Cervical Cancer Vaccine for Africa

During a recent stay in Mozambique—where I am working on a joint UNICEF–ISGlobal research project—I met some of the participants attending the Stop Cervical Cancer in Africa Conference, an annual event on the disease caused by the human papillomavirus (HPV). Under the leadership of the colourful Princess Nikky, the Forum of African First Ladies is working to combat this epidemic that affects 500,000 women every year and kills half of those affected. African women between 40 and 50 years of age account for around 80% of deaths from cervical cancer worldwide. In addition, this high mortality among women also weakens one of the pillars of social and economic sustainability in poor communities in a continent where women are both entrepreneurs and the providers of child care, food and shelter.

The good news is that an effective vaccine against HPV already exists and is ready to be delivered on a mass scale in Africa; immunisation can prevent 70% of cases of cervical cancer in adult women. In recent decades, immunisation has become one of the cornerstones of global health policies, with vaccines being used to tackle age-old diseases cause death and suffering among poor populations, such as tetanus, polio, pneumonia and certain types of diarrhoea. The favourable cost-benefit profile of immunisation programmes justifies the hope invested by the international community in the effort to expand access to existing vaccines and in the possibility that we will soon have new vaccines for diseases such as malaria.

Nevertheless, in the case of the HPV vaccine, programmes for mass distribution do face certain problems. Unlike the basic set of vaccinations administered to newborn babies and infants, the HPV vaccine must be administered to girls during the period just before they become sexually active, which in Africa tends to be between the ages of 10 and 14. The challenge will be to reach this older, more disperse population, which tends to be more closely protected by misgivings and suspicions. The recent controversy about polio vaccination in Muslim countries is an example of the kind of cultural and social barriers African health authorities will have to face.

However, it is possible that the main threat to the global fight against cervical cancer will come not from the Sahel desert but from the capitals of some of the world’s most developed countries, whose global health budgets are becoming dangerously low. It is thanks to the GAVI Alliance (Global Alliance for Vaccination and Immunisation)  and its decision to invest both economic and political resources in this area that we are now talking about the HPV vaccine in Africa. This public-private coalition—which includes public donors, the governments of affected countries, and private organisations such as the Bill & Melinda Gates Foundation and the “la Caixa” Foundation—has spearheaded the global immunisation initiative on a scale without precedent. GAVI’s negotiations with pharmaceutical companies, for example, could reduce the cost of the HPV vaccine to $5 a dose (in Spain a dose costs between €20 and €30) and consolidate programmes already underway in five African countries, including Mozambique.

In recent years, Spain has played an important role in this effort. Public figures such as H.R.H. The Infanta Cristina of Spain, who participated in the recent conference, and researchers, such as Silvia de Sanjosé (Instituto Catalán de Oncología) and Clara Menéndez (ISGlobal), have kept Spain’s commitment alive and the Spanish government continues to contribute to the GAVI Alliance. (Other institutions, such as The Global Fund to Fight AIDS, Malaria and Tuberculosis, have been less fortunate in this respect, as we will explain next week). Greater public awareness about this effort is essential, and the programme must receive long-term support; there is too much at stake for African women.

 [This post was originally published in the 3.500 millones blog in the Spanish newspaper El País.]