At the end of February, an oncology conference was held in honour of the platinum jubilee of the Tata Memorial Centre, Mumbai. At this conference, leading Indian oncologists argued with leading health authorities from other parts of the world that India does not need a structured human papillomavirus (HPV) screening or vaccination program as rates of cervical cancer in India have declined with the implementation of basic sanitary and hygiene awareness campaigns. This statement should make your jaw drop.
One of the most common sexually transmitted diseases in the world, the HPV has many different strains, the deadliest of which can cause cancer. And the HPV vaccine is one of the few medical therapies in the world that we know actually prevents cancer – specifically, cervical cancer. Despite being easily preventable with this simple vaccine series, cervical cancer continues to plague women across the world, with World Health Organisation (WHO) estimates placing the number of deaths due to cervical cancer at 270,000 annually. Roughly 65 countries worldwide have introduced the HPV vaccine, but most of these countries are developed countries, while the burden of HPV is usually worst in developing countries. In India, specifically, the most recent estimates show that over 120,000 Indian women are diagnosed with cervical cancer every year and over half of these women die from cervical cancer. With India’s cervical cancer deaths accounting for a quarter of the world’s cervical cancer deaths, how can any medical professionals argue against screening and vaccination for the number one risk factor for cervical cancer?
The discussions at this conference are particularly disheartening in light of the fact that other outlets seemed to be encouraging both HPV screening and vaccination in a push to improve women’s health in India. To argue against a cancer vaccine that we know has the ability to save countless lives is ridiculous. Particularly in light of very recent evidence showing the decreased prevalence of HPV in the United States after implementation of a vaccination program. No amount of public health campaigns advocating improved hygiene practices should ever diminish the importance of an HPV vaccination campaign and for medical physicians to even suggest such a thing is abhorrent. In the past one of the biggest hurdles for the HPV vaccine in India has been the associated financial burden, however, given reports of a $500 million grant given to the government for vaccine implementation, there really is no better time than now to emphasise the importance and impact of both HPV screening and vaccination.
The HPV vaccine has been plagued with unfortunate rumour after unfortunate rumour ever since it was released. From false arguments that it led to increased sexual activity to headlines blaming the vaccine for debilitating side effects – the vaccine seems to have got more negative press than anything else despite the obvious preventive health benefits of this vaccine. Add to the fear-mongering these misplaced arguments by medical experts and the HPV vaccine continues to be undervalued despite its clear public health benefits.
Everything in medicine is a balance of risk versus benefit. However, patient well-being and safety are always at the forefront of healthcare. From both a public health perspective and a medical perspective, the importance of the HPV vaccine cannot be overstated. So, in honour of the recently celebrated International Women’s Day, let’s take a step forward for women’s healthcare in India instead of taking several backwards.