Merck has a long-standing commitment to help improve access to GARDASIL® [Human Papillomavirus Quadrivalent (Types 6, 11, 16 and 18) Vaccine, Recombinant] in developing countries, where more than 85 percent of the world’s cervical cancer cases occur.1
Merck is committed to supporting public health initiatives that increase access to vaccines where they are most needed. We have engaged in a number of multi-disciplinary partnerships that help resource-poor countries gain access to human papillomavirus (HPV) vaccination.
In September 2012, the Republic of Uganda, through the Ministry of Health (MoH) and supported by Merck, announced the launch of a national vaccination program with GARDASIL. Cervical cancer is the most frequent cancer diagnosed among women in Uganda,2 and incidence rates of the disease in the country are about three times the global average.3 An estimated 3,500 women in Uganda are diagnosed with cervical cancer each year.4 Through this agreement with Merck, the vaccination program is being implemented with 460,000 doses of GARDASIL donated to 12 districts in Uganda, enough to vaccinate approximately 140,000 eligible girls 9 to 13 years of age over a two-year period. The program represents the first phase of Uganda’s national roll-out plan for human papillomavirus (HPV) vaccination.
In 2010, Merck also partnered with the Government of Bhutan and the Australian Cervical Cancer Foundation (ACCF) to initiate a six-year program aimed at reducing incidence of cervical cancer in Bhutan. Through this partnership, Bhutan became the first developing nation in the world to implement a national cervical cancer vaccination program. The first year of the program provided an opportunity for appropriate girls and young women between the ages of 12 and 18 to be vaccinated with GARDASIL, and achieved an approximately 90 percent vaccination rate for all three doses, according to the Bhutan Ministry of Health. In subsequent years, the program continues to provide an opportunity for appropriate 12-year-old girls to be vaccinated with GARDASIL.
These programs in Uganda and Bhutan are serving as models for other developing countries that aspire to implement national cervical cancer vaccination programs.
Partnerships for Cervical Cancer Prevention and Treatment
Merck is also working to create novel partnerships that take a comprehensive approach to cervical cancer prevention and treatment.
For instance, in September 2011, Merck announced its plans to contribute $3 million over three years to Pink Ribbon-Red Ribbon™, to address both cervical and breast cancer in sub-Saharan African nations. Pink Ribbon-Red Ribbon is a historic initiative that brings together public and private sector partners, including Susan G. Komen for the Cure®, the George W. Bush Institute, the President’s Emergency Plan for AIDS Relief (PEPFAR), UNAIDS, the U.S. government and other corporate organizations. Through this three-year commitment, Merck will work with Susan G. Komen for the Cure to support the initiative to raise awareness about the burden of breast and cervical cancer, mobilize additional partners and work towards increased access to cervical cancer screening, treatment for women and HPV vaccination of appropriate girls in sub-Saharan Africa.
In July 2012, Merck announced, through its partnership with Susan G. Komen for the Cure, that it will support the African Center of Excellence for Women’s Cancer Control. Activities supported, in coordination with local NGOs, the Zambian government, the US government and PRRR partners, include the scale up of breast and cervical cancer education to increase knowledge and awareness and reduce stigma throughout Zambia. Merck will also support the Zambian Ministry of Health’s plans to conduct an HPV vaccine demonstration project across the province of Lusaka by donating 180,000 doses of GARDASIL to vaccinate 25,000 eligible girls over two years, and will provide technical support for the program.
In April 2011, Merck began providing GARDASIL to a first-of-its-kind cervical cancer program in Rwanda, including both HPV vaccination and HPV DNA testing. Merck has committed to provide over 1.4 million doses of GARDASIL over the three-year program. This program was made possible by a collaboration established in 2009 between Merck and QIAGEN, the leading global provider of sample and assay technologies, to increase access to HPV vaccination and testing. This initiative marked the first time a vaccine manufacturer and a molecular diagnostics company have collaborated to address the burden of cervical cancer in one comprehensive approach. As part of the program, which Merck worked on closely with the Government of Rwanda, more than 96% of targeted girls were vaccinated with the full three doses of GARDASIL in 2011 and 2012.
Commitment to Support HPV Vaccine Introduction
Beginning in 2006, Merck partnered with the international nonprofit organization, PATH, to provide GARDASIL for the conduct of post-licensure HPV-vaccine demonstration projects in Peru, Vietnam and India. GARDASIL was provided to vaccinate approximately 30,000 appropriate girls participating in HPV Vaccines: Evidence for Impact demonstration projects. The overall initiative was designed to strengthen the capacity of developing countries to prevent cervical cancer by generating and providing necessary evidence for public sector introductions of HPV vaccines, informing global advocacy efforts and providing analyses to help accelerate access to HPV vaccines. The projects suggest that high coverage with HPV vaccines can be achieved through various delivery strategies in the countries studied.5
Additionally, through the charitable GARDASIL Access Program, Merck has donated more than one million doses of GARDASIL for use in smaller-scale HPV vaccination projects in eligible lowest-income countries around the world. The program has enabled organizations and institutions to gain operational experience designing and implementing HPV vaccination projects, with the goal of supporting the development of successful child and adolescent immunization models. In light of changes in the global health funding landscape, and after consultation with various stakeholders, it was decided that, as of August 2012, the GARDASIL Access program will no longer award doses to new projects. However, Merck’s full donation commitment of at least three million doses of GARDASIL will be honored, and options for how remaining doses of GARDASIL could be used are currently being explored. Experiences and lessons learned from past and current Program participants will continue to be disseminated to the public health community by Axios Healthcare Development, a U.S. non-profit organization, which manages the GARDASIL Access Program. Learn more about the GARDASIL Access Program and this development.
5 LaMontagne et al, Bull World Health Org 2011.
Last Updated July 30, 2013