GUYANA is set to start the human papilloma virus (HPV) Vaccine Programme this year, according to Health Minister Dr. Leslie Ramsammy and 25,000 girls between nine and 11 years old are the target population. In a statement, Ramsammy said the programme will be started in collaboration with the International Planned Parenthood Federation (IPPF) and the Guyana Responsible Parenthood Association (GRPA).
He said the programme will cost some $40M and the ministry, through its collaboration with the IPPF and GRPA, has already mobilised the resources.
For 2012, the number of girls to be provided with the HPV vaccine is expected to grow to about 40,000 and the cost is expected to increase to about $60M per year.
Cervical cancer is one of the main cancers in women worldwide and is either ranked number one or number two for women cancer in countries around the world.
Cancers represent one of the major causes of deaths and are ranked as the number four main cause of death in Guyana.
About 450 persons die each year from cancer and one of the most important cancers in Guyana is cervical cancer in women. In 2007, 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.
The mortality rate currently 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 human papilloma virus is the causative agent for more than 85 per cent 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, they are not likely to contract the cancer.
The Health Minister said the Ministry of Health has consulted widely and in keeping with guidelines issued by the WHO has chosen the age group of nine to 11 years old.
Ramsammy added that 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 USA and OMNIMED of Boston, Guyana has introduced a National Policy and Strategy for the Prevention and Control of Cervical Cancer 2009 -2012.
The JHPIEGO 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 Ramsammy’s invitation to help build a programme to prevent, diagnose and treat infectious diseases.
Screening
The Health Minister said screening for HPV is another important component of the strategy.
He pointed out that 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 is not universally accessible and few women in developing countries have been able to access this test.
Ramsammy said 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 2010 and we will introduce the HPV test in 2011,” he said.
He stated that 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 October 4th for discussion and for finalising arrangements to introduce a form of the HPV test in 2011.
According to Ramsammy, Visual Inspection with Acetic Acid (VIA) is an entry point for screening, diagnosis and treatment for cervical cancer.
“The most developed part of the National Policy and Strategy is the VIA technology…VIS is already in use and almost 10,000 Guyanese women have benefitted from VIA screening in the last two years,” Ramsammy said.
He pointed out that this programme has been rolled out in many of the regions where doctors, nurses and medex have been trained.
In other regions, the service is available through outreach programmes.
The Health Minister said the health sector is working with several policy guidelines to address HPV incidence in Guyana.
“This is a very important programme for Guyana. It is our intention to ensure that we prevent and control cervical cancer and that by 2020 very few women should face the possibility of death because of cervical cancer,” Ramsammy said.