Roll out of HPV vaccines closer

Guyanese girls, aged 12 to 14 years old, will soon be able to benefit from the free distribution of the Human Papilloma Virus (HPV) vaccine, which should provide immunity from the virus responsible cervical cancer, the leading cause of cancer among women.

Minister of Health Dr Leslie Ramsammy, in an interview with Stabroek News on the acquisition, distribution and implementation of the recently procured multi-million dollar doses of the vaccines Gardasil and Cervarix, said the vaccine will cost about US$70 per dose for individuals before they become sexually active. However, since the evidence of the HPV infection in men is less strong than that in women, priority will be given to females.

Ramsammy stated that not every country has been able to provide vaccines for both boys and girls. The ministry’s goal, he said, is to have every boy and girl access free HPV vaccines by 2015. The programme, targeted at females only, will cost US$1.2 million per year for 70,000 doses of the vaccine.

“I am glad that this year I am able to procure the vaccine to start the programme even though the budget didn’t include $1.2 million for the HPV vaccine,” Ramsammy said.

The minister noted Guyana is working with the GAVI Alliance (formerly the Global Alliance for Vaccination and Immunisation) to support the programme so that in 2012 every child in Guyana can be vaccinated. “We believe that we will be able to introduce the vaccine later on to both boys and girls,” he said. GAVI has been providing vaccination and immunization support to Guyana since 2001/. Up to March this year, Guyana received support to the tune of US$2,166,429, according to the GAVI website disbursement page.

Ramsammy said the cost of the HPV vaccine is decreasing and it is expected to drop to US$42 and then further lowered to US$21 per full dose. This, he said, will enable the ministry to offer vaccines for boys as well.

Explaining the control mechanisms for shipment, Ramsammy said that 20,000 doses have already arrived in Guyana and samples must be sent back to the manufacturer. This is done so that they can see that the efficacy is the same and it has not been contaminated.

The samples have already been re-sent and they are currently awaiting advice from the manufacturer, Ramsammy reported. “Once that is obtained we will be ready within one week to distribute in our heath sector,” he said.

In Guyana it is estimated that more than 50% of sexually active women are infected with at least one strain of the HPV virus.
Having young girls receive the three-dose booster shots of the vaccine will significantly reduce the diagnosis of cervical cancer in women in future years.
For the past 2 years, the cervical prevention and control programme entailed investments of $50 million per year to complete awareness, treatment and radio therapy programmes.

Ramsammy said cervical cancer has now surpassed breast cancer as the number one cancer in Guyana. “That is the truth in most countries… up to three years ago Guyana ranked breast cancer as the leading cancer of women. But that was because we were not diagnosing cancer at its earliest,” he recalled, adding that it is likely that cervical cancer will eventually be the lead cancer in every country.

“That is why our diagnostic programmes are so important because we want to be able to nip everything in its bud before it blossoms into a cancer,” he said.

Ramsammy explained that 170 new cases are diagnosed annually but noted that this is not necessarily the number of occurrences, just what was found.

The primary focus of the programme, he said, is early diagnosis. “With this programme we aim for earlier diagnosis that we used to have so we can take action to prevent the spread of cervical cancer that is due to HPV infection in women… Make them more aware of cervical cancer and let them know that it is preventable,” he emphasized.

He explained that HPV is extremely prevalent in both males and females and the earlier a person becomes involved in sexual activity, s/he is more likely to get infected.  “Like HIV, it stays in your body for a long time but unlike HIV, HPV may take 20 years to manifest itself, but during those years changes are happening that are not visible but transmissible,” Ramsammy indicated.

He said the disease demonstrates no signs or symptoms and because of this, it can silently spread massively in any population.