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Will GiveWell fund HPV vaccination to prevent cervical cancer by 1st January 2027?

Main Draft
23rd Oct
Josh Hart
Josh Hart 13:57

GiveWell has recommended grants to over 10 charities over the years. They are currently investigating 12 charity areas with other areas of research in the pipeline including HPV vaccination to prevent cervical cancer.

The following sections are quoted from GiveWell’s explanation of the topic.

“Cervical cancer kills approximately 300,000 women per year and is thought to require infection of the cervix with specific types of human papillomavirus (HPV). The burden of cervical cancer is greatest in sub-Saharan Africa, but also substantial in the Pacific islands, Southeast Asia, Eastern Europe, the Caribbean, and parts of South America.

At least 14 HPV types can cause cancer.2 Expert opinion suggests that the most common cancer caused by HPV is cervical cancer, and nearly all cases of cervical cancer are caused by sexually transmitted HPV.

Estimates based on a cancer surveillance database suggest that, globally, cervical cancer is typically fatal, but it is more often fatal in low-income countries than high-income countries. These data also suggest that, globally, the average age of cervical cancer diagnosis is 53 and the average age of death is 59.

 WHO and the US Centers for Disease Control and Prevention (CDC) recommend two doses of HPV vaccine for girls 9 to 14 years old.

[GiveWell] did not identify compelling direct evidence that the HPV vaccine reduces the risk of developing cervical cancer or dying of it; however, indirect evidence from randomized controlled trials (RCTs) provides strong evidence that HPV vaccination of women who are not already infected with high-risk HPV strains reduces the risk of developing precancerous changes of the cervix by approximately two thirds. A modeling study based on the effect of vaccination on HPV infection risk, which we draw from in our cost-effectiveness analysis, also suggests strong protection against cervical cancer. Given the link between HPV infection, precancerous changes of the cervix, and cervical cancer incidence and mortality, we believe this constitutes fairly strong evidence that HPV vaccination reduces the risk of developing cervical cancer and dying of it.

Under our default assumptions, HPV vaccination in the average country of the WHO African region is within the range of cost-effectiveness of programs [GiveWell] would consider recommending funding, but vaccination in other regions is below that range.