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Experts Appeal for Integrated Programs to Prevent Cervical Cancer

Mexico City, May 14, 2008—Experts in vaccination and cervical cancer today appealed for support to develop integrated programs to prevent and to control cervical cancer, one of the main causes of mortality in women of Latin America and the Caribbean.

In a declaration issued at an international conference on prevention and control of cervical cancer, the experts expressed "concern over the high burden of this disease," with the highest mortality rates from cervical cancer in the world, and its economic impact in Latin America and the Caribbean. The meeting was sponsored by the World Health Organization (WHO), the Pan American Health Organization (PAHO), the Albert B. Sabin Vaccine Institute, and the U.S. Centers for Disease Control and Prevention (CDC).

They agreed, "to take advantage of the opportunity with the possibility of introducing the vaccine against the HPV in order to improve screening services using new strategies and technologies." They noted that vaccines against HPV are now available "that offer great hope in preventing 70 percent of the deaths from cervical cancer, but are currently very expensive." The experts resolved "to work together to achieve attainable prices for all the countries in the Region," and find ways to negotiate to ensure sustainability of vaccination programs.

At the scientific meeting, they evaluated an analysis of HPV and cervical cancer that found HPV immunizations eventually would prevent 500,000 vaccinated girls from dying of cervical cancer in adulthood, if the vaccine were given to 70 percent of each group or "birth cohort" of 12-year-old girls over 10 consecutive calendar years.

Dr. Jon Andrus, technical adviser on the unit of immunization of the Pan American Organization of Health, said, "Cervical cancer is related to poverty, but is preventable if we improve access to detection and treatment and promote the introduction of vaccines against HPV when they are attainable."

The scientists and experts at the meeting also agreed that immunization programs must continue to be a high priority regional public good, and urged PAHO to negotiate the most attainable vaccine prices so they can be introduced in national immunization programs as soon as possible.

The Declaration of Mexico recognized that the human papillomavirus (HPV), is the cause of virtually 100% of cervical cancers and that the vaccine against HPV is important, although does not replace screening programs, diagnosis, and treatment, which all need to be improved.

Dr. Ciro de Quadros, of the Albert B. Sabin Vaccine Institute, said "We need a vaccine that is attainable both for the countries for the pharmaceutical industry, because there are many new vaccines on the horizon and we want to be fair so that these are developed rapidly and help us save lives."

Introduction of this vaccine should be included within the vision of a comprehensive program for prevention and control of cervical cancer, said Dr. Cuauhtémoc Ruiz, who heads PAHO’s Immunization Unit. He noted that the main obstacle to its introduction is the high cost of the vaccine, which countries of the region would have difficulty financing. "Preparation and strengthening of the operational part of the programs are also required, with special emphasis on the vaccine cold chain, training, epidemiological surveillance, and laboratory network, he said.

DECLARATION of the HUMAN PAPILOMA VIRUS MEETING

Mexico City 12-13 May, 2008

Recognizing that cervical cancer is one of the most common causes of death among women in Latin America and the Caribbean (LAC);

That 33,000 women die each year of cervical cancer in Latin America and the Caribbean.

That it is estimated that, if this trend continues, the number of deaths from cervical cancer will double by 2030.

That it primarily affects vulnerable populations such as poor women and indigenous populations.

Expressing concern for the high burden of this disease, with the highest mortality rates in the world and its economic impact in Latin America and Caribbean.

That now we know HPV causes virtually 100% of cervical cancers.

That today there are vaccines against HPV, which offer great hope towards the prevention of 70% of the infections by this virus.

That the primary limitation for its use is the high cost.

That vaccines against HPV do not replace screening programs, diagnostics and treatment.

That with the introduction of this vaccine we have an opportunity to strengthen prevention and comprehensive control through improving coverage and quality of screening, diagnostics, and treatment services.

The participants resolve to:

Promote the integration among programs responsible for immunization, prevention, control, and adolescent and reproductive health with the goal of strengthening efforts toward the prevention and control of cervical cancer.

Take the opportunity with the introduction of the vaccine against HPV to strengthen sexual and reproductive education, training of personnel, as well as screening services, diagnostics and treatment.

Continue considering immunization programs as a regional public good with high political priority.

Consider the introduction of a vaccine against HPV based on technical, programmatic and operational criteria of individual countries, taking into consideration the need to strengthen the cold chain, epidemiological surveillance systems, and the laboratory network in countries.

Work together and with PAHO's Revolving Fund to obtain affordable prices for HPV vaccines so that all the countries in the region can introduce the vaccine in their national immunization programs as soon as possible.

Generate mechanisms and negotiating processes with high-level financing stakeholders at the national level, which will ensure the sustainability of vaccination programs, prevention and control of cervical cancer.

Country Participants: Argentina, Barbados, Brazil, Canada, Chile, Colombia, Costa Rica, Cuba, Dominican Republic, Ecuador, El Salvador, Guatemala, Honduras, Jamaica, México, Nicaragua, Panamá, Peru, United States, Paraguay, Venezuela

The Pan American Health Organization, founded in 1902, works with all the countries of the Americas to improve the health and quality of life of their peoples. It serves as the Regional Office of the World Health Organization (WHO).

The Albert B. Sabin Vaccine Institute is a non-profit public organization dedicated to saving lives by stimulating the development and distribution of vaccines throughout the world. The Institute is committed to continuing the work of Dr. Albert Sabin, developer of the oral live virus polio vaccine, who envisioned the enormous potential of vaccines to prevent deadly diseases.

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