Widespread and timely uptake of the new vaccine will save the lives of many Indian women by targeting a highly preventable and treatable disease
Women’s issues have been consistently deprioritised and marginalised in healthcare and medical research. Many female-specific ailments, particularly those relating to reproductive health, are still woefully understudied, with their causes and treatment unknown.
India accounts for nearly a fifth of global mortality due to cervical cancer, a severe public health problem predominantly affecting women from lower socio-economic groups.
In this light, the launch of India’s first indigenous cervical cancer vaccine must be celebrated as it moves us towards gender-equitable health.
Widespread and timely uptake of the new vaccine will save the lives of many Indian women by targeting a highly preventable and treatable disease. Cervical cancer affects about 0.0125 billion women each year.
In fact, as evidence shows, not only do vaccines save lives, improve health and enhance economic growth. They also raise equity by reducing income-related disparities.
Many studies have shown a ‘gender health gap’ that leads to women’s symptoms being ignored or dismissed, leading to delays in diagnosis and poorer care.
In India, social and cultural norms coupled with a lack of education and financial independence push women away from health care facilities.
Family often controls their access to health care and their concerns are neglected in favour of household and caregiving duties.The situation is even worse in rural areas, where healthcare resources remain scarce.
At the primary care level, the acceptance of cervical cancer screening has not been encouraging due to a lack of awareness and fear of undergoing a procedure.
As a result, fewer than one in 10 women aged 30–49 years have been screened for cervical cancer in India in the last five years. A lifesaving vaccine assumes even more importance in a context where preventive measures and treatment are limited.
Introducing the low-cost vaccine into the current market is also a game-changer in the worldwide battle against cervical cancer.
Since the introduction of HPV vaccines, high-income countries such as the United States, the United Kingdom, Australia and others have significantly reduced cases of cervical cancer.
However, it remains a leading cause of cancer-related deaths in women in low- and middle-income countries (LMICs). These countries currently depend on the vaccines manufactured by pharma multinationals Merck and GSK (Glaxo SmithKline), which cost about Rs 3,000 per dose.
The Indian vaccine is likely to be priced at a more affordable Rs 200–400, making it a viable alternative for the masses in India and other LMICs.
The HPV vaccine must be included in the country’s Universal Immunisation Programme. The vaccine is expected to be available by the end of the year and the focus now shifts to creating demand for it to reach more women and girls.
Although the usual groups routinely included in the national programme are infants and children, the recent success with Covid-19 vaccines has given us the confidence and experience to expand vaccination to other population groups.
For the HPV vaccine, the target age group for immunisation programs is 9–14-year-old girls.
Although the current vaccination schedule recommends two doses, recent data suggests that even one dose is effective against cervical cancer, which would make it possible for the vaccine to be available to more girls.
Conversations around sexual health are still considered taboo in India, while myths about the impact of vaccines on women’s sexuality and fertility are rife. Therefore, it is essential to have a team of experts and workers on the ground who can address these questions and misconceptions and build public trust, driving parents and young women to take the vaccine.
Building awareness through a concerted and effective communication plan will also be vital in ensuring girls are able to get the vaccine when it is most effective before they are exposed to the virus, or, before the start of sexual activity.
In this regard, valuable lessons can be drawn from the programmes in Sikkim and Punjab, which have used schools and teachers to initiate vaccination in the local community.
High acceptance and high coverage in the pilot projects suggest that the introduction of HPV vaccination in India’s immunisation program is feasible and scalable.
The new vaccine marks a significant step towards equitable healthcare for India. Cervical cancer remains the second-most common cancer amongst Indian women aged 15–44 years, killing more than 60,000 women annually.
CERVAVAC, developed by the Serum Institute of India, is effective against at least four variants of the cancer-causing human papillomavirus, responsible for 85 per cent to 90 per cent of cervical cancer cases.
If implemented well, this breakthrough gives us a great chance of meeting the World Health Organization’s target of vaccinating 90 per cent of girls by the age 15 and eliminating cervical cancer by 2030.
Views expressed are the authors’ own and don’t necessarily reflect those of Down To Earth
Shagun Sabarwal is South Asia Region and Global Monitoring, Evaluation and Learning Director, WomenLift Health
Shereen Bhan is North America Region and Global Leadership Development Director, WomenLift Health
Prabhdeep Kaur is Scientist (F) and Head of Division of Noncommunicable Diseases, ICMR-National Institute of Epidemiology
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