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A study has found that cost is the biggest hurdle in the introduction of human papillomavirus (HPV) vaccines in Latin America and the Caribbean.
Experts say that without interventions such as vaccination, cases of cervical cancer — largely caused by HPV infection — will increase in the region as the population grows and life expectancy for women increases.
Researchers assessed the cost-effectiveness of implementing a HPV vaccination programme in Argentina, Brazil, Chile, Colombia, Mexico and Peru.
According to the study — a collaboration between six research centres including the US Centers for Disease Control and Prevention and the Harvard Medical School — there are currently two HPV vaccines available worldwide. Both prevent infection with HPV types 16 and 18, which cause up to 60 per cent of cervical cancer cases in the region, according to the study.
The major obstacle for vaccine introduction is its price, currently US$360 for the three-dose regimen.
Even if this were reduced to US$25, running the programme for five years in the six countries would cost US$290 million — a significant implication for national healthcare budgets.
"Even a price of US$5 per dose will present substantial national budgetary challenges for sustaining introduction over time", Jon Andrus, from the immunization unit at the Pan American Health Organization (PAHO) and an advisor on the study, told SciDev.Net.
At the current price, the authors say that, for countries that can afford it, screening is more cost-effective than vaccination as the main preventative measure. But as the cost of vaccination decreases, pre-adolescent vaccination following by screening three times per lifetime could become more cost-effective.
And in the poorest countries of the region, vaccination alone "for a markedly reduced price" would be the most feasible option for reducing cancer rates, the researchers say.
The study was presented at a cervical cancer conference in Mexico City, Mexico, last week (12–13 May).
At the end of the conference, representatives from 21 countries issued a declaration committing to work with PAHO's Revolving Fund — a system that obtains affordable vaccines by bulk buying. This will help ensure affordable prices for the introduction of the HPV vaccine in national programmes as soon as possible.

Link to executive summary of the study [172kB]

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