Health Minister challenges ‘Naysayers’ of HPV vaccine

Jan 09, 2012 News

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“Naysayers can bring their concerns to us,” said Minister of Health Dr. Bheri Ramsaran even as he refuted suggestions that the Human Papilloma-virus (HPV), which is a strong risk factor for cervical cancer, is known to affect a miniscule amount of women thus a massive programme to combat its impact may be irrelevant.
His assertion comes in wake of a decision to launch a massive vaccination campaign this week to combat HPV and by extension cervical cancer. The move, according to the Minister can be considered the most costly vaccination programme the public health sector has ever embarked on.
“The naysayers will have to come to us with their facts and qualifications, because the Ministry has found that our rigorous approach over the years has been working effectively,” the Minister said, even as he alluded to the fact that the Ministry is not undertaking the programme on its own but rather in collaboration with the Pan American Health Organisation.
With a primary aim of arresting the potential impact of women contracting cervical cancer and also to prevent other health issues such as genital warts and even cancers of the anus, vagina and vulva, the Ministry of Health made a decision to engage the ambitious programme, which will target mainly young females between the ages of 11 and 13 years, according to the Minister.
“The Government has decided to undertake this programme because we are in the business of prevention. This is not just about vaccinating people, it’s about addressing a real challenge…The cost is significant and I am not in a position to say the actual cost right now because I will have to get this from my technical people but it is a very costly programme,” the Minister admitted.
He explained that the cost of the programme does not only entail the procurement of the vaccine, Gardasil (a vaccine used for the prevention of the Human Papilloma-virus HPV) but also the training of personnel to administer the vaccine, which will be provided free of cost to the recipients.
Reiterating the importance of prevention, the Minister asserted that the Ministry is aware that the effects of the disease is not likely to be felt immediately but rather later in life, perhaps when persons are between the ages of 35 and 50.
“The Ministry doesn’t just go and do things ‘willy nilly’. Our rigorous approach to dealing with health challenges has been proven over the years to be very successful. The Ministry has had success in its prophylaxis programmes and our vaccination programmes can be considered one of the better in the world.”
The programme was first introduced by former Minister of Health, Dr. Leslie Ramsammy, who had anticipated that approximately $40M would have been utilized to introduce the vaccine to about 25,000 girls and eventually mount to about $60M to cater to 40,000 girls.  At the time, he had hinted to the possibility of the vaccine being offered to girls as young as nine-years-old and will start as a collaborative effort with the International Planned Parenthood Federation and the Guyana Parenthood Association.

Cervical Cancer, the former Minister had said, is one of the main cancers in women worldwide. He reported even then that approximately 450 persons die each year from cancer and one of the most common cancers in Guyana is that of the cervix. In 2007, a total of 77 women died of cervical cancer, he said, and Guyana has had a cervical cancer incidence rate of about 45 per 100,000 women. “This means that each year about 150 to 200 women are diagnosed with cervical cancer. At present, the mortality rate associated with these cancer cases is about 20 per 100,000 women,” the Minister had pointed out. This, he said, means that each year about 80 women die because of cervical cancer and studies have shown that the HPV is the causative agent for more than 85 percent of cervical cancer.
The main transmission route for HPV is through sex and the modes of transmission of this virus are similar to that of HIV.
Based on this, Guyana has included HPV vaccine as an important component of its national policy and strategy for prevention, diagnosis and treatment of cervical cancer. As such the HPV vaccine is intended to protect against future infection with HPV, with the rationale being that girls are immunized against its impact even before they become sexually active.
The age range (11-13) was chosen as it has become evident that young women are becoming involved in sexual relations as early as 13-years-old, Minister Ramsaran told this newspaper.  In this regard, he pointed to the fact that the Ministry does not premise its efforts on treatment alone but on prevention as well, a mode which, he said, is very evident in other areas such as the Human Immunodeficiency Virus (HIV). He made reference to the Ministry’s Prevention of Mother to Child Transmission (PMTCT) programme, which has seen the Ministry seeking to ensure that women who are infected with HIV being provided with an antiretroviral regime at an early stage of their pregnancy that serves to ensure that their babies are not affected. “If we didn’t do this, 99 per cent of our babies born to infected mothers would be infected so we will not limit our success to HIV when we know that we can do more,” the Minister asserted.
It is for this reason, he said, that the Ministry is keen on addressing the potential impact of cervical cancer which will be introduced in at least four pilot Regions, including Regions Three, Four, Five and Six, before the programme is expanded.  Over a six-month period, some 20,000 doses will be administered at both health centers and primary schools in the identified Regions, Dr Ramsaran said.

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