HPV

By: Franklin Iheanacho

The tri-sector engagement approach is a collaborative approach involving the non-profit, public and private sectors coming together to work towards a common goal, while maintaining their unique priorities. Such an approach is powerful and can lead to achieving goals that could not otherwise be accomplished without the collaboration.

There have been many attempts from the private, non-profit and public sector to increase HPV vaccination. In the non-profit sector, numerous nonprofits are advocating for HPV vaccination and related HPV diseases. One of the greatest impacts globally is the GAVI alliance and the Pan American Health Organization collaboration in 2013 that led to the immunization of 180,000 girls in several different developing countries. In addition, there has been an implementation of vaccination programs in the countries visited. GAVI has also successfully negotiated the price per dose for Gardasil and Cervarix to $4.50 and $4.60, respectively (3). These two non-profits have been able to target the biggest obstacle when it comes to vaccinations: high cost.. Their success can be used to build off the tri-sector engagement, this will also allow non-profit efforts covered and already implemented, expansion and continuation of bargaining will then be the goal for the non-profit sector of the engagement

High vaccine cost is linked to the monopoly of pricing by pharmaceutical companies seeking to recover from the high research and development costs. (2). This is where investments in R&D towards other pharmaceutical or biotechnology companies, preferable in developing nations, are imperative to generate low cost biogenerics limiting the monopoly Merck (owner of Gardasil) and GlaxoSmithKline (owner of Cervarix) have in HPV vaccinations. This should be the aim and goal for the private sector portion of the tri-sector engagement.

Lastly the public sector’s involvement with HPV vaccination has been complicated. The issues can be divided into developed nation issues and developing nation issues. In developed nations, subsidizations are often provided but of course the extent to which tax payers should cover immunization is usually debated. Public payers often ration that subsidizations should go towards adolescent females, with the expectation that high uptake of the vaccine will build herd immunity. Such program models are implemented in Australia, Canada and the UK. The issues here are HPV, HPV-related disease and vaccines tend to be labeled as female-exclusive even though men also can get infected and transmit the virus. This also suggests that HPV is exclusively a heterosexual concern if the goal of high uptake for women is to develop herd immunity. HPV does transmit sexually from non-heterosexual sex and true herd immunity cannot be achieved by immunizing only girls. (2). To combat these nations should subsidize for boys and increase public awareness of the importance of immunization for boys and LGBT people.

For developing nations limited health budgets make it difficult for governments to address HPV vaccination with other contending issues.The main issue lies in the fact that immunizations are currently not subsidized. It is imperative that the other two sectors implement immunization programs with the governments of developing nations to improve this issue (1).

References

Agosti, J. & Goldie, S. (2007). Introducing HPV Vaccine in Developing Countries — Key Challenges and Issues. New England Journal Of Medicine, 356(19), 1908-1910. http://dx.doi.org/10.1056/nejmp078053
Graham, J. & Mishra, A. (2011). Global challenges of implementing human papillomavirus vaccines. International Journal For Equity In Health, 10(1), 27. http://dx.doi.org/10.1186/1475-9276-10-27
GAVI ALLIANCE. (2013, February 4). GAVI funds vaccines to protect girls against cervical cancer - Gavi, the vaccine alliance. [Website]. Retrieved March 1, 2017, from GAVI: The Vaccine Alliance, http://www.gavi.org/library/news/press-releases/2013/gavi-funds-vaccines-to-protect-girls-against-cervical-cancer/

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