Vaccine Response to Cervical Cancer

Plans are in place for Kenyan girls and women to access the world's first cervical cancer vaccines through an international action plan launched in Nairobi yesterday.

The move comes a few months after the world's first cervical cancer vaccine, Gadsil, was introduced into the local market.

Gadsil, approved in the US last year, has already been registered in the country and is available commercially.

But at the commercial cost of Sh10,000 per dose, it is just available to a handful of Kenyan girls and women.

However through the campaign launched yesterday during the ongoing global summit on Aids - Global Call - thousands of schoolgirls could be vaccinated and several million women screened for cervical cancer.

The campaign launched in Nairobi by legislator Betty Tett, will galvanise a global movement akin to the one that has made anti-retroviral drugs available to the poorest in the world in the past three years.

Preferential costing

Already, studies are going on in Uganda, Peru, India and Vietnam to determine the best delivery systems, cost and accessibility and if found suitable, findings will be presented to vaccine manufacturers for preferential costing.

"We are asking governments in developing countries to prioritise cervical cancer in their national development and health programmes and make budgetary allocations so that we can approach donors and manufacturers as a group and reap the benefits of economies of scale," said Tara Acharya of Rockefeller Foundation during the four month campaign launch.

Gadsil makers Merck Sharp and Dohme have shown willingness to offer the three dose once a lifetime vaccine at preferential cost to developing countries that can present a workable investment case.

GlaxoSmithKline have also developed a cervical cancer vaccine Cervarix and have already applied for local registration.

They hope to have it in the market before the end of this year. According to GSK managing director John Musunga they hope the vaccine to be fairly priced.

The Global Call comes at a time cervical cancer has become the single biggest killer of women in Kenya among all other tumours. According to data released in December by the Kenya Medical Research Institute cancer registry, cervical cancer is now the number one killer tumour of women, surpassing breast cancer.

The data covering 3,310 cases showed cervical cancer accounting for 23 per cent of all cancer cases while penile cancer was almost non-existent despite being caused by the same agent - the Human Papillomavirus (HPV).

The virus is one of the most common sexually transmitted infections and a leading cause of the cancer. The virus is transmitted through sexual intercourse, though other peripheral risks involve things like sex toys or surgical gloves. It is estimated that the lifetime risk of a woman getting HPV is 50 per cent.

"But the chances of the HPV turning cancerous in HIV positive women is even higher especially in Africa where the burden of Aids is significantly higher. Approximately 77 percent of women with HIV also have HPV," says Dr Florence Manguyu, a senior policy advisor with the International Aids Vaccine Initiative.

But availability of technologies is no proof that they will be picked up. Although the gold standard diagnosis for cervical cancer - Pap smear - which allows for detection and early treatment is available in Kenya, less than one per cent of women in the country have been screened.

At Kenyatta National Hospital, which has the country's only public radiotherapy unit, over 500 cases are referred for treatment every year.

Since many women are unable to travel to Nairobi from other parts of the country for diagnosis and treatment, this figure possibly represents a very small proportion of the total number of women in need of care.
In fact, limited research suggests that over 600,000 women throughout Kenya may have signs of cervical cancer and thus require treatment to prevent the disease from developing.

Kenya Medical Women's Association with the Family Planning Association of Kenya run the Well-Woman Clinic in Nairobi, which offers cancer screening services.

The Global Call brings 13 civil society and public health organisations from across the world and wants to make sure this new cervical cancer treating technologies are available to the developing countries as soon as possible.

source : allafrica.com