The Gambia recently launched HPV vaccination into their routine immunization program. Capitalizing on HPV vaccine stock that remained from last year’s HPV demonstration program, The Gambia rolled out HPV vaccine to all 9 to 14-year-old girls in two phases, first in the districts that implemented the prior HPV demonstration program, and then nationwide.
PATH, with financial support from Gavi, the Vaccine Alliance, has been at the forefront in expanding access to the HPV vaccine for young women in Gavi-eligible countries. PATH provides technical assistance to countries for the planning, implementation, and evaluation of national HPV vaccination programs.
In The Gambia, PATH provided technical assistance to the Expanded Programme on Immunization (EPI) team and partners to finalize introduction and training materials, conduct trainings, prepare the regions, and implement social mobilization and communications activities. We partnered closely with the, EPI Manager, Dr. Dawda Sow, and throughout the implementation process, he exhibited exceptional leadership in the planning, coordination, and implementation of the national rollout. Because he trusted the expertise and competencies in his team and allowed them to plan and make decisions, the planning progressed quickly and efficiently, and the team introduced HPV vaccine within a month of starting these preparations.
“ Witnessing the strong leadership by the EPI Manager and his team for an efficient roll out of HPV vaccine was impressive. ”— Kelli Capellier, Program Officer at PATH
Partnering to reach more girls with HPV vaccine
To date, our global team and partners have supported demonstration programs in 27 countries and assisted 19 countries in national introductions. PATH closely collaborates with local nongovernmental partners and ministries of health that are integral to this effort. Beyond Gavi, we work closely with the World Health Organization (WHO), United Nations Children’s Fund, United Nations Population Fund, Bill & Melinda Gates Foundation, and many other global partners around the world.
In addition to The Gambia; Cote d’ Ivoire, Kenya, Liberia, Malawi, Solomon Islands, Uzbekistan, and Zambia also launched routine, national HPV vaccination programs in 2019.
Equitable access to HPV vaccine
Cervical cancer disproportionately affects women in developing countries with more than 85% of cases occurring in low- and middle-income countries. The WHO recommends two doses of HPV vaccine for girls aged 9 to 14 years, and three doses for girls aged 15 years and older and those who are immune compromised or HIV positive (regardless of age). Although HPV vaccines are highly effective in preventing precancerous lesions, which are the necessary precursor to cervical cancer, uptake to date in low-resource settings such as The Gambia has been limited due to logistical barriers, costs, and vaccine availability.
The current supply of HPV vaccines provided to Gavi from manufacturers is insufficient to meet demand in 2020 and 2021. Some Gavi-eligible countries have or will have to postpone multi-age cohort vaccinations so all approved countries can start vaccinations for a single-age cohort initially. The Gambia’s girls are now protected but more equitable, transparent global allocation of the limited HPV vaccine supply to countries according to public health considerations would improve access to those most at risk, particularly for girls in the countries where the burden of cervical cancer is greatest. PATH supports the Strategic Advisory Group of Experts (SAGE) in immunization in its call for a dialogue on global access to HPV vaccine.