By Dagfinn Høybråten, Board Chair – Gavi, the Vaccine Alliance
With its natural beauty and breath-taking scenery Lao is without a doubt one of the brightest jewels of Southeast Asia. However it is also one of the poorest nations in Asia with a weak health system and stark geographical disparities in health outcomes. Last week I was privileged to visit the country with a group of Australian parliamentarians. It was a chance to witness first hand the critical work Gavi, the Vaccine Alliance, is doing to fight preventable disease in this captivating, land-locked Southeast Asian country, and also to meet with national political leaders.
One of the institutions we visited was the Sethathiraj Hospital and Cancer Centre in the capital Vientiane. Here we learned of the scourge cervical cancer represents to local women. Medical specialists told us that the hospital treats many women with this type of cancer, but that they struggle to deal with the number of patients presenting with large, late-stage tumours.
Part of the problem is that people in remote rural areas have little or no access to diagnosis in the early stages and so need to travel a long way to the capital for medical help. To make matters worse, for most of these villagers the necessary medical treatment is prohibitively expensive.
This is part of a sad story we witness in most developing countries, where cervical cancer kills more than a quarter of a million women every year, or roughly one every two minutes. More than 85% of those who die from the disease live in the poorest parts of the world where access to screening and treatment is limited, and often non-existent. Most simply do not receive the treatment they need.
Although the trip to Lao was a stark reminder of these realities, we also witnessed how this situation is changing. Lao People’s Democratic Republic (PDR), to use its official name, now aims to protect Lao women against most cases of cervical cancer by implementing the human papillomavirus (HPV) vaccine, with the help of Gavi.
My travel companions the Australian Members of Parliament (MP) witnessed the results of this when visiting Ban Akad Primary School. As we arrived, the schoolyard was filled with young girls in school uniforms waiting in line to get their HPV vaccination as part of a demonstration HPV vaccination program currently being carried out. Prevention is better than treatment and this is never more true than the form of a simple vaccination, especially when diagnosis and treatment is, in too many cases, simply not available.
Given that the HPV vaccine was first developed at the University of Queensland, for the Australian MPs it must have been inspiring to see first hand how an Australian innovation, together with Australian investment of aid money in the Gavi partnership, was protecting lives in Laos.
Laos has a growing economy and is determined to increase its spending on health and on vaccines. But the Gavi assistance with low cost vaccines and funding to help strengthen Lao’s health systems is crucial now, to get the vaccines rolled out to those in need.
The case of HPV is an example of how the Vaccine Alliance model can help shape a market to ensure a high quality vaccine reaches the people who need it, and at an affordable price. It is also a compelling case of equity. Vaccines have generally been available in the world’s richest nations, despite a greater disease burden in developing countries. However, HPV vaccine is now being rolled out in countries where people previously had no access to this powerful public health tool. By 2020, we estimate more than 30 million girls in 40 countries will be immunised against cervical cancer.
Globally, one-in-five children born each year still do not have access to the most basic vaccines, and 1.5 million children die each year of vaccine preventable diseases.
But visiting Laos gave inspiring examples of the change that is taking place.
Gavi has supported the immunisation of almost half a billion children already, saving six million lives. In January next year, the Vaccine Alliance will ask for funding from government and other donors to help vaccinate a further 300 million people by 2020, to save a further 5-6 million lives. There can be no better investment than that.