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HPV and poverty: The obstacles and solutions

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Gender inequality affects women and girls in a multitude of ways, including access to health services. When it comes to vaccines, the overall news is positive: globally, boys and girls are immunised at similar rates. However, there are variations from region to region, and this doesn’t account for specific health needs based on sex.

HPV is one of the most pressing gender-specific diseases that can be prevented with a vaccine. Gavi, the Vaccine Alliance is a key player in preventing this disease, but more support is needed to continue that work.

Understanding HPV

The human papillomavirus (HPV) is the biggest cause of cervical cancer. Worldwide, over 300,000 women die every year from cervical cancer — that’s one woman every two minutes. Over 85% of those women are in low- or middle-income countries, making preventative care especially crucial for women living in poverty. Without proper action, that could rise to over 400,000 a year by 2035.

In Gavi-supported countries, cervical cancer is the leading cause of cancer death among women, making Gavi’s immunisation work even more critical. Immunisation, screening, and treatment are the most effective ways to combat this disease. Since screenings and treatment can be difficult to access in low-income countries, the HPV vaccine — which can prevent up to 90% of cervical cancer cases — is an essential tool for protecting women and girls.

The obstacles

In the past two years, demand for the HPV vaccine has skyrocketed across the world, in low-, middle-, and high-income countries alike. The result is a supply shortage worldwide for the HPV vaccine, and supply isn’t expected to meet demand until 2024. The shortage is so severe that the World Health Organization recommends prioritising girls ages 9-14 due to the risk of cervical cancer.

The cost of the vaccine is also difficult to surmount. Despite the biggest increase of demand coming from low-income countries, more doses are going to middle- and high-income countries that can afford to pay for them from private markets. One company, which produces two of the three available vaccines, prioritises selling in high-income countries to maximise their own profit. As a result, only about one-fifth of low-income countries have access to the vaccine, compared to four-fifths of high-income countries. This leaves millions of girls living in poverty unprotected from the virus.

Gavi steps up

Gavi began its programme to address HPV in 2012. As a result, almost 4 million girls are now protected from HPV. Gavi plans to vaccinate 10 million more and save 300,000 lives by the end of 2020.

Currently, 27 countries are receiving support from Gavi to combat HPV. 18 of those countries have incorporated the HPV vaccine into their national vaccine programmes. This list includes some of the countries with the highest prevalence of cervical cancer in the world, including Malawi, Uganda, Tanzania, Zambia, and Zimbabwe.

Gavi is working with manufacturers to increase their capacity and address the supply shortage. In the meantime, Gavi-supported countries are adapting to the shortage and making sure vaccines are getting to who needs them most. This includes populations where cancer screenings and treatment are less accessible.

In addition to the number of vaccines, Gavi is working to lower their cost. Previously, the lowest cost for the vaccine was US$13. Now, the HPV vaccine is available in the lowest-income countries for as little as US$4.50. While this is an improvement, it’s still too high cost for many. Gavi is working to create sustainable prices for this vaccine worldwide.

Gavi also partners with cancer groups and women’s organisations to help with cost and access to the vaccine. They also encourage other health interventions when people come in to get the HPV vaccine. These interventions include family planning, HIV prevention, nutrition, and cervical cancer screenings and treatment.

The Gavi Replenishment

Making sure women and girls everywhere can access the HPV vaccine will be an ongoing objective until no woman is dying from cervical cancer. Gavi can continue to play an essential role in shaping the markets and improving access, and a full replenishment can go a long way in making that happen. By telling world leaders to support Gavi during this summer’s replenishment, you can help continue the fight to make this life-saving tool available to all.

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