Experts argue that vaccinating boys as well as girls for the Human Papillomavirus (HPV) would have a dual advantage as it would protect both men and their female partners from infection. HPV is largely transmitted through sexual contact.
According to the South African Society of Obstetricians and Gynaecologists, HPV is the most common sexually transmitted infection in the world. Head of gynaecological oncology at Stellenbosch University, Hennie Botha, estimates that 80% of sexually active adults will be exposed to a cancer-causing strain of the virus.
“Although women have a much higher risk of developing cancer than men, the virus also causes cancer in men. About one in every four head and neck cancers are associated with HPV. The risk of HPV infection is exactly the same in men and women,” says Botha.
The head of the National Institute of Communicable Diseases, Shabir Madhi, says men are the ones who transmit HPV to women. “If you want to interrupt the circulation of the virus sooner, then you should be targeting boys as well. But in addition to that there’re also complications of HPV infection in boys, men can develop diseases like penile or throat cancer, as well as genital warts, because of HPV.”
According to the World Health Organisation there are more than 100 types of HPV “of which 13 are cancer-causing”. A 2013 article in the South African Journal of Gynaecological Oncology estimates that 70% of HPV infections in women are cleared naturally by the immune system. “However, cervical cancer is almost always caused by persistent HPV infection,” the article states.
Currently, the national health department provides free vaccination to girls in grade four in public schools around the country. The vaccine helps prevent HPV infection, which in turn prevents the development of cervical cancer in women.
Speaking at the launch of the government’s HPV vaccination programme last year, Health Minister Aaron Motsoaledi said that 6 000 South African women are affected by cervical cancer annually and “between 3 000 and 3 500 die” as a result.
Yogan Pillay, the deputy director general of HIV, TB and women and child health in the national health department, says that so far 83% of the targeted 380 000 girls have received the two doses of the vaccine.
Cervarix, the vaccine that is being used by the public health sector costs nearly R800 per dose in the private sector. Two doses are needed. According to Pillay, the government pays about a fifth of the private sector price.
Pillay says that government has considered vaccinating boys as well but “the problem is cost. If we vaccinate boys we’ll have to get another vaccine, which covers genital warts in particular [which the current vaccine doesn’t]. “At the moment we have to focus on where the biggest problem is and that is the cervical cancer risk associated with HPV infection in girls,” he says.