/ 12 March 2007

Spread good health

International Women’s Day is a time when we take stock each year of the progress, or lack of it, on women’s rights. This stock­taking happens all over the world, involving both women and men, and it reveals some progress.

Sadly, it also suggests that we still have a long way to go. Women and girls continue to lack sufficient access to health, education and wealth, particularly in the poorest countries. Socially unjust disparities between women in rich and poor countries are an additional grim reminder of how much remains to be done.

Increasingly, however, we are being provided with the tools to make a power­ful and positive impact on women’s health. Researchers are working hard to develop new technologies. They have already developed mammograms and pap smear tests, which are part of women’s regular health checks in developed countries. We now also have the first vaccine to be developed specifically for women, a vaccine against the human papilloma virus (HPV), which causes most of the 500 000 cervical cancer cases diagnosed each year. The first of two HPV vaccines is already licensed in 38 countries.

This vaccine must be made available to women and young girls, especially those who live in the poorest countries.

Studies show that it is cost effective to invest in prevention as opposed to treatment. Some diseases, like cancer, cannot be successfully treated once they progress beyond a certain stage; therefore, prevention is especially important. Indicators show that insufficient progress has been made on women’s health, particularly in developing countries. We also know that little progress has been made in recognising a woman’s right to sexual and reproductive health — in part because women lack the means to protect themselves.

Rich countries’ health systems offer pap smear screening, which often detects HPV early enough to prevent progression into cervical cancer.

However, for most women in developing countries, pap smears are out of reach or not available. The consequences for women’s health are disastrous, especially in combination with the HIV/Aids pandemic. Therefore, cervical cancer mainly takes its toll in the poorest nations: of the 270 000 cervical cancer deaths worldwide, 85% are in developing countries.

New technologies such as the HPV vaccine should be made available, accessible and affordable for the developing world. We should not allow the example of the hepatitis B vaccine to be repeated. It had been readily available in the developed world for more than 18 years, before being introduced in the poorest countries, nations with the world’s highest incidence of liver cancer. The recent experience of global health organisations such as the Global Alliance for Vaccines and Immunisation (Gavi) shows that new and innovative financing models can facilitate the introduction and affordability of new vaccines and technologies, with dramatic effects on the number of lives saved.

The Gavi alliance could potentially play a similar role to fund the introduction of the vaccine against HPV. If no such concerted effort is made and if current trends in women’s health continue, there are projected to be more than one million new cases of HPV annually by the year 2050.

The international community must address this glaring inequity between women in poor countries and those living in developed countries. We know that mammograms and pap smear tests have saved the lives of women in the wealthy countries of the world. We know that a global effort to make such a new life-saving vaccine as the HPV vaccine widely available and affordable could similarly play an important role in curtailing millions of unnecessary deaths of women and girls in the poorest regions. This is a compelling case for action and we need woman power to drive it home!

Graça Machel is president of the Foundation for Community Development and Mary Robinson is president of Realising Rights: The Ethical Globalisation Initiative