Can Peru prevent a killer worse than breast cancer?

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PATH_Peru_girlsCervical Cancer claims the lives of approximately 250,000 women in the world annually, with over 85% of these women residing in countries that lack technologies to detect and provide treatment.  Peru has one of the highest mortality rates from cervical cancer in all of Latin America with approximately 2100 annual deaths – a number which exceeds breast cancer.  Despite the development of a vaccine to Human Papillomavirus 16 and 18 (known to be a cause of the majority of cervical cancers), its availability in many countries, including Peru, is lacking.

In 2007, the Peruvian Ministry of Health (MINSA) coordinated an effort with PATH, a global non-profit health organization to initiate a pilot program to distribute and administer the HPV vaccine to 5th grade girls in 30 schools in the Piura region.  The vaccine itself was provided by Merck through PATH.  The program was highly successful, and in 2010, it was expanded to include 527 schools (including the original 30) encompassing 5 out of 6 health districts in Piura.  Again, the program was a success with 95% of vaccines being administered in schools, covering over 80% of eligible girls.  A subsequent WHO cost analysis demonstrated the economic feasibility of the school-based HPV immunization program as projected costs would only be a fraction of Peru’s immunization budget.

MINSA has recently made a concerted effort to improve their overall immunization programs through the development of permanent technical advisory and consultative committees within the Ministry as result of the HPV program.  In addition, they have increased their immunization budget by 500%.

MINSA’s strong commitment to the 2007 and 2010 successful regional efforts in collaborating with PATH, coupled with the recent budgetary and organizational changes will provide a strong foundation for the eventual nationalization of the school-based HPV immunization program to help reduce mortality from cervical cancer in Peru.

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2 Responses to “Can Peru prevent a killer worse than breast cancer?”

  1. klfranklin24 Says:

    This was a great write-up and a new perspective as I’m less familiar with the HPV vaccine efforts outside of the U.S. I’m curious to know more about the social acceptance of this vaccine and the stages of behavior change that occurred from MINSA deciding to administer the vaccine to Peruvians being more open to girls receiving it. I think the WHO cost analysis is very important, but they social dynamics around policy and implementing the vaccine are also of importance. Were there culture barriers to expanding the vaccine coverage to other schools? The vaccine is meant for those who are or will become sexual active, but is there space where perhaps for religious reasons girls can opt-out of receiving the vaccine? The HPV vaccine is very interesting in that the disease risk is linked to ones sexual behavior which is a change from more traditional vaccines administered to children for diseases such as polio, measles and the flu virus.

  2. chiani445 Says:

    Thank you for bringing this to our attention. I know there has been an increased push for HPV vaccines in the U.S. over the past few years, it is good to see that other ministries of health are taking similar, even stronger approaches. It may be a little too soon to tell, but has there been a decrease in incidence of cervical cancer since 2010, or since 2007 when this effort increased? I’d be interested to know whether there has been a direct effect. Also, during this vaccination process, is there some sort of health education/sexual health education paired with the process? Being that this is being aimed at adolescent girls in a school setting, it would be an excellent opportunity to disseminate information.

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