from cervical cancer. The GAVI Alliance made the announcement Monday, World Cancer Day (2/4).

Most cervical cancer is caused by certain types of the human papillomavirus, or HPV. It’s transmitted through sex.

Dr. Seth Berkley says it takes an enormous toll.

“A woman dies every two minutes from cervical cancer. This kills more women than childbirth. The estimated number now is 275,000 women dying of this cancer each year – 85 percent in the developing world. This is a cancer that’s growing. So without an intervention the estimate was that there would be by 2030 430,000 deaths a year,” he said.

The GAVI Alliance CEO dispelled some myths about cancer.

“One of the interesting things, of course, is that cancers are considered to be non-communicable diseases and of course this is a misnomer. Although cancer is a disease that certainly sometimes is caused by genetic and other abnormalities, a larger percentage of the cancers actually are infectious. The other thing is that we think of cancer as being a disease of the developed world when in fact, of course, there’s an enormous amount of cancer in the developing world,” he said.

Many other vaccines are given to babies or very young children. The HPV vaccine is given to girls between the ages of nine and 13. It’s only effective before someone is infected with the virus.

If infection does occur, the virus may cause microscopic changes at the cellular level. A Pap test or Pap smear can detect those changes. However, the test, which examines a sample of cells from the cervix, may not be available to many women in developing countries.

“Eventually, then, a cancer begins to grow and that cancer will metastasize. And when the cancer’s growing you begin to have symptoms like bleeding. And eventually, when it metastasizes, you have pain because you begin to affect other organs. By the time you have common symptoms it is usually already spread and is hard to deal with in a surgical fashion,” he said.

The alliance has chosen eight developing countries to begin administering the HPV vaccine: Ghana, Kenya, Madagascar, Malawi, Niger, Sierra Leone and Tanzania in sub-Saharan Africa and Laos in Asia.

“In this first round of support 180,000 girls will be vaccinated. First countries will be Kenya, Ghana and Sierra Leone. Not sure which one will start first, depending upon preparations. Tanzania’s going to be next year in 2014,” he said.

The vaccine will be administered as part of school programs. But Berkley said that efforts must be made to reach those girls not attending school.

“By 2015 we plan to support more than 20 countries to vaccinate approximately one million girls with HPV vaccines through these pilots. And then by 2020 we’re talking about 30 million girls in over 40 countries with GAVI’s support,” he said.

The GAVI Alliance is a public-private partnership specializing in greater access to immunization in developing countries. Negotiations are currently underway with pharmaceutical companies on the cost per dose for the HPV vaccine.