Criticism of the government’s move to vaccinate girls aged 10 against the virus that causes cervical cancer continue to grow even as the Health ministry draws closer to rolling out the vaccine.
Some women politicians said that by targeting only girls of 10 years, the Health Ministry was discriminating against the rest of the population who also need it. The government is set to vaccinate school-going girls against cervical cancer across the country.
It is also targeting girls who are not in school but also fall in this age group to reduce the prevalence of the disease. The girls will get two free doses of the human papillomavirus (HPV) vaccine, six months apart, at about 9,000 public, private and faith-based facilities countrywide.
The World Health Organisation (WHO) recommends vaccination of all girls and screening, at least once every year, for older women to reduce cancer risk, and the vaccine is most effective when administered between the ages of nine and 14.
But some lawmakers like Nandi MP Dr Tecla Tum have argued that by targeting young girls, the government was locking out other women who may need the vaccine.
“There are many poor women who cannot afford the Sh4,000 for screening. So why lock them out from receiving this vaccine and even have access to screening,” she asked during a sensitization forum for Members of Parliament.
The Ministry however, argued that it is following international standards set out by the World Health Organisation (WHO) which recommends vaccination of all girls and screening, at least once every year, for older women to reduce cancer risk, and the vaccine is most effective when administered between the ages of nine and 14.
Further, Dr Rose Jalang’o from the Ministry’s department of immunisation said that the cohort was selected following a global shortage of the HPV vaccine.
“There is a global shortage of the vaccine supply, therefore we had to prioritise. For us, we chose to protect girls of this age before they are exposed to the virus,” explained Dr Jalang’o.
In Kenya, the Age of sexual debut among girls is also less than 15 years, making the vaccine, which is the first of its kind to be developed specifically targeting the prevention of cervical cancer effective.
HPV vaccines do not prevent all forms of cervical cancer, and as such, it does not replace the need for cervical cancer screening. The United Nations Children's Fund (Unicef) in a 2018 status report said it did not have sufficient vaccines to meet the increased needs, which it projected could reach 50 million doses in 2019.
There are about 100 types of HPV, of which at least 14 cause cancer. Two HPV types (16 and 18) cause 70 per cent of cervical cancers and cervical lesions.
On Thursday, the Kenya AIDS NGOs Consortium (KANCO), a regional membership network of non-governmental organisations met with women MPs in preparation for the HPV national launch set for the end of the month.
“Cervical cancer kills nine women every single day in Kenya, thus a call to invest resources and voices into this cause,” said Kanco’s executive Director, Mr Allan Ragi.
Two HPV vaccines are currently prequalified by WHO - a bivalent and a quadrivalent vaccine. In Kenya, the vaccine that will be given Gardasil, also known as Gardisil or Silgard or recombinant human papillomavirus vaccine [types 6, 11, 16, 18], is a vaccine for use in the prevention of certain strains of human papillomavirus, specifically HPV types 6, 11, 16 and 18.
Gardasil is made by Merck Sharp & Dohme, an American multinational pharmaceutical company.
“We will incorporate the vaccine into the country’s routine immunisation programme,” said Dr Jalang’o.
The World Health Organisation (WHO) recommends countries to include HPV vaccination into national immunization programmes as part of a coordinated and comprehensive strategy that includes education, access to quality screening, and treatment.
Human papillomavirus (HPV) infection is very common with most people—about nine in 10—estimated to get an HPV infection at some point in their lives. HPV is a group of more than 100 viruses, of which 13 can cause cancer. Nearly all cases of cervical cancer are attributed to HPV.
Globally, cervical cancer is the second most common form of cancer in women, with an estimated 530,000 new cases a year, resulting in an estimated 266,000 deaths.
Health ministry targets to reduce cases of cancer of the cervix — the second most common in Kenya after breast cancer, according to recent statistics released by the International Agency for Research on Cancer.
The disease claims about nine women in Kenya every day, about 3,000 per year, according to statistics from the Health ministry. There are about 40,000 new cervical cancer cases annually.
Immunization should primarily target girls aged 9 to 14 years of age, prior to becoming sexually active; and secondarily, to target girls aged 15 and above, the WHO notes.
Cost and access remain the greatest impediments towards early screening and treatment of cancer in Kenya to date.
Screening costs from about Sh3,000. Treatment too is costly with charges ranging from Sh172,000 ($1,720) to Sh759,000 ($7,590) to treat cervical cancer without surgery in Kenya and Sh672,000 ($6,720) to Sh1.2 million ($12,500) if an operation is carried out, says the National Cancer Control Programme.