India looks to bring down price of HPV vaccination
Work is ongoing to develop a low-cost vaccine to contain the prevalence of cervical cancer among women, especially in rural and tribal areas
Cervical cancer is one of the most common types of cancer found in females. Human papillomavirus (HPV) testing and cervical smear tests can help to catch the disease at an early stage, but a high proportion of women are not tested regularly due to the invasive nature of the tests. According to the US Centers for Disease Control and Prevention (CDC), more than 8 million women in the US skipped cervical cancer screening in the past five years.
In India, work is ongoing to develop a vaccine to contain the prevalence of cervical cancer among women, especially in rural and tribal areas. The vaccine would cost around £1.01 (Rs 100). Several other vaccines are also being developed for communicable diseases.
Though cervical cancer is preventable as vaccination is available, the state of Kerala has not been able to tackle the alarming increase in the number of cases, according to Dr Scott E Storme, professor and chairman, Department of Otorhinolaryngology, University of Maryland School of Medicine, Baltimore US.
During a recent visit to the state, he said: 'The vaccine should be administered to boys and girls before they are sexually active. I have vaccinated my children. We should aim towards herd immunity.'
Dr Scott was in Kochi, together with his colleague Dr Rodney J Taylor, Associate Professor, Department of Otorhinolaryngology, to address a conference on Otorhinolaryngology updates organised by Association of Otorhinolaryngologists of India (AOI), Kochi, and the Medical Trust Hospital. The experts discussed head and neck cancer, and said that smoking, alcohol and HPV were the main causes for head and neck cancer, and even cervical cancer in women. 'We do not know how certain sections of people develop cancer on exposure to HPV. The prognosis of HPV+ patients who smoke and drink is worse when compared with HPV+ patients who do not drink and smoke,' he said.
Price negotiations
With growing cases of cervical cancer in India, the Central government is negotiating with manufacturers of HPV vaccines to bring down the price of each dose from US$130 to $4.50 in India, said Centre for Cellular and Molecular Biology director Ch Mohan Rao. 'Negotiation is underway with the manufacturer of HPV vaccines to bring down the prices of vaccines so that they are easily accessible to the common man.'
Two vaccines licensed globally are available in India - a quadrivalent vaccine Gardasil and a bivalent vaccine Cervarix. With the high cost of the present vaccines, affordability and accessibility of them is a major concern for a mass vaccination programme in developing countries like India, Rao said.
Although results in the development of vaccines against HPV are promising, it would be a decade or more before they become available worldwide and are cost effective, said Nobel laureate Harald Zur Hausen, who identified the two most frequent HPV types in cervical cancer tumours. 'A cost-effective second-generation HPV vaccine is needed for developing countries to address various issues specific to the region.'
Sexually transmitted HPV infection is the most important risk factor for cervical intraepithelial neoplasia and invasive cervical cancer, he said. Unlike many other cancers, cervical cancer occurs early and strikes at the productive period of a woman’s life. The incidence rises in 30-34 years of age and peaks at 55-65 years, he pointed out.
'HPV transmission is influenced by sexual activity and age. Almost 75% of all sexually active adults are likely to be infected with at least one HPV type,' Hausen said, adding that there was a need to develop a global programme to eradicate the virus.
