A sureshot against cervical cancer?
Reported August 02, 2009
SEOUL: Despite a vaccine being available against cervical cancer, the most common cancer among women in India, it might be of little help at the
prohibitively high current price of $360 (for three doses) or about Rs 16,000 per adolescent girl.
At a symposium held here by the International Vaccine Institute, an international research organisation devoted to vaccines supported by various governments, companies and foundations, several health experts and policy makers called for the introduction of routine HPV (human papilloma virus) vaccines into national immunisation programmes, even as they expressed concern about its affordability.
“Cervical cancer caused by HPV comprises over 34% of cancers among women in India, making it the most common. Of this, 70% of the cancers are said to be caused by two strains of the virus HPV 16 and HPV 18 against which a vaccine has been developed,” explained Dr Neerja Bhatla, additional professor of the Department of Obstetrics and Gynaecology at the AIIMS.
The vaccine is of no use once a person is already infected with the virus. Hence, being a sexually transmitted virus, for the vaccine to be effective it has to be administered before a girl becomes sexually active. In India, this would have to be between 12-18 years as early marriage among girls is prevalent.
This would mean vaccinating a population of over 100 million girls at the cost of Rs 16,000 per child. That would amount to thousands of crores of rupees, several times the size of the entire national immunisation programme.
Yet another concern is that being a newer vaccine, it is not known how long the vaccine will remain effective. So far, it has been found to be effective for six to seven years. If a booster shot is required to maintain protection, the cost could be even higher.
Moreover, the vaccination is to be given as an intramuscular injection in three doses, each dose costing about $120. If the costs of trained manpower required for such an immunization programme and that of safe disposable needles are taken into account, the cost would be even higher.
However, Linda Eckert of the World Health Organisation (WHO) explained that WHO had recommended the use of HPV vaccines in immunization programmes as it was programmatically feasible and since sustainable financing could be secured. She claimed it could be made cost effective as the Global Alliance on Vacines and Immunisation (GAVI) could help subsidise the vaccine for the poorest countries and the Unicef could procure it for poor countries by negotiating for lower prices with the vaccine companies. However, she didn’t elaborate by what percentage such efforts could bring down the price of a vaccine costing over Rs 16,000 per child.
