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ISLAMABAD, Oct 2 (APP):”The prevalence of cervical cancer as the second most common type of cancerous disease among Pakistani women is alarming and the Human Papillomavirus (HPV) vaccine is critical for protecting the young girls from contracting the deadly disease,” said Senior experts and medical practitioners here on Thursday at a seminar on HPV Vaccination.
The seminar titled “HPV Vaccination in Pakistan Are We Ready to Save Our Daughters” was organized by the Sustainable Development Policy Institute (SDPI) with experts, policy makers and private sector stakeholders to deep dive into the government’s HPV Vaccine Campaign which is part of EPI program and Vaccination campaign that was launched between 15th to 27th September to vaccinate girls from 9 to 14 years age and according to reports with very low uptake.
A few reasons were identified and misconceptions and inappropriate preparedness were one of the factors for low uptake.
Dr Ayesha Isani, Director General, Health Ministry of National Health, Services, Regulations and Coordination, said the HPV Vaccination program was in the offing for years and not an out-of-the-blue campaign, which received a shocking response from the community, mainly due to a missed media campaign, which was now giving in after enhanced efforts.
She underscored that previously, a two-year community interaction was done for breast screening facility rollout for healthy women, whereas for the HPV Vaccination, the government should have planned more.
She shared that the governments of Qatar and African countries had ensured HPV Vaccination for both boys and girls of their respective populations, which is a lesson learnt.
“We have ensured equitable access to girls in the schools, but it has to be rolled out for out-of-school girls as well. However, for KP, Balochistan and GB, the vaccination is going to be launched in the next phase,” she informed.
Dr Isani recommended that the inoculation awareness campaign also needs to be taken to the doorstep level for beefed-up coverage. However, by 2030, GAVI, the global vaccine alliance supporting immunization worldwide, is pulling out from global immunization, which will cause a great issue as at this time, the funding for HPV vaccination is managed through co-sharing but the country has to prepare for the future, she added.
Prof Dr Syeda Batool Mazhar, President South Asian Federations of Menopause Societies (SAFOMS), in her presentation, said any immune deficient person is susceptible to contracting HPV infection leading to cervical cancer. However, over 80 per cent in the West are carriers of HPV, whereas scarce data show 23 per cent prevailing in Pakistani population, she added.
“It is emerging in all ages of women in Pakistan and it’s the second most common cancer in women of Pakistan. The denial of the disease among the population is one of the reasons for disease spread,” she added.
Prof Dr Syeda Batool informed that screening of diseases like cervical cancer also faces resistance from the masses, whereas Sri Lanka, a less affluent nation than Pakistan, has proper screening systems for women for cervical cancer at 35 and 45 years of age.
“In developing nations, a one-time shot is giving lifetime coverage for cervical cancer prevention,” she said.
She added that the government initiatives, like EPI vaccination, are a hope to change mindsets, as it is all a public behavior issue that needs to be changed. Commenting on the vaccine, she said it is a Chinese single-shot vaccine that has been in use in Africa and WHO had also pre-qualified this vaccine for inoculation.
She also underlined that the age cohort of nine years of age was selected due to highly promising amid better immunogenesis of antibodies after vaccination among this age group of girls.
Dr Nabia Tariq, Head of Department Obstetrics and Gynecology, Maroof International Hospital, said cervical cancer should be treated in cancer hospitals as there are cancer centers across the country in both public and private sectors.
“It is curable at early stages, whereas it requires advanced medical healthcare at the last stage of the disease. Primary prevention through awareness and vaccination should be mandatory and should be the major way forward to prevent cervical cancer,” she said.
She suggested enhancing understanding of HPV, cervical cancer disease burden in Pakistan, and the importance of vaccination among policymakers, health professionals, educators, and community leaders.
Dr Samina Naeem Khalid, Professor and Head of Maternal, Neonatal and Child Health (MNCH) Department, Health Services Academy (HSA), noted that to start the campaign, data correction was important and was started by the Health Ministry.
She regretted that despite cancer registries available in the country, access to data was not possible even in the presence of data pooling initiatives, whereas the data collection from private sector hospitals was equally an uphill task.
“Cervical cancer is among the most common types of cancers among Pakistani women, whereas GAVI, through WHO support, provided free vaccines for inoculation campaign,” she added.
Dr Samin informed that the cervical cancer patients are mostly reported at the advanced stage, mostly 50 years old and above, adding that there is usually no reporting of the disease before this age cohort.
She mentioned that there have been multiple refusals at various areas of the federal capital where medical students trained for vaccination were sent to ensure inoculations after proper counseling.
“Social media campaigns by influencers created propaganda against HPV vaccines, that’s why we were not able to maintain momentum due to that negative media campaign,” she said.
She stressed the need to empower women and girls to decide to get inoculated for HPV Vaccination, whereas healthcare providers, gynecologists, and health workers are instrumental in breaking the myth, along with teachers, journalists fraternity and social media influencers.
In her opening remarks, Dr Razia Safdar, Senior Policy Advisor SDPI said HPV is one of the most common sexually transmitted infections worldwide, with over 200 known types, and early manifestation in the form of genital warts.
“Pakistan has 73.8 million women aged 15 years and above at risk of cervical cancer. Despite its preventability, vaccination coverage in Pakistan has remained extremely low,” she said.
Huma Khawar, Strategic Advisor, Mannon Daniels GAVI, said there are preventive methods available and it’s out of the mind to see why parents were resisting the vaccination.
“Social media campaign against HPV Vaccination was countered and it resulted in improved vaccination numbers, whereas a major problem was the influencers in the community population,” she said.
Khawar mentioned that the elites of the country believed that cervical cancer was not their problem, while linking the disease to STIs, which was wrong. However, the civil society has done a marvelous job in interpersonal communication to improve awareness on vaccination as after resistance from schools, awareness sessions with parents, school principals, along with gynecologists to answer all queries of the people were conducted.
In his closing remarks, Dr Shafqat Munir, Deputy Executive Director SDPI said the misconceptions about the HPV Vaccination campaign had to be addressed through regressive awareness campaigns from urban to rural areas.
Moreover, the inoculation campaign is getting effective gradually and the government should draw down on the campaign further, he added.