The Bill & Melinda Gates Foundation’s biggest, and arguably most successful, project in global health has announced a new deal with vaccine manufacturers aimed at combatting one of the biggest killers of women in the developing world, cervical cancer.
- Seth Berkley
- GAVI
“This is a disease that is killing women in the prime of their life,” said Seth Berkley, CEO of the Global Alliance for Vaccines and Immunization (GAVI), an initiative launched by the Gates Foundation in 2000 which has in the last dozen or so years prevented millions of deaths in children by expanding access to new vaccines in poor countries.
Most cervical cancer is caused by a virus, human papillomoa virus or HPV, and the drug industry has developed a number of HPV vaccines. But these new vaccines are expensive (more than $100 per dose) and have been out-of-reach for most poor countries. Women in rich countries have access to cervical cancer screening (Pap tests) and curative treatment, but women in poor countries generally do not.
“As a result, we see an estimated 275,000 women dying from cervical cancer in these countries every year,” Berkley said. Girls and women in poor countries are hit by a ‘triple whammy,’ he said, of higher disease incidence, lack of diagnosis and lack of treatment. Without access to a preventive vaccine, Berkley said, that death toll will only increase.
Today, at the World Economic Forum on Africa meeting in Cape Town, South Africa, GAVI announced that two drug companies, Merck and GlaxoSmithKline, have agreed to provide their HPV vaccines to poor countries for $4.50 and $4.60, respectively, per dose.
“This is an important vaccine and introducing it into these countries will be transformative,” Berkley said. He said GAVI will begin rolling out the discounted HPV vaccines in Kenya later this month followed by Ghana, Lao, Madagascar, Malawi, Niger, Sierra Leone and Tanzania.
But not everybody is celebrating the announcement as an unabashed success and unqualified benefit to the poor.
- Kate Elder
- MSF
Kate Elder, who is chief of vaccine policy for Médecins Sans Frontières Access to Essential Medicines campaign, said there’s no question that the HPV vaccine is desperately needed in poor countries and that this will be a big life-saver for women. But the vaccine is still too expensive for the poorest countries, where spending on health care can be as low as $10 or $20 per capita.
“Resources are finite and under strain in these countries,” Elder said. “It may not sound like $4.50 is much compared to what we pay in Western countries, but GAVI is on a trend of increasing the cost of these vaccines and we’re concerned this trend is unsustainable.”
She said there is evidence from other vaccine purchasers, such as PAHO (the Pan American Health Organization), to indicate the Merck and GSK vaccines cost less than a dollar to manufacture. So why, Elder asks, are the poor being asked to pay five times more than the cost of the vaccine? She noted that a lot of the research that led to these vaccines took place at public universities (including in Seattle).
“We know the drug companies are still making a health profit here,” Elder said. MSF has asked for the drug makers to publicly disclose their costs so the international community — and taxpayers — can know if they are actually getting the best deal.
Berkley said he supports the push to reduce vaccine prices as much as possible, but GAVI has not supported MSF’s call for the drug manufacturers to publicly disclose the actual costs of these vaccines — or to do vaccine price monitoring aimed at establishing norms and guidelines.
Elder said this is a lost opportunity.
“GAVI has a lot of influence and was created to help shape markets to benefit the poor,” she said. “We’re disappointed they are not holding the drug industry to account.”
For more on this debate, see Bill Gates’ humanitarian plan for world (vaccination) domination
