Late last week, the Vaccine and Related Biological Products advisory committee at the Food and Drug Administration (FDA) unanimously endorsed the petition for Merckâ€™s forthcoming vaccine against human papillomavirus (HPV), a sexually transmitted disease that causes cervical cancer. The final decision from the FDA is expected on June 8 (see article in the Washington Post). As my colleague Owen Barder articulated in a previous post, this vaccine has enormous potential value (cervical cancer is the 2nd most prevalent type of cancer among women) but is not without its controversy. Even before approval, experts are predicting a shortage of the vaccine globally and a politically-charged collision with the Christian right who oppose the vaccine for fear it will inspire sexual promiscuity. [Update: The prospects of a collision with the religious right are receding - see this statement of support from the Family Research Council.]In a recent New York Times commentary, Dr. Ben Daitz of the University of New Mexico highlighted another pressing challenge facing the vaccine and its distribution and use: inequality. According to Dr. Daitz:
In the United States, cervical cancer has slipped to eighth in the rankings of the incidence of cancers among women, but in the developing world, it ranks second. A study by public health investigators in Mexico reported that an average of 12 women died of cervical cancer there each day. Increasingly, cervical cancer will become a disease of poor women who have limited or no access to basic health care, much less vaccines expected to cost $300 to $500 for a series of three shotsâ€¦.The present cost of screening-prevention methods like Pap smears and colposcopy approaches $6 billion a year in the United States. Those costs will continue in addition to the vaccine expense. Who will pay for cervical cancer prevention for the neediest women and girls?The invention of this new and exciting product seems like the perfect opportunity for the pharmaceutical company, national governments and donors to develop a logical plan to provide this life-saving vaccine to poor women around the world - a solution that neither punishes the company for its investments to prevent a disease that affects women in developing countries as well as developed ones, while also providing women in developing countries the opportunity to be protected.
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