Dagfinn Hoybraten

Dagfinn Høybråten
Board Chair of the GAVI Alliance

14 May

Cervical cancer is a scourge of women the world over, but particularly so in the poorest parts of the world, where it kills nearly a quarter of a million women every year, or roughly one every two minutes. From Mombasa to Mumbai women who have been infected with the human papillomavirus (HPV) could be developing life-threatening cervical cancer and are unaware or unable to do anything about it.

Every year an estimated 275,000 women lose their lives to cervical cancer. More than 85% of those who die from the disease live in developing countries where access to screening and treatment is limited – and often non-existent – so they simply do not receive the treatment they require.

But this is about to change.

From this week, the GAVI Alliance, a public-private partnership that supports vaccination in developing countries, will help countries to introduce the HPV vaccine. By 2020, we estimate that countries will have immunised more than 30 million girls in 40 countries against this silent killer.

Making HPV vaccine available to girls in developing countries marks a huge step for GAVI too. For the first time we will help countries offer vaccination to girls of school age. Previously GAVI’s routine immunisation support has been focused on protecting babies from the major killers of children under five, such as pneumococcal disease and rotavirus diarrhoea.

Our second major challenge was to secure agreements with vaccine manufacturers to enable us to purchase HPV vaccines at prices that are both affordable for GAVI and sustainable for countries once their economies grow beyond the threshold for GAVI support. When we made our decision to include HPV in our portfolio at the GAVI Board meeting in Dhaka in November 2011, we did it on the condition that affordable prices would be accessible. As chair of the GAVI board I was delighted when GAVI’s CEO, Dr Seth Berkley, was able to report to me that he had secured a record low price for HPV vaccine of $4.50 per dose.

The whole case of HPV not only shows that the GAVI model makes sense when it comes to market innovation, but it is also a compelling case for equity: most of the disease burden is in the poorest countries yet most of the vaccine has so far been used in the richest countries. Just three years ago the need for HPV vaccine in the developing world existed, but no vaccination programs did. But now thanks to GAVI’s model, that need is being filled.

This week, Kenya became the first country to introduce HPV vaccines with GAVI funding as part of a demonstration project, where countries are given the opportunity to explore ways to deliver HPV vaccines and to make informed decisions if they then choose to apply for national introduction. We expect Ghana, Lao PDR, Madagascar, Malawi, Niger, Sierra Leone and United Republic of Tanzania to follow suit over the next year. From 2014, a further set of countries will begin national HPV vaccine introductions giving, extending the reach of this life-saving vaccination.

Prevention is usually better than treatment. This is never more true than when the opportunity to prevent comes in the form of a simple vaccination while the diagnosis and treatment is, in many cases, simply not accessible.

It fills me with pride to know that the GAVI Alliance is at the forefront of ensuring that women in developing countries have access to the same vaccines as their counterparts in the industrialised world.


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