Cervical cancer has been in the spotlight in India recently due to the government’s renewed focus on vaccination against it. The disease disproportionately impacts women in the country, causing over 77,000 deaths each year. In her recent budget speech, Finance Minister Nirmala Sitharaman announced that the government will encourage girls aged 9-14 to receive the HPV vaccine, which prevents cervical cancer.
Experts have welcomed this decision, saying it could be a potential game-changer. Cervical cancer is caused by certain strains of the human papillomavirus (HPV). The vaccines protect against the types of HPV that are known to cause over 70% of cervical cancer cases. However, these vaccines have seen low uptake in India due to their high cost. If included in the national immunization program, the vaccines could become much more affordable and accessible to girls across the country. This would significantly help reduce new cervical cancer cases and deaths in the long run.
Cervical cancer places a heavy burden on India’s healthcare system and economy. It is currently the second most common cancer in women after breast cancer. Every year, over 1.2 lakh women are diagnosed with cervical cancer in India. Tragically, over 77,000 lose their lives to the disease each year. This accounts for about one-third of the world’s cervical cancer deaths, highlighting its alarming prevalence in the country.
The reasons for this high incidence are multifactorial. Limited awareness and access to screening in rural and remote areas allow pre-cancerous lesions and cancers to go undetected until advanced stages. Cultural taboos also impact screening rates. Additionally, socioeconomic challenges like poverty, illiteracy and lack of health insurance prevent many at-risk women from accessing prevention services. All of these factors contribute to the grave toll of cervical cancer in India.
Two vaccines are currently available globally to protect against HPV – a quadrivalent vaccine called Gardasil by Merck, and a bivalent vaccine called Cervarix by GlaxoSmithKline. An Indian manufacturer, Serum Institute, also produces a similar quadrivalent vaccine called Cervavac. However, the high costs of Rs. 4,000 per dose have been a major barrier. At the individual level, this amounts to a substantial out-of-pocket expense that is difficult to afford.
At the public health level, vaccinating tens of millions of adolescent girls across the vast population has remained a challenge without government support. As a result, vaccination rates have remained disappointingly low. This has allowed HPV, and consequently cervical cancer rates, to continue spiraling upwards in India. Experts estimate that over 365 million women aged 15 and above remain at risk of developing cervical cancer in the country.
This is where the government’s recent announcement to encourage HPV vaccination assumes great significance. If included under the universal immunization program with provision of free or low-cost vaccines, it could potentially transform the cervical cancer landscape in India. More girls would have access to protection from HPV before becoming sexually active. This would steadily reduce the pool of infected women and new cervical cancer cases in the coming decades.
Additionally, greater awareness about the disease and availability of vaccines may help address cultural barriers and low screening rates over time. Screening still remains important, but widespread vaccination stands to have the maximum impact on prevention. It could help achieve the target of eliminating cervical cancer as a public health problem in the long run, as aimed by WHO.
Some challenges remain, such as ensuring high coverage, maintaining consistent supplies, and addressing concerns over specific HPV strains not covered by current vaccines. But with strong government support, experts are hopeful this could be a turning point in the fight against cervical cancer. By focusing attention and resources on vaccination, India may be able to significantly reduce its burden from this largely preventable cancer in the years to come. This would save countless lives and reduce suffering, making this a commendable step towards healthcare for all.