Fresh from his battle to reduce HIV infections and make antiretrovirals freely available to almost two million South Africans infected with the virus that causes Aids, Health Minister Aaron Motsoaledi is now taking on cervical cancer.
In parliament yesterday, Motsoaledi announced that girls as young as nine at poorer primary schools would be given free vaccinations against human papilloma virus (HPV) from February.
As many as 520000 girls aged between nine and 10 will be vaccinated against HPV, which causes cervical cancer.
It is important that girls be vaccinated before they are sexually active if they are to be protected against HPV.
More South African women are killed by cervical cancer than by any other type of cancer. Black women and HIV-positive women are particularly vulnerable to the disease.
The drive to vaccinate schoolgirls was prompted by the severity and prevalence of the disease in young women, said Motsoaledi.
He said it was not known what the vaccination roll-out would cost but he was negotiating with pharmaceutical companies on the pricing of the vaccine.
“It’s not about the money; it’s about the human suffering … we are obliged at all times to put money aside for treatment but we are not obliged at all times to put money aside for prevention,” said Motsoaledi.
He said about 6000 women were treated each year for cervical cancer in public hospitals at a cost of R100000 a patient. Of these patients, 3500 died each year. In total, the cost to the state of cervical cancer treatment was about R600-million a year.
Cervical cancer, caused by two strains of the HPV, is less prevalent than breast cancer but kills more people. In South Africa, about 80% of cervical cancer fatalities are black women.
The virus is sexually transmitted.
The vaccine costs between R500 and R750 a dose and three doses must be administered over a six-month period forit to be effective.
University of Stellenbosch gynaecologist Haynes van der Merwe said Motsoaledi’s announcement was ”indeed good news”.
In the US, a similar vaccination programme has been largely ineffective because too few girls were given all three injections over six months. But Australia has effectively rolled out the HPV campaign to schoolgirls aged 12 to 13.
Advocacy group Equal Education welcomed the move. Its deputy general secretary, Doron Isaacs, urged a roll-out of condoms at schools as well.
Motsoaledi’s spokesman, Joe Maila, said the vaccine was not being made available to boys because HPV caused cancer in girls but genital warts in boys.
“Because of this [severe effect on] girls, we have targeted them as a starting point.”
But the Centres for Disease Control in the US, and the SA Dental Association, have called for boys to be vaccinated before they are sexually active.
This is because young men worldwide are contracting deadly oral and throat cancers caused by the HPV.
The increase in throat and oral cancer among people under the age of 45 was “massive”, said University of Pretoria dental professor Andre van Zyl. He said throat cancers were previously most commonly diseases of old people and heavy smokers.
“Oral sex is perceived to be a safer sexual behaviour in an Aids-dominated world,” said Van Zyl.
“However, though it is true that the spread of HIV infection is lowered by non-genital sex, the spread of HPV has become more prevalent and, in turn, the incidence of HPV-related throat cancer has increased dramatically over the past decade,” said Van Zyl.
“These young people could never imagine that they might develop throat cancer so it is imperative that they visit the dentist regularly.”
Van der Merwe urged women to visit a gynaecologist once a year for an examination to detect precancerous cells before they develop into cervical cancer.
“At Tygerberg hospital yesterday we saw 16 patients with cervical cancer. Most present themselves too late for treatment,” said Van der Merwe.
* This news story was resourced by the Oral Cancer Foundation, and vetted for appropriateness and accuracy.