Uganda risks losing funding for cervical cancer vaccination, after the country failed to meet the targets required to qualify for national support from the Global Alliance for Vaccines and Immunisation (GAVI).
Developing countries like Uganda qualify to apply for national funding from GAVI if they are able to vaccinate more than 50 per cent of the eligible population.
For the Human Papillomavirus (HPV) vaccine, the eligible population are girls aged nine to 11, totalling about 580,000 in Uganda.
Gerald Mutungi, head of non-communicable diseases at the Ministry of Health said the government had vaccinated 25 per cent of the eligible girls.
GAVI committed the first $28.6 million funding round that kickstarted a nationwide vaccination programme against cervical cancer, after Uganda reached 80 per cent of the eligible girls in a pilot programme.
The HPV vaccine was introduced in the national routine immunisation programme in 2015.
GAVI’s website now shows it will end the support for the HPV vaccine in Uganda in 2020, two years ahead of that funding round’s timeline.
The organisation will also give less money for the HPV vaccine than had been committed.
Out of the money that GAVI had committed for the period 2001 to 2022 to Uganda’s HPV vaccination programme, $10 million has been withheld.
A perusal of the GAVI website suggests that discontinuation of funding is attributed to the underperformance of the HPV vaccination programme.
For the HPV vaccine to be effective, a girl has to receive at least two doses before she becomes sexually active.
The vaccine is most effective if girls receive three doses, but officials say that two are a good compromise.
Dr Mutungi said that the HPV vaccination campaign in Uganda has generally underperformed following the government’s decision to change the mode of delivery.
The first round of vaccination was done at schools. Health workers would visit girls at their schools to deliver the vaccine. But according to Dr Mutungi, this mode of delivery was terminated because it became too expensive.
Dr Mutungi said the government spend Ush110,000 ($29.2) for each health worker who left their work station to reach the girls at their respective schools.
In the second round of vaccine delivery, the government asked that the girls obtain their vaccine at health facilities.
Dr Mutungi said this strategy has not been successful, since most children this age fear injections and are unlikely to volunteer to take one.
The government is now experimenting with getting schools to transport the girls to health facilities instead of depending on the initiative of individual parents.
Failure to receive the vaccine means that girls who came of age, at a time when reduced prices of the HPV vaccine provided an opportunity to avoid contracting the leading cause of cancer deaths among women in Uganda, could now lose out too.
According to Dr Noleb Mugisha the head of the comprehensive community programme at the Uganda Cancer Institute, about 2,500 women die from cervical cancer every year in Uganda.
Information from the Ministry of Health shows that GAVI funds more than 95 per cent of Uganda’s immunisation programme.
Funding for the 2018/19 financial year will total Ush87 billion ($23.1 million).