As Canadian women, mothers, physicians, and global-health advocates, we would like to draw attention to a great opportunity for the advancement of health in our time: the global elimination of cervical cancer.
Every two minutes of every day, a woman somewhere dies of cervical cancer. The vast majority of these women who die — hundreds of thousands of them every year — are poor women from poor countries who have limited or no access to screening and treatment facilities. These women suffer untold agony as their cancer progresses, and ultimately die untreated and without relief.
Cervical cancer is a disease that mirrors the disparities of the world today; 85 per cent of the deaths and most of the devastation of this terrible disease occur in Africa, Asia and Latin America.
Here in Canada, among women who fortunately have routine access to screening procedures, each year significant numbers will be newly diagnosed as having cervical cancer, with an estimated 1,300 new cases in 2008. Their disease is usually cured by early intervention, although in 2007, the deaths of 390 women in Canada were related to cervical cancer. The threat of cervical cancer hangs heavy over the heads of all women.
We now stand at a very special moment in health history. Based on science that merited the Nobel Prize for medicine this year, new vaccines are available to prevent infection with the virus that is the basic cause of cervical cancer, human papilloma virus (HPV). The virus is extraordinarily common in both women and men, and can lead to a variety of cancers, most commonly cervical cancer among women who are not screened and treated early on.
Now, for the first time, this potentially fatal infection can be prevented by immunization with the new powerful HPV vaccines. Indeed, the HPV vaccines might be considered to be the first effective vaccines against a form of cancer. The devastation and fear of cervical cancer have inspired many of us to work personally and professionally to see the end of this dreaded condition.
In 2007, the Canadian government adopted the policy that access to HPV vaccines is "critical" for Canadian girls. A countrywide scheme was devised to provide the vaccine to girls through schools of every province. Over the past year, further research and experience indicate the HPV vaccines are extraordinarily safe and do not encourage high-risk or early sexual behaviour among girls.
As with most new vaccines, the need for possible future booster doses has not been resolved yet, but this will become apparent and can be dealt with as years of experience accumulate.
Thinking beyond our borders, we encourage Canadians, our government and all citizens to play a role in ensuring global access to these new lifesaving technologies. Women and children throughout the world should have the means of prevention of infection with the HPV virus and cervical cancer, just as the women and children of Canada do.
Significant policy discussions during the coming weeks at key international institutions — the World Health Organization and the Global Alliance for Vaccines and Immunization — will influence whether HPV vaccine will become widely available for women and girls in the world's poorest countries.
The ultimate price per dose will be critical in making the HPV vaccine affordable, cost-effective, and a feasible addition to existing immunization programs. Noting that our government invests to protect our own women and children with this new technology, we ask that women and girls around the world are given access to this vaccine that will prevent death and untold suffering.
Dr. Dorothy Shaw is president of the International Federation of Gynecology and Obstetrics; Dr. Jane Schaller is executive director of the International Pediatric Association.
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