Editorial: A game changer

Cervical cancer is the second most common cause of cancer deaths, after breast cancer, in women of reproductive age. India accounts for about a fifth of the global burden, with 1.23 lakh cases and around 67,000 deaths per year. The disease is largely preventable and a combination of early screening and vaccination can be a powerful tool to reduce the virulence. Against this backdrop, the nod for the first indigenously developed vaccine to fight cervical cancer could be a game-changer in India. The Drugs Controller General of India (DCGI) has granted market authorisation to the Pune-based Serum Institute to manufacture the vaccine, Cervavac, against the human papillomavirus (HPV). The sexually-transmitted HPV is responsible for more than 95% of cervical cancer cases. The vaccine, which has been almost four years in the making, has reported encouraging results in clinical trials. If things go according to SII’s schedule, Cervavac should be ready for mass manufacturing by the end of the year. The government should not lose time in including the vaccine in the country’s Universal Immunisation Programme. The continued opposition to the vaccine by the right-wing groups is highly deplorable. They deserved to be ignored in the interests of public health. The Ministry of Health and Family Welfare’s data shows that there are more than 4 lakh cervical cancer patients in the country at any given time. There is little awareness among women for the prevention of this cancer and less than 10% of Indian women get screened. All women aged 30-49 must get screened for cervical cancer even if they have no symptoms and get their adolescent daughters vaccinated with the HPV vaccine.

The drug regulator’s approval of the homegrown vaccine is a significant step in the fight against cervical cancer. In 2018, the National Technical Advisory Group on Immunisation recommended the inclusion of cervical cancer vaccines in the country’s Universal Immunisation Programme. But the high costs of vaccines, then manufactured by pharma multinationals Merck and Glaxo Smithkline, proved to be a deterrent. HPV vaccination can prevent more than 90% of cervical cancers when given at the recommended age. It has been reported that Cervavac has demonstrated a robust antibody response that is nearly 1,000 times higher than the baseline against all targeted HPV types and in all doses and age groups. According to the World Health Organisation (WHO), a vast majority of cervical cancer deaths happen in middle- and low-income countries. The global health agency’s plans to vaccinate 90% of women below the age of 15 by 2030 have not made much headway largely because of big pharma companies’ monopoly on the vaccines. It is here that India’s indigenous vaccine can play a greater role in the fight against cervical cancer. Cervavac will be made available to developing countries in the near future at an affordable price.