Human papillomavirus vaccine support

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Record low price agreed for HPV vaccines

GAVI HPV Vaccine Infographic

View infographic to see how Gavi’s support for HPV vaccines will help redress inequity, delivering vaccines to countries with the highest burden. Download as PDF.

A record low price for HPV vaccines has opened the door for poor countries to vaccinate millions of girls against a devastating women’s cancer.

Thanks to the Vaccine Alliance, the poorest countries now have access to a sustainable supply of HPV vaccines for as low as US$ 4.50 per dose. The same vaccines can cost more than $100 in developed countries and the previous lowest public sector price was $13 per dose.

For HPV demonstration programmes, Gavi will cover the full cost of HPV vaccines. However, countries introducing HPV vaccine nationally are required to meet the standard co-financing commitment.

HPV vaccines are available in the routine immunisation programmes of mostly high-income countries.  And yet of the 266,000 women in the world who die of cervical cancer every year, more than 85% are in low-income countries where access to cancer screening and treatment services is often lacking.

The high cost of the vaccine and challenges of immunising girls aged 9 to 13 years have been barriers to introduction in poorer countries. Gavi is working to bridge the equity gap by providing the vaccine at affordable and sustainable prices, and to support countries with demonstration projects in order to build capacity and infrastructure to deliver the vaccines.

Since Gavi began providing support for HPV vaccines in 2013, over 20 countries have been approved to introduce the vaccines - the large majority will be HPV demonstration projects. This will allow them to test the best ways to deliver HPV vaccines to girls. These demonstration projects will pave the way for countries to build the capacity and infrastructure needed to vaccinate girls nationwide. Rwanda will introduce HPV vaccine nationally. By 2020, it is estimated that over 30 million girls in more than 40 countries will be vaccinated against HPV.

The vaccine

Safe and effective human papillomavirus (HPV) vaccines protect against HPV types 16 and 18 which cause about 70% of cervical cancer cases.

Cervical cancer is a leading cause of cancer deaths among women in Gavi-eligible countries. Gavi’s commitment to protecting women against cervical cancer supports the UN Secretary-General’s Global Strategy on Women’s and Children’s Health to address key global health priorities by increasing access to life-saving vaccines.

Two application pathways

Countries that have demonstrated the ability to deliver HPV vaccine to adolescent girls, can apply for national introduction support. Demonstrated ability is defined as prior experience in delivering multi-dose vaccines to at least 50% of a target population of 9-13 year old girls in an average-sized district; please see Gavi new and underused vaccines support (in English and French) for more details. Countries lacking experience can apply for support to conduct smaller-scale demonstration projects in order to gain the experience necessary to apply for national roll-out.

Working with partners

Gavi is partnering with cancer, reproductive health and women’s organisations to help countries deliver HPV vaccines cost-effectively, integrated with other important interventions for girls such as adolescent reproductive health, HIV prevention, nutrition, family planning and safe motherhood.

Initial experience in offering HPV vaccination in Africa, Asia and Latin America has been encouraging. Lessons learnt documents are available through the Reproductive Health Outlook Cervical Cancer library.

WHO, the Alliance for Cervical Cancer Prevention, the Cervical Cancer Action coalition and the UNFPA have called for comprehensive cervical cancer prevention plans that include both vaccination of young girls and screening and treatment of women.


Partners

Many organisations are actively involved with clinical and operational research, policy analysis, and advocacy related to HPV vaccine. Collaborating partners and their main roles include:
 

World Health Organization (WHO) offer technical information, standards and guidelines;
 

United Nations Population Fund (UNFPA) brings expertise in reproductive health;

International Agency for Research on Cancer (IARC) carry out epidemiological studies assessing HPV type-specific prevalence among various populations;

The Cervical Cancer Action coalition for advocacy and education;

Alliance for Cervical Cancer Prevention provides news, resources, advocacy and information;

PATH supports operational research in India, Peru, Uganda and Vietnam to inform decisions about how to introduce HPV vaccines;

Vaccine manufacturers and academia conduct clinical research;

Gavi offers financial support for the introduction of vaccines into the routine immunisation of eligible countries.

1http://globocan.iarc.fr/factsheet.asp 

Cervical cancer is the leading cause of cancer death among women in Gavi-eligible countries

The growing burden of cervical cancer

An estimated 266,000 women die every year from cervical cancer. Over 85% of those deaths occur among women in developing countries. Without changes in prevention and control, cervical cancer deaths are forecast to rise to 416,000 by 2035; virtually all of those deaths will be in developing countries.

Most cervical cancer is caused by a sexually transmitted infection - human papillomavirus (HPV). HPV is highly transmissible and infection is very common.

Immunisation coupled with screening and treatment, is the best strategy to rapidly reduce the burden of cervical cancer. However, in resource-poor countries where women often lack access to cancer screening and treatment services, immunising girls before exposure to HPV, is critical.

Affordable HPV vaccines for developing countries

Safe and effective vaccines protect against HPV types 16 and 18, which cause about 70% of all cervical cancer cases.

WHO recommends HPV vaccination of girls aged 9-13 years through national immunisation programmes in countries where cervical cancer constitutes a public health priority, and where vaccine introduction is feasible, sustainable financing can be secured and vaccines are considered cost-effective. 

High prices have been a major barrier to introducing these vaccines in developing countries where the cervical cancer burden is highest.  However, thanks to the Vaccine Alliance and its partners, a newly agreed price of US$ 4.50 means that countries will now have access to more affordable and sustainable HPV vaccines.


Licensed HPV vaccines

Two human papillomavirus (HPV) vaccines have been licensed in over 100 countries many of which are Gavi-eligible. Both have been prequalified by WHO for purchase by UN agencies.
 

Both vaccines require three doses given over six months.

The vaccines have been proven to remain effective for at least five years when three vaccine doses are given, but the protective period is likely to increase as further data are analysed.

Research is ongoing to determine if fewer doses will provide adequate levels of protection.

Feedback

Ian Frazer

Professor Ian Frazer
creator of the HPV vaccine


“Today’s announcement by GAVI of country approvals for HPV demonstration projects is another big step forward to ensuring that girls living in developing countries enjoy the same access to HPV vaccines as girls elsewhere in the world. ” 

+60

For 2013, more than 60 countries were co-financing new and underused vaccines supplied by the Vaccine Alliance. Their contributions totalled US$ 70 million.

Gavi

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