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The economic burden of HPV

Helping to build a better future
Young women in developing countries have a huge potential to create social and economic change, helping to build a better future for all.

However, many are currently disadvantaged by the accessibility and quality of their country’s healthcare systems and are unable to seek help, reach medical facilities, or pay for treatments [1]. By working to address these problems we can help tackle some of the world’s most pressing health inequalities.


 

The Global Burden of HPV

4.8% of cancers worldwide can be attributed to the human papillomavirus (HPV) [2]. Of the 274,000 deaths due to cervical cancer each year, more than 80% occur in developing countries [3].

Affecting relatively young women, it is the largest single cause of years of life lost to cancer in the developing world, most often affecting women who are caregivers and breadwinners in their community [3]. The deaths of these women can have a devastating impact on the well-being of their families, and subsequently the country’s economy.

When considering the direct costs related to the prevention and treatment of cancer, and the economic value of lives lost and disability caused, de Souza et al. estimated cancer had an impact of approximately US$1.16 trillion worldwide in 2010 [1].


Global investment in cervical cancer prevention could save up to 230million years of life free of disability, with an economic value of $1trillion USD in 2010 [1].


The other half of the story

HPV is preventable through a vaccination, which is administered to adolescent girls and offers protection against the strains of HPV that cause 70% of cervical cancers. These vaccines provide the best opportunity for significantly reducing the future burden of cervical cancer in places such as Africa, where it is a leading cause of cancer death among women [4].

For many developing countries, the HPV vaccine is not just an effective solution, one that prevents 1,500 deaths for every 100,000 vaccinated, but it is often the only solution, because they currently lack the capacity to offer screening programmes for cervical cancer.

Recently, the companies that manufacture these vaccines agreed to a reduced sales price in developing nations. However, barriers to the wider distribution of the vaccines remain. This is particularly true in rural areas, where few adolescent girls attend school or receive regular preventative care, making access an issue [4].

Other barriers include low levels of awareness of cancer in the general population, and among health professionals. This results in delayed seeking of medical attention as well as delays in diagnosis [1]. Subsequently, about 80% of cancer patients in Africa are diagnosed at advanced stages of cancer, when pain relief is often the only choice of treatment [4].


 

Increasing access to diagnostics

Facilities for the diagnosis and treatment of cancer in most developing countries are minimal and there are almost no national cancer control programmes in place. Whilst African nations account for over a million new cancer cases a year, the lack of resources and basic infrastructure mean that most Africans have no access to cancer screening, early diagnosis or treatment. In Sub-Saharan Africa more than 95% of women have never been tested for cervical cancer [1].


Only 5% of global resources for cancer are spent in developing countries [5].


Currently, many developing countries have neither the resources nor the capacity for their health services to organise or sustain screening programmes [6]. This is, in part, because of the high prevalence of other infectious and non-communicable diseases which makes them the priority for funding, human resources and capacity in the health services, leaving little left to implement new programmes based on traditional methods.

Up to one third of new cancer cases in developing nations could be prevented with proper primary prevention measures in place, and survival rates for one third of patients could be increased if the cancer was detected earlier [6].

Working together to achieve the goals

The UN’s Sustainable Development Goals have outlined the requirement for premature mortality from non-communicable diseases to be reduced by one third by 2030 through the promotion of prevention and treatment. Providing frontline health workers with a better tool to diagnose HPV, and therefore prevent cervical cancer, will help combat the premature death of women in developing and developed nations.

This will give women of all ages the opportunity to attend school, raise families and gain employment – ultimately contributing to their country’s economy.

“Placing tools such as this in the hands of health workers provides women in low-income countries with the same access to early detection that has dramatically reduced cervical cancer-related deaths in higher income countries. When a mother dies, the tragedy also extends to her children, family and community, with her loss particularly affecting her children’s health and education,”
David Bell
Director of Global Health Technologies supporting Global Good, a collaboration between Intellectual Ventures and Bill Gates

References

[1]  B. H. F. C. A. C. A. a. G. L. Jonas A. de Souza, “Global Health Equity: Cancer Care Outcome Disparities in High-, Middle-, and Low-Income Countries,” Journal of Clinical Oncology, 2015.

[2]  P. M. M. a. C. F. MD2, “HPV Vaccination in Southern Africa: A Jab of Hope in the Fight Against Cervical Cancer,” Cancer Cytopathology, 2016.

[3]  M. a. S. J. G. M. M. Jan M. Agosti, “Introducing HPV Vaccine in Developing Countries — Key Challenges and Issues,” The New England Journal of Medicine, 2007.

[4]  American Cancer Society, “Cancer in Africa,” 2011.

[5]  C. International, “Scaling up cancer diagnosis and treatment in developing countries: what can we learn from the HIV/AIDS epidemic?,” Annals of Oncology, 2010.

[6]  A. M. B. &. R. R. Rengaswamy Sankaranarayanan, “Effective screening programmes for cervical cancer in low- and middle-income developing countries” World Health Organisation – Bulletin, 2001.

[7]  Roche, “Current Status of Cancer in Africa,” 2010.

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