Vivien Tsu is director of PATH’s cervical cancer prevention project and associate director, reproductive health program
Our worst fear back in 2006-when the human papillomavirus (HPV) vaccine against cervical cancer finally came to market at a whopping $120 per dose-was that the girls who most needed it would be the ones least likely to get it.
More than 85 percent of cervical cancer cases occur in low- and middle-income countries, especially in Africa and Asia. Those same countries find it difficult to offer screening services, like Pap smears and HPV tests, that have nearly eliminated cervical cancer in wealthy countries. How would these countries ever be able to afford an expensive vaccine? Furthermore, could immunization programs geared to vaccinating babies effectively reach young adolescent girls? And would parents' concern about cervical cancer caused by HPV override their hesitation to mention a sexually transmitted infection to their young daughters?
Easing the way for immunization
The GAVI Alliance, an international organization that helps low-resource countries introduce needed new vaccines, greatly eased the first problem when they began offering HPV vaccine in 2012. Using the power of bulk purchasing, GAVI and UNICEF worked together to get the vaccine at a lower price. GAVI offered it to qualified countries for 20 cents a dose-and sometimes for free.
Meanwhile, groundbreaking work by PATH to understand cultural issues and to demonstrate and evaluate strategies for delivering the vaccine helped answer the other questions. Yes, the countries could reach the right girls and yes, once they understood the issue, parents would flock to protect their daughters against a deadly cancer.