The HPV vaccine: the global success of prioritising women’s health

Let's talk about the HPV vaccine - a revolutionary drug and global strategy that proved how investing in and raising awareness about women's health benefits everyone.

Understanding Cervical Cancer and HPV

Cervical cancer ranks as the fourth most common cancer among women worldwide. Nearly all cases are caused by high-risk strains of the human papillomavirus (HPV), a common virus transmitted through sexual contact. While most HPV strains are harmless, some high-risk types can infect cervical cells, leading to cellular changes that may result in cancer. High-risk HPV strains can also increase the risk of other cancers, such as those of the throat and mouth.

The first HPV vaccine was approved in the United States in 2006 for girls aged 9-26ⁱ, with the UK following suit by introducing a routine HPV vaccination programme in 2008ⁱⁱ. Today's vaccines are highly effective and, when combined with screening programmes, are nearly 100% effective at preventing cervical cancer. In the UK, we are on the verge of seeing a generation that is fully protected against cervical cancer.

Despite these advances, in 2022, a staggering 94% of all cervical cancer deaths occurred in low- and middle-income countries. This highlights the significant global disparities in access to vaccination, cervical screening, and treatment.

WHO Global Strategy

In 2020, the World Health Organization (WHO) launched the "Global Strategy to Accelerate the Elimination of Cervical Cancer as a Public Health Problem." This initiative aims to address the global disparities highlighted by the prevalence of cervical cancer. It is the first WHO global strategy focused on the elimination of a non-communicable disease.

The strategy is summarised by the "90-70-90" targets:

• Vaccination: Ensure 90% of girls are fully vaccinated with the HPV vaccine by age 15.
• Screening: Ensure 70% of women are screened using a high-performance test by age 35, and again by age 45.
• Treatment: Ensure 90% of women with pre-cancer receive treatment, and 90% of women with invasive cancer are properly managed.

By achieving these targets by 2030, it is predicted that we could see global elimination of cervical cancer within the next century. Specifically, the WHO aims to reduce the incidence of cervical cancer to fewer than 4 cases per 100,000 women-yearsⁱⁱⁱ. It is projected that by 2030, the cumulative number of cervical cancer deaths averted will be 300,000. This will rise to over 62 million by 2120.

Achieving the Goal: Increasing Screening Rates

The second pillar of the 90-70-90 goals emphasises the uptake of cervical cancer screening. Many factors contribute to low screening rates, and these differ across the globe. To address this, the WHO has provided comprehensive technical and clinical guidelines within regional action plans that are tailored to increase screening rates in targeted communities.

The development of at-home sample collection options will likely help advance the improvement of screening rates. In the UK, various at-home sample collection kits and HPV test kits are now available^iv. Recently, the FDA approved Roche’s HPV self-testing kit, the cobas® HPV test, which is clinically validated and FDA-approved to detect high-risk HPV strains from a single patient sample. This test aims to help clinicians better stratify patients by risk, enabling early and appropriate patient management decisions.

Teal Health has recently received an FDA breakthrough designation for their Teal Wand, a device specifically designed for at-home sample collection. The FDA has also cleared Hologic’s digital cytology platform, which uses an AI algorithm to identify specific cells in a patient’s sample, improving the sensitivity of screening.

Although most of these self-test kits are available primarily in countries like the UK and the US, they hold potential as low-cost screening options in countries currently with limited clinical access. With appropriate follow-up and management strategies, these self-test kits could significantly increase screening rates, moving towards the WHO’s 90-70-90 targets.

Beyond Women's Health: Broader Benefits of the Global Strategy

Health inequality affects every aspect of society, and addressing it brings wide-ranging benefits.

Economic Impact

Investing in the Global Strategy yields substantial economic returns. According to the WHO, for every dollar invested, an estimated $3.20 will be returned to the economy by 2050 due to increased women's participation in the workforce. When considering broader societal benefits, this return is thought to increase to $26.00.

By 2030, movement towards the 90-70-90 targets is projected to help retain approximately 250,000 women in the workforce, contributing an estimated $28 billion to the global economy. The impact on social mobility for women in low- and middle-income countries aiming to meet the 90-70-90 targets is likely to be even more significant when looking beyond the economic impact.

Broader health implications: a universal benefit

Beyond economics, this global effort has greatly advanced our awareness and understanding of women's health. For myself personally, my HPV vaccine at age 14 was my introduction to gynaecological health; something I fear that I otherwise would not have been exposed to until being offered a smear test over 10 years later.

Research and development of cervical screening devices and methods alone have had a direct impact on our knowledge of other gynaecological cancers, sexual health, contraception, and pregnancy, to name a few. AI-driven screening platforms and programmes, which are also in place for e.g. breast and prostate cancer, can be adapted for so many other diseases. Moreover, the infrastructure developed by the HPV vaccine programme provides a robust foundation for addressing other diseases in the future.

Prioritising women's health benefits everyone, advancing a healthier, more equitable society.

At Mewburn Ellis we’re passionate about women’s health and, the patents and applications that we’re involved with in this space have the potential to change women’s lives, helping the companies that are developing them to secure funding and protect investments as they transition from concept to clinic.

If you’d like to work with us to develop an IP strategy and build a robust patent portfolio that works for your business, do get in touch. 

ⁱ Centers for Disease Control and Prevention (CDC). FDA licensure of bivalent human papillomavirus vaccine (HPV2, Cervarix) for use in females and updated HPV vaccination recommendations from the Advisory Committee on Immunization Practices (ACIP). MMWR Morb Mortal Wkly Rep. 2010 May 28;59(20):626-9. Erratum in: MMWR Morb Mortal Wkly Rep. 2010 Sep 17;59(36):1184. PMID: 20508593.

^{ii https://ukhsa.blog.gov.uk/2018/06/18/ten-years-on-since-the-start-of-the-hpv-vaccine-programme-what-impact-is-it-having/} 

ⁱⁱⁱ Global strategy to accelerate the elimination of cervical cancer as a public health problem. Geneva: World Health Organization; 2020. Licence: CC BY-NC-SA 3.0 IGO 

^iv  https://onlinedoctor.superdrug.com/hpv-test.html 

This blog was originally written by Alice Jefferies.