Editorial: India’s laudable push in the war against cervical cancer

A nationwide HPV vaccination drive targeting adolescents before virus exposure could be a transformative step in prevention

By launching a nationwide HPV (Human Papillomavirus) vaccination for adolescent girls, India has taken a decisive step in the war against cervical cancer, a largely preventable yet one of the most common causes of cancer deaths in India. The vaccination drive, coupled with increased screening and assured treatment access, can dramatically reduce the suffering caused by the dreaded disease within the span of a generation. Unfortunately, India bears one of the heaviest burdens of cervical cancer globally, reporting nearly 78,000 new cases and over 43,000 deaths annually. It is the second most common cancer among Indian women, after breast cancer, and is caused by the HPV infection of the genital tract. Early age of marriage, multiple pregnancies, tobacco use, and poor genital hygiene are linked to increased chances of infection. Most of these risk factors can be addressed through awareness, screening, and vaccination. The World Health Organisation (WHO) has set a clear elimination target, outlining what is called the “90–70–90” strategy: 90% of girls to be fully vaccinated with HPV vaccine by age 15; 70% of women to be screened with a high-performance test at ages 30 and above, and 90% of women identified with disease to receive appropriate treatment. India’s vaccination launch is a crucial step towards achieving these targets. Over 140 countries have implemented vaccination against HPV infections, and global data has confirmed its safety and effectiveness. Total elimination of the disease requires sustained efforts and ensuring widespread coverage of HPV vaccination.

India’s alarming cervical cancer mortality rate is attributable to the poor screening, lack of early detection, resistance to vaccination and poor hygiene. While urban areas have shown some decline due to factors such as improved hygiene, large rural and underserved populations continue to be present with advanced cervical cancer disease. Against this backdrop, a nationwide vaccination drive could be a game-changer. It would be an effective strategy to target adolescents for vaccination before their exposure to the virus. A time-bound, mission-mode approach can help overcome the inertia that often slows the inclusion of new vaccines into routine immunisation. If implemented effectively, it could shield millions of girls from high-risk HPV strains responsible for the majority of cases. The vaccine, indigenously developed by Pune-based Serum Institute of India (SII), is 97% effective in preventing the disease. While cervical cancer is preventable if detected early and managed effectively, it kills one woman every 8 minutes in the country. The vaccination campaign must prioritise rural districts and underserved communities where screening rates are low, and cancer detection often comes too late. The HPV vaccine has long been available in the private market, and a few States piloted limited public programmes over the past decade. However, cost concerns, logistical hurdles and policy hesitations delayed a universal rollout, leaving coverage fragmented and inequitable.

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