Regional HPV vaccine design boosts cancer equity
The World Health Organization (WHO) has set an ambitious goal of having 90% of girls vaccinated against human papillomavirus (HPV) by 2030. To meet this target, regionalized vaccines can help, especially in areas like Africa where the HPV35 genotype is prevalent.
Regional Disease Patterns
HPV vaccines have transformed cervical cancer prevention, but the next generation of vaccines must better reflect regional disease patterns. The recent WHO Global Status Report on Cancer paints a sobering picture, with HPV being one of the world’s most serious infectious causes of cancer.
Cervical cancer kills hundreds of thousands of women each year, with the greatest burden falling on lower-income countries and regions where screening and treatment are less accessible. Much of this disease is preventable with HPV vaccination, combined with screening and treatment.
The first HPV vaccines focused on a small number of the most important cancer-causing HPV types. The current 9-valent vaccines have expanded protection and increased potential impact. However, HPV genotypes are not distributed evenly across regions.
Beyond the Universal Vaccine Model
The default approach in vaccine development has often been to aim for a universal product: one vaccine composition, many countries, and broad coverage. This approach has obvious advantages, but it is not always optimal.
A more regionally-tailored approach to HPV vaccine design deserves serious attention. For Africa, that could mean prioritizing a vaccine that includes HPV35, rather than assuming that the best next product must be a high-valency vaccine designed for every market at once.
The principle is straightforward: vaccine design should be guided by the disease burden in the population that will use it. Low and middle-income countries experience the highest burden of deaths from cervical cancer, with Africa having the highest rates in 2024.
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Better surveillance is needed to understand HPV genotype distribution across regions, especially in places where cervical cancer incidence and mortality are high. This would allow vaccine composition to be more responsive to disease burden rather than market assumptions.
HPV vaccines have already shown what prevention can do, and the next step is to make sure that vaccine innovation is driven by the goals of equity and impact.
If HPV35 is helping drive cervical cancer in parts of Africa, future HPV vaccines for Africa should be designed accordingly.
According to the report, 90% of girls need to be vaccinated against HPV by 2030. The right to health demands more than access to any vaccine; it requires access to prevention tools that are effective, high quality, and appropriate to the people and places where the burden is greatest.
They are working to meet this target.
Vaccine design is key to cervical cancer elimination.
It requires access to centrifuges designed for specific purposes.
