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Ready Photo Application In The Vaccine
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By Celina M. Hanson.
Received: 23 February 2015 / Revised: 24 April 2015 / Accepted: 12 May 2015 / Published: 20 May 2015
This Week In Operation Warp Speed
Developing countries suffer greatly from the problem of cervical cancer, but do not have the resources to establish screening programs that have led to significant reductions in incidence and mortality in developed countries. The human papillomavirus (HPV) vaccine offers an opportunity to prevent cervical cancer in low-risk areas with the help of Gavi The Vaccine Alliance. In addition to domestic startups, states can apply for a demonstration program to help them make informed decisions about domestic startups. This article summarizes the results of the approvals and implementation of the Gavi HPV program. After two rounds of applications, 23 countries have been approved to screen nearly 400,000 girls for vaccination. All countries are considering a school-based approach with different strategies to reach and vaccinate girls who are not enrolled in school. The results so far are as follows: Reaching the selected girls was difficult; Strong links with the academic sector are important and general acceptance is high. Initial reports are encouraging but need to be confirmed in a population study later this year. The experience of these countries is consistent with the existing literature describing HPV vaccine factors in low-income people.
The fight against cancer is a source of stress and pain for people and their families in all countries. However, addressing the disease in low-income countries, where morbidity and mortality are high due to economic and health system challenges, has other challenges. This is particularly evident in cervical cancer, which is often referred to as an “unrecognized disease” [1]. In 2012, there were approximately 528,000 cases of cervical cancer worldwide, and nine out of 10 cervical cancer deaths occur in developing countries.
These types of illnesses and deaths are primarily due to the quantity and quality of safety and care. There are several ways to diagnose cervical cancer: cytology, visual inspection, and DNA testing for human papillomavirus (HPV). In fact, screening methods have reduced the incidence and mortality of cervical cancer in many manufacturing facilities; however, cervical cancer screening has not affected cervical cancer mortality in many low-income countries, largely due to lack of early screening and treatment [3].
Is a tetravalent vaccine that provides increased protection against HPV types 6 and 11, which can cause warts, cervical changes, and respiratory papillomatosis [ 4 , 5 , 6 ]. Most cervical cancers are caused by human papillomavirus (HPV) types 16 and 18 [7]. It has also been shown to cause oropharyngeal and anogenital cancer [8, 9]. Studies have shown that both vaccines are safe, immunogenic, and effective and can protect against HPV genotypes [10]. Both vaccines are recommended for girls aged 9 to 13 by the World Health Organization (WHO) [11].
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These vaccines were first introduced in high-income countries in 2006 [12], but their use is limited in low-income countries due to the high cost of the vaccine and difficulties in providing care. Gavi The Vaccine Alliance, an international business alliance that aims to bridge the gap between the introduction of new vaccines in high- and low-income countries, is working with vaccine manufacturers to reduce the cost of all vaccines to less than $5 per dose. 13]. ]. ] in Gavi-responsive countries where the burden of disease is high [ 14 , 15 , 16 ]. In November 2011, Gavi opened a funding window for countries wishing to introduce the HPV vaccine.
In most cases, for some routine vaccines, Gavi provides funding for countries to start at national level. For national HPV vaccine coverage, Gavi not only requires countries to achieve per capita gross national income (GNI per capita) of US$1,580 and level three diphtheria, tetanus, and pertussis (DTP3) coverage of at least 70% like any other vaccine, but also to demonstrate the feasibility of providing high-dose vaccination to at least 50% of girls aged 9–13 years in a central area [17]. In the case of the HPV vaccine, Gavi, through its partners WHO, BMGF, PATH, UNICEF and UNFPA, developed an additional support system as a demonstration project (Figure 1). This approach would give countries the opportunity to become familiar with the HPV vaccine, as many of the Gavi-eligible countries did not have the HPV vaccine (Figure 2) or other multivalent vaccines for this age. In addition, the introduction of the country without information leads to several problems in the vaccination of young people, a group not covered by routine vaccination or many other health measures [18, 19]. In addition, the vaccine protects against a sexually transmitted infection that many communities do not know much about, especially cervical cancer [20]. Finally, the experience of many countries in different contexts has shown that early HPV vaccine trials provide a good opportunity to learn how to communicate better and improve delivery methods, thus increasing vaccination rates [ 21 , 22 ]. All these “lessons learned” support national policies and can be used for the development of the whole country. On the contrary, in other countries that did not pilot pilots; Early approval of vaccines may be associated with potentially preventable complications [ 23 , 24 ].
Figure 1. Gavi has developed two human papillomavirus (HPV) vaccines. Option 1 shows traditional Gavi support for country initiation. This strategy requires countries not only to achieve a gross national income (GNI) per capita of US$1,580 and a DTP3 level of at least 70%, but also to demonstrate their capacity to contribute more. – Vaccination of at least 50 percent of girls between 9 and 13 years of age in the entire region. For countries that do not have this information, Gavi has offered a second option. Option 2 allows countries to learn more about this group of vaccines before deciding whether to introduce national HPV vaccination.
Figure 2. Global map showing HPV vaccination in Gavi-eligible and non-Gavi eligible countries. As of January 1, 2015, only three Gavi-eligible countries had introduced HPV nationally, Bhutan, Lesotho, and Rwanda. Most Gavi-eligible countries have never had an HPV vaccine. A number of Gavi-eligible countries have had pilots for the Gavi HPV program in the past and without Gavi support.
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The Gavi HPV Demonstration Program encourages countries to participate in a two-year “learning by doing” project. To be eligible for the demonstration program, a country must have a diphtheria, tetanus and pertussis grade three (DTP3) rate of at least 70% of the national level, a measure chosen as representative of the effectiveness of its vaccine. The demonstration program requires countries to implement vaccines and assess their availability, feasibility, acceptability and cost and make informed decisions about their implementation at the national level. The program also calls on countries to review strategies that could include HPV vaccination and the provision of additional adolescent health services to girls and boys to help achieve this. Finally, the program promotes the implementation of all national cervical cancer prevention measures, including HPV vaccination as primary prevention.
The cost of HPV vaccination varies widely depending on many factors, such as vaccine production equipment, population density, and delivery method [ 25 ]. Estimated national costs of HPV vaccination in low-income countries ranged from US$3.13 to US$5.15 per fully vaccinated girl and from US$4.23 to US$5.81.