A female scientist in a laboratory looks through a microscope.

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Left behind: Young girls everywhere need to have access to the HPV vaccine

As we observe Cervical Cancer Elimination Day of Action, there is a pressing need to ensure that all women everywhere have access to the HPV vaccine, along with appropriate screening and treatment to prevent unnecessary deaths. Report from the Pacific Friends of Global Health.

As we observe Cervical Cancer Elimination Day of Action, there is a pressing need to ensure that all women everywhere have access to the HPV vaccine, along with appropriate screening and treatment to prevent unnecessary deaths. Despite being one of the most preventable and successfully treatable forms of cancer in 2020 there were at least 340,000 deaths worldwide. 90% of these deaths were in low and middle-income countries - and women and girls continue to be left behind.

The HPV vaccine was co-invented by Professor Ian Frazer, 2006 Australian of the Year, whose research on the link between human papillomavirus and cervical cancer established that 95% of cervical cancers are caused by HPV. The HPV vaccine is one of the most impactful initiatives supported by Gavi, the Vaccine Alliance which has supported the provision of the HPV vaccine to lower-income countries since 2012. This vaccine is instrumental in averting approximately 17.4 deaths for every 1000 children vaccinated and since 2012, Gavi investments have helped overcome supply challenges to protect 16.3 million adolescent girls.

Nossal Institute Hon. Professor Helen Evans, said: “The world has made extraordinary progress against cervical cancer and indeed Australia is on track to achieve elimination by 2035. Global cooperation through Gavi, the Vaccine Alliance, has powered the scale-up and rollout of the Australian-discovered HPV vaccine, through the developing world, saving more than 16 million lives.

Despite this success, stronger financial and political commitment is needed to ensure that young girls everywhere have access to this vaccine.

“The picture is not nearly so positive for women in low and middle-income countries including our near neighbour Papua New Guinea and we are now at an inflection point. We are grappling with supply constraints and disrupted health systems due to the pandemic, leading to a worrying decline in HPV vaccine coverage. We need to get back on track.”

This year, a landmark initiative to eliminate cervical cancer in the Western Pacific was officially launched in Papua New Guinea. Eliminating Cervical Cancer in the Western Pacific is a partnership between the Western Highlands Provincial Health Authority in collaboration with C4 partners: the Daffodil Centre (a joint venture between Cancer Council NSW and The University of Sydney), the Kirby Institute UNSW Sydney, the Australian Centre for Cervical Cancer Prevention, and Family Planning NSW. By April 2023, over 2,500 PNG women had been screened for HPV as part of the initiative.

“We hope that the success of the ECCWP program in the Western Highlands of PNG and across Vanuatu will pave the way for similar programs to be implemented in other Western Pacific nations that suffer from similarly high rates of cervical cancer, and where we know that early diagnosis and treatment can be lifesaving, as here in PNG,” said Professor Andrew Vallely, Head of UNSW's Global Reproductive Health at the Kirby Institute.

Professor Evans said that cervical cancer strikes women right at the time when they are most engaged in child rearing and contributing to their communities. The protection afforded by the HPV vaccine is much more than a health measure. When women survive their families and the broader community also benefit

“When we lighten the burden of cervical cancer we create a springboard for the empowerment of women and girls,” Professor Evans said.

The WHO SAGE recently recommended a single-dose vaccine schedule for the HPV vaccine down from a two-dose schedule which will potentially simplify the vaccination process.

“Encouraging signs of an expanded supply post-COVID and single dose vaccination represent a powerful opportunity,” Professor Evans said.

“This creates the very real possibility of reaching the target of protecting approximately 86 million adolescent girls in lower and middle-income countries with this lifesaving vaccine by 2025.”