The Fight Against Cervical Cancer: An Interview with Anamaria Bejar of Gavi

By Milagros Alonso

“The fight against cervical cancer it is a fight for the rights of women» since only 12% of adolescents worldwide have access to the vaccine against human papilloma virus (VPH), assured Anamaria Bejar, public policy director of Gavi, the Alliance for Vaccines, for which she highlighted that in Argentina it is included in its National Vaccination Calendar.

A social anthropologist and specialist in health services management, Bejar oversees the public policies of Gavi, an alliance of international organizations such as the WHO, Unicef, the World Bank and the Bill and Melinda Gates Foundation to improve global access to vaccines and reach the 18.5 million girls and boys who have not received a single dose in their lives.

In an exclusive dialogue with Télam from Geneva, Switzerland, where the organization’s headquarters are located, the Peruvian academic responded on the axes of the Gavi program against HPV, a virus that is transmitted through sexual contact and is the main cause of cervical cancer .

Bejar stressed that Argentina is “an example for health and inclusion policies”, since in 2011 the HPV vaccine was incorporated into the National Calendar for 11-year-old girls and, in 2017, coverage was extended to boys of the same age. age.

Since cervical cancer is preventable in 93% of cases through vaccination and periodic gynecological check-ups, it is destined to become the first cancer disease to be eradicated in the history of mankind.

-: What are the pillars of the HPV vaccine program?

– At Gavi we have prioritized the introduction of one-dose HPV vaccines instead of two as before. By 2025 we hope to have protected 86 million adolescents between the ages of 9 and 14. But we also send a global message about the importance of giving access to a vaccine that is one of the most effective that exists with more than 90% efficacy and that is capable of preventing a disease that greatly affects the female population. The fight against cervical cancer is a fight for women’s rights, for the right to health that we all have and that it is important that it be a priority as part of gender equality.

– Does Gavi also promote the vaccine for children?

– At the moment, no. We focus on female adolescents because the vaccine is more effective against cervical cancer, although HPV also causes other diseases in children. Fortunately, in many countries the provision already exists. In Argentina it exists for boys and girls, but unfortunately, it is not like that in all countries because the vaccine has a stigma related to sexual debut. Arguments are used such as that this vaccine has to do with giving permission for girls to start their sexual life and these speeches damage the possibility of health.

It is very important to take into account that this vaccine is an effective public policy measure for States, in the sense that curing cervical cancer is much more expensive than preventing it. And the vaccine is one of the ways to prevent it along with the Papanicolaou (PAP) exam, the regular study of the cervix.

– Regarding the immunization objectives, how are you progressing with the program?

– This vaccine, with the support of Gavi, has prevented 17 deaths in every 1,000 girls vaccinated in the world. But there is still a lot to be done because the world average in 2021 for vaccination was only 12% of adolescents who should have access to this vaccine. For this reason, we have made it one of Gavi’s priorities for this year. Since the vaccine is not cheap, access is given much more in countries with more resources.

– Is there a gender gap in women’s access to vaccines?

– We focus on vaccines for the first year of life for a series of diseases and there are no differences between boys and girls in the world. But the gender factor intervenes because it is normally the mothers who lead the domestic and care work. And many of the barriers to accessing vaccination for their children have to do with the barriers they experience because they are women who are refugees, who live far from a health center, or who are discriminated against for being indigenous or Afro-descendant. There are many gender factors surrounding immunization that go beyond how many vaccinated boys and girls there are.

Also, we host Covax, the mechanism that provided vaccines against Covid, and part of the priority groups to get vaccinated are health workers. Globally, 70% of health workers are women. So, the fact that at this moment 81% have already had access to the vaccine, we consider it an important achievement.

– Is Gavi working on any program together with Argentina?

– We had relations regarding the Covax. But we focus more on countries in Africa, Asia and, in Latin America, on Haiti. You are an example for health policies and inclusion of marginalized populations such as the trans population. You also have a universal access system, which is another of the things we want to move the global agenda for. In many countries, health is solely private; in that you take the lead.

Cervical cancer is the third most diagnosed type of tumor in our country and, according to data from the National Cancer Institute, it is estimated that every year 4,500 new women are diagnosed and more than 2,300 die from this disease.