Poorer Countries Get Price Cut on HPV Vaccine – But Is It Enough?

Some of the world’s poorest countries are getting price cuts for vaccines that protect against 70 percent of all cervical cancers. The two companies involved, Merck and GlaxoSmithKline, announced recently that their vaccines (Gardasil and Cervarix) would be sold to those countries for $4.50 and $4.60, respectively. These prices are an improvement from the previous $13 per dose. But is it enough to help poorer countries make commonly available the vaccination against certain strains of human papillomavirus (HPV), the sexually transmitted infection which can cause some cervical cancers?

The Pap test was the first step in reducing cervical cancer deaths: after its introduction in 1950, the U.S. experienced a significant drop in cervical cancer deaths (almost 70 percent from 1955 to 1992). The HPV vaccine could be the next big step in preventing cervical cancer deaths: The National Cancer Institute believes the vaccine could reduce these deaths worldwide by as much as two-thirds. Currently the disease still kills an estimated 275,000 people every year, with 85 percent of those deaths in developing countries.

The lowered prices are made possible by the Global Alliance for Vaccines and Immunizations (GAVI) Alliance, created in 1999 with funding from the Bill and Melinda Gates Foundation, which negotiated with Merck and GlaxoSmithKline. Before the price reduction, the series of three shots needed cost a woman a total of about $39; now they’ll cost more than $25 less—a big difference for women living in poverty.

However, the price is still too high. The international poverty line is set to those who live on less than $1.25 a day and, in 2008, 1.4 billion people lived under that line. For one out of four people in developing countries, it would take more than three days to earn enough to get one dose of the HPV vaccine, and more than 10 days to have enough for the full three-dose treatment. And that assumes they don’t need money for anything else, like, say, food.

Kate Elder, vaccines policy adviser to Médecins Sans Frontières, an association operating immunization programs around the world, believes Merck and GlaxoSmithKline are still maximizing their profits at the expense of the people in poorer countries. She says,

This vaccine is critical for millions of girls in developing countries, where cervical cancer is the main cause of cancer deaths among women. The price is unjustifiably high and will add to the already spiraling vaccination costs faced by low-income countries. … It’s a lost opportunity to negotiate for a truly low price.

Although it’s not yet enough, the price drop is at least a step in the right direction. The new prices for the vaccine will first apply to a few million doses going to Kenya, Ghana, Laos, Madagascar, Malawi, Niger, Sierra Leone and Tanzania as a part of demonstration projects.

Photo of young women in Ghana by Flickr user usaid.africa licensed as a U.S. government work, and map by Wikimedia Commons author Tony0106 licensed under Creative Commons 3.0

Comments

  1. Many countries make their own vaccines or regulate the prices that private countries can charge as part of their public health programs. Almost all vaccine research is done with government funds which gives governments a lever to exert government control.

  2. It isn’t remotely enough. For one thing, since not all cancer-causing strains of HPV are affected by the vaccine, the ones not included are becoming more common, with no protection against them available. That’s basic evolutionary biology, and the vaccine manufacturers and the governments who are pushing for vaccination never seem to get around to mentioning it. For another thing, Gardasil has caused a great many severe side effects, and girls injured by the vaccine in those poor countries aren’t going to have the resources to deal with the damage. No matter how low the price, these vaccines are at best only a partial solution to the problem of cervical cancer, and they add their own risks.

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