By Dr. Gregory Simon
What do neglected tropical diseases (NTDs) have to do with women’s health? A recent review entitled, “Effective Health Interventions for Adolescents That Could Be Integrated with Human Papillomavirus Vaccination Programs”, has just been published looking at how combining multiple health interventions with human papillomavirus (HPV) vaccinations increases the effectiveness of HPV delivery. Integrating NTD treatment (especially for soil transmitted helminths and schistosomiasis) with HPV vaccinations had especially promising results.
Treating HPV is imperative for women’s health as HPV is 99.9 percent responsible for all cancers of the cervix. In 2006, the first vaccine to prevent cervical cancer was approved by the FDA. This vaccine protects against two high risk strains, those known to potentially cause cancer, and two low risk strains typically resulting in genital warts. Since that time, the usefulness of the HPV vaccine has expanded. Many developed countries have even added the HPV vaccine to their list of mandatory vaccinations for children and young adults. However, the cost of the initial HPV limited the access of this vaccine to those in low-income countries.
In 2013, a record low price introduction for HPV vaccines opened the door for low-income countries to begin vaccinating millions of girls against HPV. Thanks to organizations like the GAVI Alliance, the poorest countries now have access to HPV vaccines for as low as US$ 4.50 per dose (costing more than $100 in developed countries)! This price reduction will continue to be essential in reaching the 275,000 women in the world who die of cervical cancer every year, with more than 85 percent living in low-income countries.
In order to make distribution of HPV vaccine as effective and sustainable as possible, it will be necessary to decrease the costs of distribution, and integration of health services is one of the easiest and most cost-efficient ways to decrease distribution costs. The recent review carried out by the World Health Organization’s Department of Reproductive Health and Research, examined 33 health-related interventions of which 14 demonstrated benefits that were deemed potential candidates for delivery in conjunction with the HPV vaccine. Among these included treatment against soil transmitted helminths (STHs) and schistosomiasis, as well as bed net distribution that could prevent the spread of lymphatic filariasis (LF). Given that schistosomiasis is a the causative agent on a disease known as FGS, a disease which has been demonstrated to exacerbate the risk of acquiring HIV/AIDS; combining treatment of schistosomiasis with HPV vaccinations is a natural complementary intervention that can have many external benefits. In addition, treating for STH and LF infection can enhance health outcomes specific to young girls as they enter adulthood, reducing anemia and improving nutrition to better equip mothers and her children’s immune systems to fight off additional health threats.
As policymakers, non-profit organizations and global leaders, it is important to see the link between NTDs and women’s health and ensure that the programs such as expanded HPV vaccinations include treatment for NTDs. For only 50 cents per person per year, young girls around the world can be protected from the effects of NTDs.
