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HPV vaccine strategies: equitable and effective?
  1. Sarah Hawkes1,
  2. David A Lewis2,3
  1. 1Institute for Global Health, University College London, London, UK
  2. 2Western Sydney Sexual Health Centre, Parramatta, New South Wales, Australia
  3. 3Department of Medicine (Immunology and Infectious Diseases), Westmead Clinical School, University of Sydney, Sydney, New South Wales, Australia
  1. Correspondence to Dr Sarah Hawkes, Institute for Global Health, University College London, London WC1N 1EH, UK; s.hawkes{at}

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Immunisation programmes are recognised as being among the world's most successful public health programmes. Their impact on rates of infectious diseases (and subsequent reduction in complications and health burden) makes them one among the most cost effective and economically attractive of all health interventions. Indeed, the influential 2008 Copenhagen Consensus identified childhood vaccines as the fourth ranked ‘best buy’ for all global development interventions.1

In the same year, the GAVI Alliance (a global public-private partnership that currently works to increase access to immunisations in 53 eligible low-income and lower-middle-income countries) prioritised support for human papillomavirus (HPV) vaccines—and this was followed by financial commitments in 2011, based on a price reduction to an acceptable and feasible price to achieve increased coverage of the vaccine. GAVI has now secured a price of US$4.50 for the HPV vaccine—a remarkable reduction on the market price of this life-saving intervention.2

This achievement is made even more notable by the fact that the HPV vaccine is to be offered to girls aged 9–13 years: a demographic that falls outside the remit of most public health programmes in low-income and lower-middle-income countries. Several countries have struggled to find ways to reach their target population—a feat made more challenging by the fact that in 2013, 57 …

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  • Competing interests None.

  • Provenance and peer review Commissioned; internally peer reviewed.

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