Public Health Officials Meet To Discuss Ways To Make HPV Vaccine Available To Women In Developing Countries

Sixty experts from public health agencies, pharmaceutical companies, nongovernmental organizations and philanthropic foundations on Tuesday met in London for a two-day conference to discuss ways to make human papillomavirus vaccines available to women in developing countries, the AP/Washington Post reports (Cheng, AP/Washington Post, 12/12). Merck's HPV vaccine Gardasil and GlaxoSmithKline's experimental HPV vaccine Cervarix in clinical trials have been shown to be 100% effective in preventing infection with HPV strains 16 and 18, which together cause about 70% of cervical cancer cases. FDA in July approved Gardasil for sale and marketing to girls and women ages nine to 26, and CDC's Advisory Committee on Immunization Practices later that month voted unanimously to recommend that girls ages 11 and 12 receive the vaccine (Kaiser Daily Women's Health Policy Report, 8/29). Gardasil costs about $360 for the three-shot series (AP/Washington Post, 12/12). According to Reuters, Cervarix is expected to be priced similarly (Hirschler, Reuters, 12/12). According to the World Health Organization, 500,000 women worldwide are diagnosed with cervical cancer annually, 80% of whom live in developing countries (Gerlin, Bloomberg, 12/12). In addition, more than 95% of women in the developing world never have a cervical smear, and 80% of cervical cancer deaths occur in developing countries, BBC News reports.

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Nothemba Simelela, a senior official at the International Planned Parenthood Federation, said there often is a "15-to-20-year delay between the time that new vaccines are approved in the West and the time they reach developing countries," adding, "The world cannot afford to wait 20 years to begin saving women from cervical cancer" (BBC News, 12/12). Howard Zucker, WHO assistant director-general for health technology and pharmaceuticals, in an e-mail statement to the meeting at the Royal College of Physicians said, "New vaccines against HPV in the developing world could save hundreds of thousands of lives if delivered effectively." Officials from GSK and Merck at the meeting said they had not set prices or agreed to sell their vaccines without profit in developing countries, Bloomberg reports.
Gardasil, which has been approved in 50 countries, will be sold by Merck at "dramatically lower prices" in developing countries, Gregg Sylvester, Merck senior medical director for adolescent health, said. Deborah Myers, GSK director of external and government affairs and public partnerships, said the company will implement a "tiered pricing" system for Cervarix that bases the price on a country's gross domestic product and the size of its orders (Bloomberg, 12/12). According to the AP/Post, some experts at the meeting said developing countries should be establishing their own vaccine manufacturing capacity. "By flooding the market with a cheap vaccine, countries can cut the price of a vaccine substantially," John Schiller of the National Cancer Institute said. Julian Lob-Levyt -- executive secretary of the Global Alliance for Vaccines and Immunization, an organization that purchases vaccines for developing countries -- said GAVI "would be prepared to subsidize the price [of HPV vaccines] in the short term, if in the long term it became affordable." Lob-Levyt added that a decision on whether to subsidize the vaccines would not be made until more data are available on the vaccines' potential impact in developing countries (AP/Washington Post, 12/12). The global health group PATH in June launched a five-year program that is using a $27.8 million grant from the Bill & Melinda Gates Foundation to conduct research in India, Peru, Uganda and Vietnam about ways to reduce potential hurdles for distribution of HPV vaccines in developing countries (Kaiser Daily Women's Health Policy Report, 6/8). "We have wonderful tools for preventing cervical cancer now," Jacqueline Sherris of PATH said, adding, "We know what to do. But the challenge is to move forward and develop the will to actually implement those strategies" (Bloomberg, 12/12).

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View drug information on Cervarix [Human Papillomavirus Bivalent; Gardasil.

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