HPV campaign fails to reach targets

With women's reproductive health considered a stigmatized topic, for the longest time, cervical cancer remained sidelined in the national health policy. Recently, when the government finally decided to initiate an HPV vaccination campaign, public mistrust brought the drive to an unfortunate end.

According to the World Health Organization (WHO), cervical cancer, which forms in the cervix, the lower part of the uterus, is the fourth most common cancer affecting women globally. It is mainly caused by persistent infection with high-risk types of the human papillomavirus (HPV), a virus transmitted through sexual contact.

Data from the HPV Information Centre shows that cervical cancer is the second most common cancer among Pakistani women aged 15 to 44. Each year, over 5,000 women are diagnosed with the disease, and at least 3,000 of them die as a result. The country's cervical cancer mortality rate ranges between 60 to 85 per cent, far higher than the global average of around 45 per cent.

In September this year, an HPV vaccination campaign was launched across Karachi and the rest of Sindh for 15 days, targeting 4.1 million girls aged nine to 15. An international organization, GAVI, provided 13 million doses of the HPV vaccine free of cost to the Government of Pakistan. Yet, the 15-day campaign could not meet its targets.

Despite officials from the Expanded Programme on Immunization (EPI) claiming a 65 per cent coverage rate across Sindh, actual ground realities paint a different picture. According to EPI data, the vaccination coverage in Kemari district was only 16 per cent. Other areas also saw low coverage rates. In East District, 37 per cent of 291,552 girls were vaccinated while in South District 39 per cent of 173,772 girls were vaccinated and in Central District 42 per cent of 284,976 girls received the vaccine.

Parents' lack of interest remained a major hurdle despite pre-campaign awareness efforts by health authorities. Vaccine opposition groups also ran a negative campaign on social media, with some using AI-generated videos to spread fear and panic among parents. Khushab Khattak, a resident of Banaras, Karachi, questioned why the campaign was only run in Sindh and Punjab and not in K-P or Balochistan.

"The government is ignoring major health threats while pushing the HPV vaccine aggressively in schools. This, in my view, raises doubts about the true motive behind the drive. My daughter's school insisted on her attendance on vaccination day, and many parents like me, unaware of the vaccine's purpose, chose not to allow their children to receive it," said Khattak.

On the other hand, Professor Dr Jahan Ara Hasan, Head of Gynaecology at Dow University of Health Sciences, emphasized the fact that apart from cervical cancer, the HPV vaccine could prevent oral and anorectal cancers among both men and women, therefore the immunization drive was a critical initiative.

"Sadly, many parents refused the HPV vaccine since they believed it contained an implant for controlling fertility. Even some educated parents were skeptical since the vaccine being administered is a Chinese HPV vaccine, known as Cecolin, which appears dubious in terms of trials and efficacy," said Dr Hasan.

Conversely, the campaign is seen by many as a test run before officially incorporating the HPV vaccine into the EPI program in 2026. According to Dr Raj Kumar, the Project Director of EPI, Rs797 million has been earmarked for the procurement of vaccines over the next three years. Each year, 700,000 girls aged nine to 15 will be vaccinated. "Though the federal government will handle the procurement, Sindh is responsible for funding its share," said Dr Kumar.