Over the last several years, Gardasil and the concept of vaccinating against human papillomavirus (HPV) have gotten quite a lot of press here in the United States. But combating HPV and cervical cancer in developing nations is a whole other challenge.
More than a quarter of a million women die from cervical cancer every year, and 80% of those women are in the developing world. But cervical cancer is among the most treatable of cancers if it is caught early.
Yesterday, my coworker Susanna Smith blogged on Akimbo about the prevention of cervical cancer in low-resource settings. Here are some of the approaches to prevention she highlights:
…women in developing countries often do not get regular PAP smears because the test requires specialized equipment and advanced technical skills for which local practitioners don’t have the training. Another high-tech cervical cancer screening tool is colposcopy, which allows for the close inspection of the cervix with specialized equipment. Again, this is tool is not widely available in developing countries.
A DNA test for HPV is also available, which detects the presence of 13 of the most dangerous strains of HPV. Like the PAP, this test requires appropriate laboratory equipment and skilled lab technicians. A new version of this test called careHPV is currently being adapted for low-resource settings. It is expected that careHPV will be available in China by 2011 and in India by 2012. Healthcare providers with basic training could use this low-resource adaption even in places that lack electricity or running water. It produces results in less than three hours, allowing for same day treatment.
Though prevention, of course, is arguably better than treatment, condoms are not totally effective against HPV – HPV is spread by skin to skin contact, not through bodily fluids exchanged during partner sex play. And Gardasil, the HPV vaccine, is not readily and cheaply available throughout much of the developing world.
That said, a bit of infuriating sexual health and immigration discrimination: the United States makes the Gardasil vaccine mandatory for young women seeking U.S. citizenship. So this expensive vaccine is definitely a barrier to entry for young women seeking U.S. citizenship. Yet it isn’t required for American citizens – there has been serious outrage at this suggestion.
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