Health Sector – UHC, National Health Policy, Family Planning, Health Insurance, etc.

Indigenous HPV vaccine, the rhetoric and the reality

Note4Students

From UPSC perspective, the following things are important :

Prelims level: About human papilloma virus (HPV)

Mains level: Present trends of cervical cancer prevalence in India and the Globe

Why in the news?

Recent discourse suggests HPV vaccination prevents cervical cancer, but evidence linking HPV to cancer is inconclusive and most infected individuals don’t develop cancer, raising doubts about vaccine necessity.

What is Cervical Cancer?

Cervical cancer is a type of cancer that starts in the cells lining the cervix, which is the lower part of the uterus that connects to the vagina. It is usually a slow-growing cancer that may not have symptoms in its early stages.

Present  trends of cervical cancer prevalence in India and the Globe                

  • Global Trends: Cervical cancer is the fourth most common cancer among women globally, with an estimated 604,000 new cases and 342,000 deaths reported in 2020. 
    • Mortality rates vary widely by region, with the highest rates observed in low- and middle-income countries due to limited access to screening and treatment.
  • Trends in India: In India, cervical cancer is the second most common cancer among women aged 15-44 years. It accounts for approximately 17% of all female cancer deaths in the country, with over 97,000 new cases reported annually.

 

Recent debate – How does vaccination against HPV prevent cervical cancer and consequent death?                                                       

  • Efficacy Against HPV Infection and Cervical Cancer: HPV vaccines target high-risk HPV types, notably types 16 and 18, which are responsible for a significant proportion of cervical cancer cases worldwide. 
    • Clinical trials and real-world data consistently demonstrate the effectiveness of HPV vaccines in reducing HPV infection rates and preventing cervical cancer.
  • Public Health Impact and Benefits: Countries with high HPV vaccination coverage have observed significant declines in HPV infection rates and cervical cancer incidence among vaccinated populations. 
    • Vaccination programs aim to achieve herd immunity, thereby reducing overall transmission of HPV and protecting unvaccinated individuals.
  • Debate and Challenges: Debate surrounds the universal versus selective vaccination strategies, with considerations on cost-effectiveness, accessibility, and cultural acceptance.
    • Challenges include vaccine hesitancy, particularly in some regions, as well as affordability and logistical barriers to widespread vaccination coverage.

Challenges Prevalent in Vaccine Manufacturing    

  • Complex Manufacturing Processes: Vaccine manufacturing involves complex biological processes and stringent quality control measures. 
    • Developing and scaling up production requires specialized facilities and skilled personnel, which can be costly and time-consuming to establish.
  • High Regulatory Standards: Vaccines are subject to rigorous regulatory scrutiny to ensure safety, efficacy, and consistency. 
    • Meeting regulatory requirements in multiple jurisdictions adds complexity and may delay the approval and market entry of new vaccines.
  • Supply Chain and Distribution: Maintaining a reliable supply chain for vaccine components and ensuring cold chain storage and distribution are critical challenges. 
    • This becomes even more pronounced in resource-constrained settings or during global health emergencies where demand surges.

Its Impact on India                     

  • Delayed Access to Affordable Vaccines: India’s capability to produce vaccines at scale is hindered by stringent patent laws and complex regulatory requirements. 
    • This delays the availability of affordable vaccines domestically, impacting public health initiatives and access for vulnerable populations.
  • Economic and Health Implications: High costs associated with vaccine development and production limit affordability and accessibility, exacerbating healthcare inequalities. 
    • This affects India’s ability to address preventable diseases effectively, impacting public health outcomes and economic productivity.

Unavailability of Competing Vaccines and Future Scope

  • Lack of Market Competition: Despite the expiration of earlier patents, there is a notable absence of competing HPV vaccines from domestic manufacturers in India. 
    • This limits options for consumers and healthcare providers, potentially leading to higher prices and reduced accessibility, particularly in the private market.
  • Potential for Future Development: Several Indian biotech companies had announced plans to develop HPV vaccines, indicating a future scope for competition and potentially lower prices. 
    • However, these initiatives have not materialized into market-ready products, highlighting challenges in vaccine development and commercialization in India’s regulatory and economic environment.

Way forward: 

  • Promote Research and Development Incentives: Encourage and support Indian biotech companies through research grants, tax incentives, and streamlined regulatory pathways for HPV vaccine development.  
  • Enhance Public-Private Partnerships: Foster collaborations between government entities, academic institutions, and private-sector vaccine manufacturers to improve vaccine accessibility and affordability. 

Mains PYQ: 

Q What are the research and developmental achievements in applied biotechnology? How will these achievements help to uplift the poorer sections of the society? (UPSC IAS/2021)

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