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7 Facts About Cervical Cancer in Thailand

Cervical Cancer in Thailand
Cervical cancer is one of the greatest threats to women’s lives globally. With an estimated 570,000 new cases in 2018, it ranks as the fourth most frequent cancer in women. In the South-East Asia region, it is the third most common type of cancer. Last year, there were an estimated 158,000 new cases and 95,766 cervical cancer-related deaths in the region alone. The World Health Organisation (WHO) has urged the countries in this region to speed up their efforts to eliminate cervical cancer by 2030. Thailand, one of the countries in the South-East Asia region, has made great strides towards eliminating the disease in the past two decades. Here are seven facts about cervical cancer in Thailand.

7 Facts About Cervical Cancer

  1. Twenty years ago, cervical cancer was the most common cancer for women in Thailand. Currently, it is the second most frequent cancer among women in Thailand behind only breast cancer. It is estimated that every year 8,622 women are diagnosed with cervical cancer in Thailand and that 5,015 die from the disease.
  2. According to amfAR, the human papillomavirus (HPV) causes nearly all cervical cancer cases. This makes HPV the leading cause of cervical cancer among women in Thailand. Other factors that could cause cervical cancer are smoking, HIV and hormonal contraceptive use.
  3. In the last decade, cervical cancer in Thailand has seen the largest decline in incidence compared to the other four leading causes of cancer deaths for women. One can largely attribute this to the Safety, Acceptability, Feasibility and program implementation Effort (SAFE) which Thailand adopted in 2000.
  4. The SAFE approach is a single-visit method in which patients receive screening for cervical cancer and obtain treatment if necessary. This makes it cheaper than other screening methods since it does not require advanced equipment. The ease of implementation has seen 32 Thai provinces take up the SAFE approach.
  5. One reason the SAFE method yielded such great results was that nurses in the country were tasked with doing cryotherapy. This was important because, at the time, the ratio of doctors to patients was low at about one doctor per 60,000 people. As of 2018, that ratio had improved to one doctor per 2,000 people.
  6. In June 2018, the U.N. awarded Thailand with the UN Public Service Award for its initiative to provide cervical cancer treatment to women in rural areas.
  7. Another measure taken to prevent cervical cancer in Thailand is the provision of the HPV vaccine to girls aged between 10 and 13 years. Thailand is one of four countries in the South-East Asia region to have introduced the HPV vaccine nationally.

It is quite possible that Thailand will meet the WHO’s request to eliminate cervical cancer by 2030. The country is a good example to other low and middle-income countries on how they can deal with the disease.

– Sophia Wanyonyi
Photo: Pixabay

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Strides in the Race for Vaccine Accessibility

vaccine accessibility
Vaccines are second only to clean water in reducing the rate of infectious disease. Vaccines prevent about 6 million deaths every year, and those that have been in use for decades show a 99 percent decrease in the rates of people contracting those diseases. Unfortunately, vaccines are not affordable for many people living in poverty throughout the world, making them much more vulnerable to infectious disease. Several factors contribute to the current lack of vaccine accessibility in many parts of the developing world. However, there are also significant improvements that are being made in decreasing the financial gap between those who receive vaccinations and those who do not, helping make vaccines more accessible to everyone.

The Current Situation

The price of the vaccine doesn’t always reflect the cost: People in developing countries are not only paying for the cost of manufacturing the vaccine, but also for expensive shipping costs, refrigeration, tariffs on imports, and taxes on medical supplies. These additional costs are often much more than the cost of the actual vaccine, and they make what would otherwise be an affordable vaccine inaccessible to a lot of people.

Clinic visits cost money too: In addition to buying the vaccine with all of its fees piled on top, people also have to pay to visit a clinic to receive these vaccines. The hours of health clinics are often inconvenient as well, forcing people to forgo wages from work in order to see a doctor.

Many vaccines require multiple rounds: A lot of vaccines, such as RTSS for malaria, MMR for measles and the HPV vaccine require multiple rounds of vaccination in order to be effective. This simply compounds all of the other barriers to vaccine accessibility; those receiving the vaccine have to pay for treatment again as well as take time off of work to visit a clinic.

Doctors are few and far between: In many parts of the developing world, there are very few doctors, and these doctors are limited in the number of patients they can treat each day. Therefore, even if one can afford to pay for the vaccine and can make it to a clinic, there is no guarantee that they will be able to be seen by a doctor.

Improvements to Vaccine Accessibility

Local health centers’ capacities are being strengthened: Gavi, a non-governmental organization dedicated to providing vaccines to the developing world, is working to strengthen the capacity of existing health centers to deliver immunizations. Gavi is working to increase the proportion of people who are receiving a full cycle of vaccines rather than “dropping out” after the first dose by providing sustainable funding to health clinics across the developing world.

Foreign aid decreases the price of vaccines: Providing foreign aid specifically for vaccines decreases the cost to those receiving treatment, and in turn, spares families from having to pay far more for treatment if someone contracted an infectious disease. Foreign aid for vaccinations has the highest return on investment of any type of aid besides education.

People are going beyond wanting to vaccinate to actually vaccinating: The Poverty Action Lab at MIT is implementing research on how to motivate people from desiring to vaccinate to doing it. This research is increasing the numbers of people receiving preventative immunizations in the developing world and reducing the rates of disease.

Infrastructures to keep vaccines cold for cheaper: The governments of Ethiopia and Gambia have created cold chain infrastructures in order to reduce the cost of transporting vaccines that need to be refrigerated. These infrastructures are far from perfect, as some cold storage facilities in Ethiopia have not been kept as cold as they need to be in order to protect the vaccines.

However, progress is still being made in reducing the cost of vaccines and allowing them to be more accessible to those living in poverty. Gavi is working to implement more cold chain infrastructures in other countries in Sub-Saharan Africa.

Moving Forward

There is clearly still a long way to go in ensuring vaccine accessibility to everyone who needs it, but a lot of progress has been made in breaking down the current barriers to accessibility. Vaccines are much cheaper than the cost of treatment for those who have the diseases vaccines aim to prevent, and investing in vaccinations relieves the world’s poor of the additional burden of treatment costs. Vaccines are one of the greatest assets in our toolbox to fight poverty, and great strides are being made in the effort to make accessibility a reality.

– Macklyn Hutchison
Photo: Flickr

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Rise of Cancer in the Developing World

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While many people know cancer is one of the leading causes of death globally, few realize cancer has become a significant burden on the developing world. The World Health Organization (WHO) reports more than 60 percent of new cancer cases occur in Africa, Asia, and Central and South America, concluding that cancer in the developing world accounts for more than 70 percent of all cancer deaths.

In 2012, there were 14.1 new cases of cancer, compared with 12.7 million new cases in 2008. Part of the reason for this is globally, the population is aging. Developing nations are seeing an increase in many cancers because people living longer and having a change in lifestyle. Many people in developing countries are adopting the lifestyles of those in industrialized nations and are now facing new risk factors such as poor diet, obesity and smoking. This is causing an increase in common cancers such as breast cancer, colon cancer and lung cancer.

Breast cancer was the most common cause of death in women in 2012. Treatments and testing for breast cancer that are available in industrialized countries have not yet reached the developing world. Cancers caused by infections such as cervical cancer (often caused by the Human Papilloma Virus [HPV]) also cause more deaths in the developing world because there are fewer screening and treatment programs for the disease.

As a result of gains by global health professionals, such as the reduction in infectious disease and the decrease in the child mortality rate, many more people in developing countries live to older ages. Unfortunately, work in chronic disease prevention and intervention needs to catch up. Developing countries do not have the resources to screen, prevent and treat chronic diseases such as cancer.

Global health has historically been focused on communicable (or infectious) diseases. Julio Frenk, Dean of the Harvard School of Public Health, says there needs to be a switch in thinking that allows for a more comprehensive view of global health. First, because communicable and non-communicable infections are not as separate as once thought. The WHO estimates that one fifth of cancers are caused by communicable infections such as HIV, HPV, hepatitis B virus, and Helicobacter pylori. In addition, infections, hunger and maternal deaths are no longer the only problems of the poor. The world’s poor people are increasingly prone to non-communicable diseases and injury.

There is a misconception that because there are “bigger fish to fry,” such as infectious diseases and poverty, people should not worry about cancer. However, in many middle-income countries, cancer is now one of the leading causes of death and yet it still receives little attention. There is also the issue of having access to screening be inequitable. In middle-income countries, only the most affluent people have access to cancer screening.

Fortunately, information is beginning to be spread about the need to add cancer to the global public health agenda. Bill and Melinda Gates gave a $50 million grant to create the Alliance for Cervical Cancer Prevention.

– Elizabeth Brown

Sources: WHO, CBC, HSPH
Photo: UN Special

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Kenyan Girls Protected from Cervical Cancer

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Every year, approximately 275,000 women lose their lives to cervical cancer. The vast majority of these women live in developing countries where it is difficult to access the necessary healthcare, and where the ability to screen, diagnose and treat the life-threatening cancer is rarely available. However, the fight against cervical cancer in developing countries received an unprecedented boost when the GAVI Alliance announced recently that it had guaranteed a record low price of $4.50 per dose for the human papillomavirus (HPV) vaccines.

For the first time, the GAVI Alliance will make the vaccination available to girls of a school age on a widespread scale, and at an affordable price. The GAVI Alliance has already begun their vaccination program in Kenya where cervical cancer is responsible for the deaths of more Kenyan women than any other cancer. In the past, most of the HPV vaccine programs have only been available in richer countries despite the fact that the need for these programs has always existed in developing countries. Dr. Seth Berkley, CEO of the GAVI Alliance, said that through their partnership with WHO and UNICEF, their support for HPV vaccines is “bridging the gap between rich and poor countries, enabling HPV vaccines to reach girls no matter where they live.”

The vaccine is distributed in three doses, and since Kenya has high enrollment rates among girls, schools will become the main centers for the HPV vaccines. With the support of community health workers, the treatment will also be available to girls who are unable to attend school, and who are often at higher risk of contracting the disease.

Seven other sub-Saharan countries will also receive support from the GAVI Alliance in the near future; Ghana, Lao PDR, Madagascar, Malawi, Niger, Sierra Leone and Tanzania. The GAVI Alliance estimates that by 2020, it will have immunized more than 30 million girls in 40 countries. In these countries, where access to diagnosis and treatment is seldom available, providing a preventative vaccine is the clearly preferred option. This news provides hope to millions of girls and women in developing countries who remain at risk of contracting cervical cancer.

– Chloe Isacke
Source: GAVI Alliance,Impatient Optimists
Photo: WUSC

95% Discount on HPV Vaccines for Girls in Poverty

95% Discount on HPV Vaccines for Girls in Poverty

HPV vaccines costing an average of $130 a dose in the United States will now be offered in poor countries for as low as $4.50 a dose, a monumental step made possible by the generous and focused work of the GAVI Alliance. These vaccines help prevent strains of human papillomavirus, or HPV, that cause almost 75% of cervical cancers.

According to GlaxoSmithKline and Merck, the two pharmaceutical companies offering these deeply slashed prices, more than 85% of cervical cancer deaths occur in the developing world. “We hope that this will help reduce the burden of cervical cancer and positively impact future generations,” said GSK President and General Manager Christophe Weber in a press release. GSK already supplies 80% of its total vaccine volume to developing countries.

The GAVI Alliance, formerly the Global Alliance for Vaccines and Immunization, was launched under a generous donation from the Bill & Melinda Gates Foundation in 1999; the Alliance works to partner charitable donations with private pharmaceutical companies by negotiating significantly lower vaccine costs for countries in need. This model has allowed over 370 million children to receive immunizations since GAVI’s founding.

In the next few months, GAVI will provide support to countries worldwide by carrying out demonstration programs that raise awareness among the vaccination target group — pre-adolescents — which will allow countries to incorporate the vaccine into their own immunization programs.

– Naomi Doraisamy

Sources: GAVI Alliance, Merck
Photo: Polifaso