South Africa became the first African country on Wednesday to provide grade four girls in all government schools with an expensive cervical cancer vaccine at the state's cost. Health Minister Aaron Motsoaledi launched the vaccine programme at Gonyane Primary School in Bloemfontein.
The vaccine protects against the sexually acquired human papilloma virus (HPV), which causes about 70% of cervical cancers, according to Helen Rees from the Wits Reproductive Health and HIV Institute.
Cervical cancer is the second most common cancer among South African women, but is the most deadly because it is often detected too late. Of the 6 000 annual cervical cancer cases, more than half of those who contract it die.
Women infected with HIV are five times more likely to develop cervical cancer than uninfected women.
Per dose, the vaccine costs R595.39 in the private sector, according to the medicines price register published by the department of health. Ideally, three doses are needed, but the government will only be providing two. "Although the vaccine was originally developed to be given in three doses, some research shows that two doses are as effective," said Rees.
According to the health department's deputy director general Yogan Pillay, the health department gets the vaccine, Cervarix, at about a fifth of the cost from the manufacturing pharmaceutical company, GlaxoSmithKline.
"Virtually all sexually active people will at one time in their life be exposed to HPV. We also chose this age [nine years and older] because we know that these girls are least likely to have started sexual activity," said Motsoaledi.
He said the government's antenatal survey showed that girls as young as 10 are falling pregnant.
According to the minister, more than 3 000 health professionals have been trained to administer the vaccine in more than 17 000 schools across the country. The first dose is being given in March and April and the second in September and October.
Men can develop cancers from HPV too, namely cancers of the penis or anus, but Rees said these kill much fewer people than cancer of the cervix.
"Also if we vaccinate a significant number of girls, we will see less HPV in the community as a whole, called herd immunity, which will benefit boys too."
She said about 80% of girls need to be vaccinated for herd immunity to develop.
HIV, ARVs and the cervical cancer vaccine
Life saving cancer vaccine will be difficult to implement
Schoolgirls to get cervical cancer vaccines from 2014
Cervical cancer vaccine touted as lifesaver
The right choice of contraceptive is crucial. Science can help you to choose one that's right for you.
In the Free State, access to health services can depend on who you know, as the tragic case of one woman illustrates.
Where traditional beliefs are more real than textbooks, treating illness is a balancing act for sangomas and medical doctors alike.
Bhekisisa means "to scrutinise" in Zulu
In South Africa, Zulu patients who would like to be thoroughly assessed by a doctor, would ask the physician to "bhekisisa" them.