Millions of girls will have access to the lifesaving HPV vaccine thanks to a partnership between GAVI and Merck that will reduce the vaccine cost to below $5. From the New York Times:
Thanks to Pap tests, fatal cervical cancers are almost unknown today in rich countries. But the disease kills an estimated 275,000 women a year in poor countries where Pap tests are impractical and the vaccine is far too expensive for the average woman to afford, so the price cut could lead to a significant advance in women’s health.
The World Health Organization, which has been pressing for faster progress in maternal health, greeted the news as “a great step forward for women and girls.”
When the new price was described, Dr. Paul D. Blumenthal, a professor of gynecology at the Stanford University School of Medicine who has pioneered cervical cancer prevention techniques in poor countries, said, “Mazel tov!” As long as there is enough affordable vaccine for the ever-growing populations of poor countries, he said, “this is good news for girls, women and their families.”
The lower prices — $4.50 for Merck’s Gardasil vaccine and $4.60 for GlaxoSmithKline’s Cervarix — were negotiated through the GAVI Alliance, which was created in 1999 with a grant from the Bill and Melinda Gates Foundation to deliver more vaccines to the world’s poor.
The low price will initially apply to a few million doses for demonstration projects in Kenya, Ghana, Laos, Madagascar and elsewhere, but Dr. Seth Berkley, the alliance’s chief executive officer, said he hoped that by 2020, 30 million girls in 40 countries would get the vaccine at that price or less.
The vaccines must be kept refrigerated, and the three doses are normally given over six months — requirements that add to the difficulty of deploying them in poor countries.
The vaccines cost about $130 a dose in the United States, and each girl needs three doses. The lowest price that any other agency or government has negotiated, Dr. Berkley said, is the $13 paid by the Pan American Health Organization, which negotiates a bulk price for Latin American countries.
Since Latin America includes a mix of poor and middle-income countries, the manufacturers do not offer rock-bottom prices there, he said. The alliance subsidizes vaccine costs for the poorest countries in Africa, Asia and elsewhere, with the subsidies shrinking as the countries get richer.
The vaccines protect against the strains of human papillomavirus, or HPV, that cause 70 percent of cervical cancers. The Merck one also prevents genital warts, which are caused by related viral strains.
Gardasil and Cervarix, given to girls as young as 9, have caused controversy in the United States, where many parents fear side effects and worry that girls will see the vaccines as condoning sex at a young age. The vast majority of girls in the United States have not been inoculated.
In Australia, where the vaccines have been readily accepted, a recent study found a striking drop in cervical abnormalities, which are cancer precursors, among young women. In the five years after the vaccine was introduced there, cases of warts dropped by 93 percent among women and girls under age 21.
Despite the excitement among global health agencies, the charity Doctors Without Borders called the news “disappointing,” arguing that the prices should be even lower.
“Why are the pharmaceutical companies still making profits off the backs of the poorest countries?” asked Kate Elder, a vaccines policy specialist at the charity.