Inspire Inclusion, Eliminate Cervical Cancer

A few weeks ago, a WhatsApp group of schoolmates was abuzz - Ms. Seetharaman's mention of the HPV vaccine in her budget speech had raised questions.

I first heard about what was being planned in December 2022 when India began the procurement process, following the decision that boys and girls would receive the vaccine as part of the (national) Routine Immunization program by 2026.

My 11-year-old son got his HPV vaccination last year. While my girlfriends clarified questions about the vaccine, and their question on “why” boys (they don’t have a cervix!) led to this article.

Approximately 77000 Indian women die annually from cervical cancer, a tragedy since it can be prevented and treated if caught early. When boys AND girls get vaccinated, the future incidence of cervical cancer will reduce significantly. I am glad India didn’t wait a few years to include boys in the program!

The human papillomavirus (HPV) is a prevalent sexually transmitted infection that affects the skin, genital area, and throat. HPV infection, which can remain asymptomatic for decades, can lead to the development of abnormal cells, ultimately increasing the risk of cancer. Notably, untreated, persistent HPV infection accounts for 95% of cervical cancers.?

The burden of HPV infection is significant, affecting an estimated 1 in 5 men over the age of 15 years. Research tells us that men are vulnerable to HPV infection throughout their lifetimes. Although their bodies can clear most infections within two years without health issues, nearly 1 in 10 cases persist, leading to genital warts or cancers.?

HPV is sexually transmitted, and therefore, vaccinating boys is critical for the prevention of genital warts and cancers among men and women. ? Vaccination, screening women twice during adulthood (age 35 and 45), and timely treatment are the three cornerstones of eliminating cervical cancer.?

The other reason I am glad that India's HPV program is getting noticed is because of what could happen in other LMICs. The cost of 1 HPV vaccine dose has so far ranged from USD 120 to USD 24 (2 to 3 doses are needed based on age). This has made it prohibitive for many who may have wanted to take the vaccine. In 2023, when India started the procurement process, there has been an expansion in production capacity, with more than one company wanting to include their vaccine in India’s program. It is expected that by the time the vaccination program rolls out across the country in 2026, the cost per dose could be USD 5. While India joins 96 other countries in having an HPV vaccination program for its adolescent population, other LMICs, nearly 70+ countries, will benefit from the expanded production capacities and lower cost.

Eliminating cervical cancer in India in our lifetime will require the whole of Indian society to work together to ensure all adolescents (9-14) get vaccinated. Simultaneously, let's work to make screening and treatment available and affordable - those tools have improved over the years and can reduce annual deaths. Will you join the #pinkarmy?