At a cost of some $40M, the Ministry of Health is gearing to introduce the Human Papilloma Virus (HPV) for approximately 25,000 girls between the ages of nine and 11 by the beginning of next year.
According to a statement issued yesterday by Minister of Health, Dr Leslie Ramsammy, the programme will start as collaborative effort with the International Planned Parenthood Federation and the Guyana Responsible Parenthood Association. Resources have been mobilised to facilitate this initiative, the statement added.
The number of girls to be provided with HPV vaccine is expected to grow to about 40,000 and the cost is expected to increase to about $60M per year from 2012.
Cervical cancer is one of the main cancers in women, worldwide, and is either ranked number one or number two among women in countries around the world. Cancer represents one of the major causes of deaths and is currently ranked as the number four main cause of death in Guyana.
Approximately 450 persons die each year from cancer. One of the most common cancers in Guyana is cervical cancer. In 2007, a total of 77 women died of cervical cancer.
Guyana has a cervical cancer incidence rate of about 45 per 100,000 women. This means that each year about 150 to 200 women are diagnosed with cervical cancer. At present, the mortality rate associated with these cancer cases is about 20 per 100,000 women. This means that each year about 80 women die because of cervical cancer.
Studies have shown that the HPV is the causative agent for more than 85 percent of cervical cancer. The main transmission route for HPV is through sex. The modes of transmission of this virus are similar to that of HIV.
Based on this, Guyana has included HPV vaccine as an important component of its national policy and strategy for prevention, diagnosis and treatment of cervical cancer. The HPV vaccine protects against future infection with HPV. The rationale being used is that if girls are immunised against HPV before they become sexually active.
The Ministry of Health has consulted widely and in keeping with guidelines issued by the World Health Organisation, and has chosen the age group of nine to 11 years. The HPV vaccine programme is one component of the National Policy and Strategy for the Prevention and Control of cervical cancer.
In collaboration with JHPIEGO, an affiliate of the John Hopkins University in the United States and OMNIMED of Boston, Guyana has introduced a National Policy and Strategy for the Prevention and Control of Cervical Cancer 2009 -2012.
The JHPIEHO Programme in Guyana is headed by Dr. John Varallo who has been working as a Volunteer in Guyana since 2002. Dr. Varallo first came to Guyana with his colleagues from OMNIMED on my invitation to help build a programme to prevent, diagnose and treat infectious diseases.
The direct screening for HPV, through an HPV laboratory test, is being introduced to identify women who might be at high risk for cervical cancer. While a laboratory test for HPV has been around for some time, this test is not universally accessible and few women in developing countries have been able to access this test.
Guyana is in the final stages of making arrangements to introduce the HPV test as a screening tool. Guyana’s National Public Health Reference Lab will establish the capacity to test for HPV in the last quarter of this year, according to the Minister. One of the marketed tests for HPV is available through QUIAGEN, an American Science Company.
This test is not yet widely available in developing countries. A representative from QUIAGEN will be in Guyana from next month to engage discussion and for finalising arrangements to introduce a form of the HPV test next year.
The most developed part of the National Policy and Strategy is the VIA technology. This technology which is the Visual Inspection with Acetic Acid is already in use. Almost 10,000 Guyanese women have benefitted from VIA screening in the last two years.
Already this programme has been rolled out in many of the regions where doctors, nurses and other health officials have been trained. In other regions, the service is available through outreach programmes.
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