Gardasil, a Human Papillomavirus vaccine, is displayed at the Girls to Women Health and Wellness clinic in Dallas, Texas March 6, 2007.Jessica Rinaldi/Reuters
A dramatic drop in the cost of vaccines that protect against infection with HPV – the family of viruses responsible for cervical cancer – could result in millions of girls being immunized in the years to come.
The two companies that make HPV vaccine, Merck & Co. and GlaxoSmithKline, will drop their prices to $4.50 and $4.60 per dose respectively in developing countries for the period 2013-2017. Additionally, prices will drop further as if demand grows.
In Canada, by contrast, HPV vaccines sell for about $130 per dose, though governments negotiate lower prices through bulk buying.
"By 2020 we hope to reach more than 30 million girls in more than 40 countries," said Dr. Seth Berkley, CEO of the GAVI Alliance, a public-private partnership that does bulk-buying of vaccines to make them more affordable.
"This is a transformational moment for the health of women and girls across the world," he said, noting that cervical cancer is the leading cancer killer of women in the developing world.
The vaccines, Gardasil and Cervarix, currently require three doses. That will bring the total cost of vaccinating girls in the developing world to $13.50.
That is considerably more than most childhood vaccines, which cost only pennies.
The aid group Médecins Sans Frontières, which lobbies for affordable drug prices, said that, despite the price cut, HPV immunization will remain unaffordable and said it was "really disappointed" that Merck and GlaxoSmithKline did not drop their prices further.
More than 275,000 women worldwide die of cervical cancer annually, 85 per cent of them in the developing world. In developed nations, screening programs (Pap testing) and treatment have dramatically cut the death rate. In Canada about 450 women a year die of cervical cancer and some believe HPV vaccination could virtually eliminate deaths.
In the developing world, however, "facilities to detect and treat cervical cancer are few and far between, and HPV vaccines will mean the difference between life and death for so many women in the prime of their lives," said Dr. Richard Sezibera, former Health Minister of Rwanda and a GAVI board member.
HPV vaccination programs will begin soon in Ghana, Kenya, Laos, Madagascar, Malawi, Niger, Sierra Leone and Tanzania. Girls aged 9 to 13 will be targeted for the shots. GAVI said vaccination will be bolstered with education programs on nutrition, sexual health and HIV prevention.
Human papilloma virus is a sexually-transmitted infection so the idea is to vaccinate girls before they become sexually active.
In Western countries, there has been opposition to HPV vaccination from some religious groups, who argue that immunization will encourage girls to become sexually active earlier. This could also be a problem in the developing world.
Cary Adams, CEO of the Union for International Cancer Control, said the challenges with HPV are similar to those that existed when hepatitis B vaccination began. (HBV is also a sexually transmitted virus that causes cancer, in this case liver cancer.)
"When it was launched, many said it was too expensive and out of reach in developing countries. The price dropped dramatically and it is now in the routine immunization programs," he said.
André Picard