HPV Vaccine & Cervical Cancer
Cervical cancer is the second most common cancer in women worldwide, with about 500,000 new cases and 250,000 deaths occurring each year. Almost 80% of cases occur in low-income countries, where cervical cancer is the number one cause of cancer in women. Virtually all cervical cancer cases (99%) are linked to genital infection with human papillomavirus (HPV), a family of virus types which also causes genital warts and other forms of cancer. PATH, the Program for Appropriate Technology in Health, is an international, nonprofit organization that creates sustainable, culturally relevant health solutions, and works to advance acceptable and affordable new technologies for low-resource settings. PATH is partnering with GlaxoSmithKline and Merck & Co., Inc., both of which have developed HPV vaccines, to conduct pilot HPV vaccination programs in adolescent females, looking at acceptance and accessibility. The countries selected are India, Peru, Uganda and Vietnam. The PATH project also looks at issues such as adapting vaccination schedules to fit with the school year, to maximize potential uptake. PATH has received a grant for this project from the Bill and Melinda Gates Foundation. GSK's HPV vaccine, Cervarix, received WHO Pre-Qualification in 2009, which allows its purchase by UN agencies on behalf of poorer countries. GSK works with partners to help improve access to its vaccines and is committed to ensuring pricing is not a barrier to access in the developing world. For example, it has made Cervarix available at substantially reduced prices - with price reductions of up to 60% - in a diverse array of countries, including several in Southeast Asia, South Africa and Colombia. GSK has long practiced tiered pricing for vaccines supplied to government-led programs, charging lower prices in poorer countries. GSK is also supporting HPV pilot projects; for example, it has donated more than 133,000 doses of Cervarix to PATH-led projects in Uganda and India (Gujarat). Merck & Co., Inc. provides its Gardasil HPV vaccine at no-profit prices to the public sectors of GAVI-eligible countries. For other countries, Merck will offer tiered-pricing, largely based on their ability to pay. In 2008, CSL Ltd agreed to waive Merck's royalties for sales of Gardasil in the developing world, which should result in lower prices there. Gardasil received WHO pre-qualification in May 2009, which will also help make it more accessible for developing countries. Through the Gardasil Access Program, Merck has pledged to donate at least 3 million doses of Gardasil to qualifying organizations in eligible lowest-income countries, where 80% of the world's cervical cancer cases occur. The program will help them gain operational experience in the design and implementation of HPV vaccination projects. Approval has been given for donation of 496,000 doses of Gardasil for Bhutan, Bolivia, Cambodia, Cameroon, Georgia, Ghana, Haiti, India, Kenya, Lesotho, Moldova, Nepal, Nicaragua, Papua New Guinea, Tanzania, Uganda and Uzbekistan.