Diane Summers

Diane Summers
Senior Specialist Advocacy and Public Policy, GAVI Alliance

Friday
3 Feb
2012

In many countries, cancer is no longer considered a death sentence. But for the world’s poorest people it remains a stark reality.

A startling statistic underpins this situation. Of the more than seven million people who die from cancer every year, about 70% lived in low- and middle-income countries. Preventive technology like vaccines, and effective screening and treatment programmes that we take for granted in industrialised countries, are simply unavailable to the poor.

This year’s World Cancer Day calls on everyone to do their part to reduce cancer deaths. GAVI is a member of the Union for International Cancer Control and supporter of World Cancer Day. On this day, I want to highlight how GAVI contributes to the fight against cancer through accelerating the reach of vaccines that prevent cancer-causing infections.

One in five cancers is caused by chronic infections. For example, viral hepatitis infections contribute to liver cancer, one of the top three causes of cancer deaths worldwide. Cervical cancer, the third most common cause of cancer deaths among women, is primarily caused by human papillomavirus (HPV). The bacterium Helicobacter pylori contributes to stomach cancer.

Two vaccines now exist that prevent the viruses that are the primary causes of liver and cervical cancers. GAVI works to accelerate the reach of those vaccines to people living in low-income countries.

Hepatitis B vaccine was the world’s first anti-cancer vaccine. The vaccine prevents infection with hepatitis B virus, a primary cause of liver cancer and cirrhosis. When the vaccine became first available in 1981 it was too expensive for low-income countries to introduce, despite their high burden of disease.

However, price reductions achieved with GAVI support spurred a spectacular acceleration of hepatitis B vaccine introduction in low-income countries. Between 2000 and 2010, the vaccine price dropped by 68% from US $ 0.59 cents to US $0.18 cents. Consequently, by 2006 more low-income countries than high-income countries had introduced the vaccine into routine immunisation.
 

GAVI’s support to developing countries for hepatitis B vaccine has now prevented over three million deaths.

China is a well-documented success story. Following the introduction of hepatitis B vaccines into national routine immunisation programme, the percentage of immunised newborns has risen to 90% and the prevalence of hepatitis B virus carriers is markedly reduced. Less than 1% of children under five are now chronic carriers of hepatitis B.

Now, the World Health Organization identifies hepatitis B vaccines as a ‘best buy’ on a population-wide basis – that is, an immediate action that can accelerate lives saved, diseases prevented and heavy costs avoided.
 

Vaccines against the human papillomavirus infection that causes cervical cancer in women offer a similar potential.

Cervical cancer kills 275,000 women every year. Over 85% of those deaths are in developing countries. Safe and effective human papillomavirus (HPV) vaccines can prevent around 70% of cervical cancer cases.

HPV vaccines have been available since 2007. Although HPV vaccines quickly became part of routine immunisation of girls and young women in many industrialised countries, they are still largely unavailable in low-income countries. The high price of the new vaccines remains a barrier to introduction.

GAVI is working with the two WHO-prequalified vaccine manufacturers on strategies to lower the price of the vaccines to make them more affordable. A milestone was reached in June 2011 when one manufacturer offered to provide its HPV vaccine at $US 5 per dose to GAVI-eligible countries, a 67% reduction in the current lowest public price. This was the first-ever public offer of an indicative price for HPV vaccines for low-income countries.
 

A second milestone was achieved in November 2011, when GAVI took first steps towards introducing HPV vaccines in GAVI-eligible countries. GAVI will invite countries to apply for funding for HPV vaccines provided that further price reductions from manufacturers can be secured to ensure affordability. Funding proposals will have to demonstrate country’s ability to deliver the vaccines successfully or deploy pilot projects. By 2015, nine countries are expected to apply and an estimated 1.6 million young women and girls immunised.

The power of vaccines to prevent the infections that cause cancers has yet to be fully harnessed. Research continues to better understand the role of infections in cancer. With this work comes the promise of dramatic new developments of vaccines to reduce cancer deaths, and the need to roll out these vaccines in low-income countries.

GAVI is committed to accelerating the reach of life-saving vaccines, a mission aligned with the UN General Assembly’s declaration to increase access to cost-effective vaccinations to prevent infections associated with cancers.

No one should die because of where they are born.

 

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