• 11/29/2006
  • Canberra, Australia
  • Vesna Poljak and Gemma Daley
  • Bloomberg.com

Australia’s government agreed to add Merck & Co.’s Gardasil vaccine to its subsidized health program, reversing an earlier decision to exclude the shots which protect against viruses causing 70 percent of cervical cancer.

Prime Minister John Howard said Australia will spend A$436 million ($342 million) making the vaccine free for women aged 12 to 26. The turnabout followed an agreement by its distributor CSL Ltd. to cut the price by 27 percent, and criticism from the Australian university where it was developed.

“Gardasil will be available for a nationwide vaccination campaign commencing next year,” Howard told reporters in Canberra today. “This remarkable Australian drug can be made cheaply available to women.”

Cervical cancer kills about 250,000 women annually, making it the second-biggest cause of death among female cancer patients globally, according to the World Health Organization. It is caused predominantly by human papillomavirus, or HPV, a virus carried by about 440 million people.

Shots protecting against the sexually transmitted virus should be mandatory for preteen girls and available worldwide, researchers from Johns Hopkins University in Baltimore wrote in the scientific journal Nature Reviews Cancer in September.

Gardasil is the first vaccine aimed at preventing cervical cancer. It is “an immense innovation,” Didier Hoch, president of Sanofi Pasteur MSD, the vaccine joint venture between Merck & Co. and Sanofi-Aventis SA, said this week.

European Union-member states should lead other governments by making the vaccinations mandatory for all girls aged 11-12 years, the U.K.’s Lancet medical journal said last month.

In the U.S., insurance carriers for about 94 percent of privately insured Americans will pay for the vaccines, Whitehouse Station, New Jersey-based Merck said this month.

Australian of the Year

Immunologists Ian Frazer and Jian Zhou made a discovery at the University of Queensland more than 15 years ago that led to the development of Gardasil and rival Cervarix, made by GlaxoSmithKline Plc. Frazer was named 2006 Australian of the Year, the nation’s top honor, for his work.

“The government’s decision, combined with an ongoing cervical cancer-screening program, will be a significant step towards further reduction of cervical cancer risk for Australian women,” Frazer said in a separate statement today.

Health First

A government advisory committee on Nov. 8 rejected a request by Melbourne-based CSL to subsidize Gardasil, citing the expense of the three-shot course. The rejection, supported by Health Minister Tony Abbott, was challenged a day later by the Prime Minister Howard. A full course costs about A$460.

University of Queensland Vice-Chancellor John Hay said this month that it should never have been necessary for the Prime Minister to intervene.

“The Government has put the health of Australian women ahead of the Budget bottom line,” Mukesh Haikerwal, president of the Australian Medical Association, said in a separate statement today.

State and federal governments in Australia spend more than A$90 million annually screening for cervical cancer using a procedure known as a Pap smear.

The program has cut deaths from cervical cancer by about 60 percent since 1985 and has halved the number of cases of cervical cancer, the Department of Health and Ageing said in a statement yesterday. Australia has the second-lowest incidence of cervical cancer and the lowest mortality rate from cervical cancer in the world.

Boys Too

Gardasil was approved June 16 by the department’s Therapeutic Goods Administration for females aged 9 to 26 years and males aged 9 to 15.

After a two-year catch up period inoculating women as old as 26 years with Gardasil, the National Immunisation Program aims to target schoolgirls aged 12 and 13 to immunize them before they become sexually active.

HPV viruses are responsible for about 20 percent of head and neck cancers, and are a chief cause of cancer of the penis, anus and some types of skin cancer in men who have sex with other men. HPV viruses, of which there are about 200 different types, also cause genital warts.

Silent Carriers

In 98 percent of infections, the body’s own immune response successfully fights the virus. In the remainder of cases, it will persist, potentially causing disease, the University of Queensland’s Frazer said.

“From a public health point of view, vaccinating men and women is the quickest way to reduce the total burden of virus in the community,” Frazer said in an interview in Melbourne last month. The vaccine is safe in men though more studies are needed to demonstrate its efficacy, he said.

Infected men who are immunized will secrete protective antibodies along with the virus, making them less likely to spread HPV, Frazer said.

“Since this is a virus that you generally don’t know you’ve got, especially in men, there’s a case to be made for immunizing men to prevent them from infecting women even if they’ve already been infected themselves,” he said.