Towards beating cervical cancer

(MainsGS3: Science and Technology- developments and their applications and effects in everyday life.)

Context:

• The government has announced that it will roll out vaccines for the prevention of cervical cancer to girls aged between 9 and 14 years through schools.

Introduction of HPV vaccine:

• The National Technical Advisory Group for Immunisation (NTAGI) had recommended the introduction of the Human Papillomavirus (HPV) vaccine in the Universal Immunisation Programme (UIP). 
• The UIP is one of the largest public health programmes which offers free vaccines for at least 12 diseases, and has successfully eradicated diseases like polio and maternal and neonatal tetanus.
• Cervical cancer is preventable and curable if it is detected early and managed effectively and it is the second most common cancer in women in India, and the cause of a large number of deaths annually. 
• It is caused by infection with the human papillomavirus, and there are vaccines to protect against cancerous HPV.

Understand through data:

• A recent study in The Lancet shows that India accounts for the highest number of cervical cancer cases in Asia, followed by China. 
• More than 58% of all cases of cervical cancer and deaths globally were estimated in Asia with India accounting for 21% of cases and 23% of deaths, followed by China (18% and 17%). 
• According to the paper, globally, there were an estimated 6,04,127 cervical cancer cases in 2020, with an incidence rate of 13.3 new cases per 1,00,000 women a year. 
• In India, the incidence rate is 18 per 1,00,000 women, and in 2019, according to The World Health Organization (WHO) estimates, over 45,000 women died of the disease. 
• The WHO has specified that countries must reach and maintain an incidence rate of fewer than 4 new cases per 1,00,000 women a year by 2030. 
• To achieve that goal, one of the most important things required is that 90% of girls will have to be vaccinated with the HPV vaccine by the age of 15.

Rolling out of HPV vaccine:

• The indigenous HPV vaccine, called CERVAVAC, is likely to be rolled out by mid-2023. 
• The vaccine has got the approval of the Drugs Controller General of India and was cleared by the government advisory panel, NTAGI, for use in the UIP programme. 
• A one-time catch-up vaccine will be given to 9-14 year old adolescent girls, before it is introduced at nine years. 
• States and Union Territories have been asked to issue directives to appropriate authorities for organising HPV vaccination centres in schools, and identifying a nodal person in each government and private school to facilitate the vaccination after collating the number of 9-14 year olds.

Challenges ahead:

• According to The Lancet study, the burden of cervical cancer remains high in Asia and Africa, and that in many countries, the incidence and mortality of the disease remain much higher than the threshold set by the WHO initiative on cervical cancer elimination. 
• The study identified substantial geographical and socioeconomic inequalities in cervical cancer globally, with a clear gradient of increasing rates for countries with lower levels of human development. 
• However, health experts say the fact that India’s fertility rate is declining due to a variety of factors, including improved literary rate, increase in the age of marriage and so forth, should prompt everyone in the ecosystem, from the government, doctors to ground level health workers to launch campaigns on cervical cancer awareness, push vaccinations and screening for all girls.

Conclusion:

• Once the vaccine is launched through the UIP, it should reach the maximum number of the targeted population. 
• The surveillance systems and infrastructure used for COVID-19 vaccinations may also be customised to improve HPV vaccination, monitor national cervical screening programmes and improve health system capacity to deliver more efficient preventive services.