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Fighting HPV in Bhutan

  • Posted 08.21.14
  • NOVA

Human papillomavirus, or HPV, can cause cervical cancer. Bhutan is the first developing country to welcome the widespread vaccination of girls against HPV, and cervical cancer rates have dropped. Some countries have resisted the vaccine, but in Bhutan even the royal princess is onboard.

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Transcript

Fighting HPV in Bhutan

Posted: September 5, 2014

NARRATOR: Far away, seemingly lost in time, is a place known for valuing the happiness and well being of its people.

The Himalayan Buddhist Kingdom of Bhutan has a unique way of life, measuring progress not by Gross Domestic Product but rather by Gross National Happiness—and treating disease with traditional remedies combined with modern medicines.

At school, children line up to pray to the God of Wisdom to help guide them in understanding.

But the lives of these children and their families are often interrupted by disease—cervical cancer is the biggest cancer threat to Bhutanese women.

Now there’s a way to protect these girls.

Australian scientist Ian Frazer spent 15 years developing the world’s first vaccine designed to stop a cancer. He and his wife Caroline have come to Bhutan, the first developing nation to embrace the vaccine. 

FRAZER: I have been working on a vaccine that can protect against a different sort of infection, an infection that can cause the cancer. This is a virus that doesn’t make you ill when you get it, but if you have the virus infection for a long time it increases your risk of getting a cancer. But we now have a vaccine. 

NARRATOR: The key is to vaccinate girls before they’re exposed to the virus. 

FRAZER: Cervical cancer is the consequence of an infection we catch through sexual intercourse. If you’re one of the unlucky 2% who can’t clear the infection then you’re at significant risk of cancer some time during your lifetime. 

Because cervical cancer is caused by an infection, we can use all the defenses that we normally use to prevent infection including vaccines, and we’re fortunate that we now have a very effective vaccine to help prevent about 70% of cervical cancer.

NARRATOR: The vaccine targets the virus that causes the cancer—known as HPV, or human papillomavirus.

It uses precise, state-of-the-art technology. Instead of delivering a weakened or dead form of the virus, it sends in a decoy. The outer shape resembles the real virus, but there’s no viral material inside.

This tricks the immune system into mounting the defense.

Preventing HPV infection not only stops cervical cancer—it can stop other diseases, like some oral and genital cancers. And today the vaccine is also being recommended for boys.

But with new vaccines, come new fears.

In Bhutan, the vaccine almost didn’t get the go ahead.

Two weeks before it was due to launch, a tragedy occurred next door in India, where every year, around 70,000 women die from cervical cancer.

TV JOURNALIST: In 2009, young girls in the tribal villages in the Khammam district were vaccinated with the HPV vaccine. Girls in the age bracket of ten to 15 years were targeted in remote villages, schools and hostels. And by the end of it, 14,019 girls had been vaccinated. But within six months, four of them died.

NARRATOR: There was a massive outcry. Thousands voiced their concerns about safety and ethics, and called on the government to halt the vaccine.

The story went viral, gaining global currency and power.

The four deaths were investigated.

It was announced that two girls died of poisoning, one of drowning, the fourth of a fever of unknown origin.

Few reported the new evidence.

FRAZER: What has happened to these immunized girls definitely has happened. They’re real events, but the evidence is that they are not associated with the vaccine.

NARRATOR: In 2010, the Indian government suspended the vaccine.

FRAZER: If even one of those deaths had been due to the vaccine, that would’ve been bad. No vaccine should kill someone. But the impact of not vaccinating the population of India is 70,000 cancer deaths a year.

NARRATOR: In Bhutan, the reports of the four girls’ deaths in India were examined at the highest levels, including the Royal Family.

After much consultation, the Bhutanese authorities chose to continue the rollout of the HPV vaccine. The threat of cervical cancer was too great.

ROYAL PRINCESS: We’re seeing many more cancer patients, and especially women, it’s very sad to see. It’s heartbreaking actually to see woman in their last stages and children near their bedsides. And I think it’s very important to do something about it.

Credits

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IMAGE:

Image credit: (Bhutan)
© WGBH Educational Foundation 2014

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