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Approximately 75 per cent of the world’s children receive routine basic immunisations. Every country has a national immunisation programme (known by a variety of names) that delivers vaccines to infants, children, and often adolescents. In some countries the programme also delivers vaccines against influenza, pneumococcal infection, hepatitis B, HPV and other diseases, as well as vaccine booster doses, to adults.
The development and demonstration of the safety and effectiveness of HPV vaccines is a major breakthrough in medical science that could prevent most cases of cervical cancer.
Cervical cancer is one of the most common cancers that affect a woman’s reproductive organs and various strains of the human papillomavirus (HPV), a sexually transmitted infection, play a role in causing most cases of cervical cancer.
Shockingly, Nigeria’s Health Minister, Professor Onyebuchi Chukwu stated that Nigeria documents 10,000 new cases of cancer annually with 8,000 of these cases being cervical. Unfortunately, cervical cancer accounts for 15 per cent of female cancers as compared to just about 3.6 per cent in the developed countries.
Ironically, less than 0.1 per cent of Nigerian women have ever had cervical cancer screening in their lifetime and less than 1 per cent is aware of the existence of this silent killer. Consequently, cervical cancer kills a woman every hour in the country. Although 100 per cent preventable, the cancer kills more women aged between 24 to 35 years old in developing countries than any other cancer in other parts of the world.
But Nigeria’s population of 40.43 million women aged 15 years and older are at risk of developing cervical cancer. Worse still, about 23.7 per cent of women in the general population are estimated to harbour cervical HPV infection at a given time.
Currently, Nigeria has commenced the vaccination of girls between the ages of nine and 15 with the Human Papilloma Virus (HPV) as part of a national strategy to reduce the mortality associated with cervical cancer. The launch took off with initial vaccination of indigent girls from Abuja on the February 4, 2011. A month later, the second dose was administered to them. The final dose of the Human-Papilloma Virus vaccine was administered to a set of 186 girls aged between nine and 15 on August 15, 2011.
The government has also procured 4000 doses of the vaccine which would be available at Federal Teaching Hospitals across the six Geo-political zones of the country. “This is a sign of commitment from the Federal Government geared towards protecting future generations of women from the dreaded cancer of the cervix,” said Prof. Chukwu. “The vaccine would protect against 70 per cent of all those possible causes of cervical cancer.”
Certainly deaths associated with cervical cancer, which is due to lack of awareness of the disease, late presentation of patients to the hospital and cultural beliefs, are best avoided. In fact, it is expensive. Similarly, getting all girls vaccinated might be expensive. “Nigeria cannot afford to cover the cost of vaccination for all girls in Nigeria due to paucity of funds, but following negotiations between Global Alliance for Vaccines and Immunisation (GAVI) and the vaccine manufacturers, most Nigerian girls would be able to access the vaccines at subsidised rate,” assured Professor Chukwu.
According to him, “GAVI has been able to negotiate with the manufacturers such that the full cost would not be more than $15 and we think that many homes can afford to spend such money to prevent their daughters from becoming victims of cervical cancer.”
Unfortunately, Professor Isaac Adewole, the principal investigator, Operation Stop Cervical Cancer Nigeria stated that every 10 minutes, two women die from cervical cancer worldwide, affecting more of younger productive women between 20 years and mid 30s. Sadly, he stated “once a woman is affected, it can take between five and 30 years for the virus to develop into full cancer, but since it has no early symptoms, the woman feels very healthy while the virus continues to ravage her. By the time the symptoms begin to show, the situation becomes uncontrollable. Virtually nothing can be done to remedy the situation and the woman waits for death.”
Today vaccines are available for primary prevention of cervical cancer. Theses vaccines are already in use in other places. According to Professor Adewole, the Vice-chancellor, University of Ibadan, Ibadan, Oyo State “the availability of the cervical cancer vaccine is crucial to reducing Nigeria’s maternal mortality, to improving maternal health, to saving Nigeria lots of money.”
“Currently those women with invasive cervical cancer cannot be cured. But when you vaccinate girls, they would not develop cancer and as such we would be saving money. A vaccination programme like this is also cost effective,” Professor Adewole stated.
Professor Oladapo Campbell, a consultant oncologist, Department of Radiotherapy, UI , Ibadan, who lauded Nigerian’s step to make Human-Papilloma Virus vaccine available, stated “if we are able to organise vaccination against HPV, the virus that causes cervical cancer, in effect we will be reducing incidence of this cancer by 60 to 70 per cent. That is a giant step in cancer control in Nigeria by the government.”
But, “the Federal government should really get experts to handle the HPV vaccination. It is a very delicate issue. With experts involved, they would be able to create policy about how to carry out the vaccination exercise.”
HPV vaccination is not all there is to cervical cancer prevention. According to Professor Campbell, “cancer education is very important and this must be at all levels–school, community, in cities and rural areas. In fact, it is better to prevent cancer than to cure. Also, early detection of cancer is important.”
“For instance, with increased cancer education level of cancer stigmatisation has reduced. If you remember about 15 years ago, to pronounce cancer was very difficult but people now accept and face reality about cancer management.”
Since the vaccine only covers some high-risk types of HPV, experts still recommend regular Pap smear screening even after vaccination. In addition, to this is the use of condoms to protect against contracting HPV.Share