20 Dec, 11 | by BMJ Group
Every two minutes a woman dies of cervical cancer. Not surprisingly, 90 percent of these deaths occur in the poorest countries where women often do not have access to screening tests and treatment, or they are simply too expensive. Because of the lack of these services, vaccines against the human papillomavirus (HPV) that causes 70 percent of cervical cancer cases can mean the difference between life and death.
Several times in my life, I have witnessed profound suffering in some of the most underprivileged corners of the world. And I am always struck at the strength of the local women I meet. In difficult environments and lacking even the most basic elements to provide a healthy life for their children, they grasp my hands, smile, and tell me their stories. Like majestic Acacias trees on the African plain, these women are the deep roots and the strong trunk and branches that support their families. They cannot fall sick. If they die, all is lost for their children.
Cervical cancer exacts a terrible and unjustifiable social and economic toll on women, their families and communities—a toll that will rise in coming decades if left unchecked. It is estimated that if current trends continue, as many as 430,000 women a year will die by 2030, 85 percent of them in low and middle income countries.
Like HIV/AIDS, HPV kills women in the prime of their lives, with enormous impact. Children whose mothers die prematurely have a lower chance of getting a good education and receiving adequate healthcare. Entire families can quickly become destitute when the mother dies or while they try to bear the costs of medical care.
It is with these women in my heart, and in memory of those who lost their battle to cervical cancer, that I so warmly welcomed the news on 17 November that millions of women in developing countries may soon be protected against HPV.
On that date, the GAVI Alliance, a global health partnership that brings the best of the private and public sector to provide life-saving vaccines to poor countries, announced that it will support the introduction of HPV vaccines. GAVI’s decision will lead the way for poor women to enjoy the same access to these vaccines as women in richer nations. This is truly justice for underprivileged women.
Until very recently it took 10-15 years for vaccines available in high income countries to be available in low income countries. GAVI’s decision and the visionary support of its board have created the right momentum to shorten this time lag. If all goes well, widespread introduction of the HPV vaccine should begin much faster. The hope is to immunise nearly two million girls by 2015.
But some obstacles remain. Vaccine manufacturers need to further lower their price in order for the introductions to be sustainable for funding agencies and the recipient governments who must help co-finance the cost. Secondly, even though demand for the vaccine is high among developing countries, the question remains about whether they have the infrastructure to introduce it. A closer look into such issues will be necessary.
The announcement that the GAVI Alliance will support the introduction of the HPV vaccine is an important example of how we must continue to strive for equity in health. And it will help ensure that the world’s less privileged women remain the strength behind their children, their families, and their communities.
Mary Robinson, the first woman president of Ireland (1990-1997) and UN High Commissioner for Human Rights from 1997-2002, is former chair of the GAVI Alliance Board.