HPV vaccine and contraceptives in the MDG fight

85% of the approximately 285 women who die annually from HPV-induced cervical cancer are found in the developing countries of the world. Unsafe abortions and risky births are estimated to claim the lives of 000 and 47 women each year. Only 000-300% of women in developing countries have access to long-acting contraceptives, writes the government's ambassador for global health, Anders Nordström, due to two new, global launches of HPV vaccines and long-acting contraceptives in the work to reach MDG 000 and 1.

Today, 70% of the world's poor are estimated to be women. Living as a woman in a society with a lack of infrastructure and where access to education and health care is limited entails a number of risks. Among these are two that particularly seriously affect girls' and women's health, the risk of cervical cancer and the risk of unsafe abortions and deliveries.

Every year, about 285 women die from cervical cancer caused by the human papillomavirus (HPV). Of these, 000% live in developing countries where access to good healthcare and proper treatment is limited.

Similar figures apply to deaths due to unsafe abortions and risky births. Every year, an estimated 47 women die as a result of unsafe abortions, and in the case of risky births, just over 000 women are estimated to lose their lives each year. And today, only one to two percent of women in developing countries have access to long-acting contraceptives, which would drastically reduce these numbers.

Working for improved global health means a direct task to work for improved child and maternal health care. Millennium goal five establishes the importance of this work through the goal of having reduced maternal mortality by three quarters from the 2015 level by 1990. This is a major challenge that requires both preventive measures and initiatives to continuously improve the life situation for women's health.

For Sweden, the work is expressed in a number of different ways. Through development policy, money is channeled to country programs or multilateral organizations. Through global multilateral cooperation, normative work can be done to achieve improved knowledge and consensus regarding the importance of investing in the health of women and children.

To get there, it is necessary that several sectors work together and that all levels are involved. Efforts are needed both in the form of assistance, which contributes financially and materially, and in the form of people on site who work directly for an improved access to and knowledge of health care. At the same time as continuous work is being done to improve health care, it is equally important to look at the meaning of preventive measures. Health is a key to development and to achieve this, additional efforts and resources must be set aside.

In the spring of 2013, two major initiatives will be aimed at girls and women in developing countries. The work focuses on the two risk areas of cervical cancer and maternal mortality and focuses on preventive measures to achieve results. This involves the distribution of HPV vaccine to 180 girls in eight developing countries and long-acting contraceptives to 000 million women. Sweden is part of the initiatives through its collaboration with the Global Vaccine Alliance (GAVI) and the Bill & Melinda Gates Foundation.

The goal is for more than 30 million girls to be vaccinated against HPV by 2020. It would protect them from one of today's most common causes of death among women in developing countries.

The Global Vaccine Alliance (GAVI), one of Sweden's major recipients of multilateral aid, is now contributing on a pilot basis to the HPV vaccination of 180 girls aged nine to 000. The HPV vaccination will initially be implemented in eight countries (Ghana, Kenya , Lao, PDR, Madagascar, Malawi, Niger, Sierra Leone, Tanzania) and the idea is that more than 13 of the world's poorest countries will be involved in the project by 40. The goal is for more than 2020 million girls by 30 to be vaccinated against HPV. It would protect them from one of today's most common causes of death among women in developing countries.

The distribution of the long-acting contraceptive Jadelle also hopes to reach large dimensions. The collaboration between the pharmaceutical company Bayer HealthCare and the Bill & Melinda Gates Foundation hopes to result in the contraceptive being distributed to 27 million women in the world's poorest countries, at a 50% reduced price.

Sweden, through Sida, fully supports this work. The work is in line with Sweden's global work for improved Sexual and Reproductive Health and Rights (SRHR). The motto is that in order to succeed in achieving sustainable development, good health is a prerequisite. The question we must ask ourselves, however, is how our work is received by our recipients. In order to succeed in generating sustainable and credible collaborations, we must also include other aspects in the health work and consider the consequences that Sweden's and our partners' investments may entail.

Preventive measures such as HPV vaccinations and the distribution of contraceptives challenge deep-rooted social structures.

Preventive measures such as HPV vaccinations and the distribution of contraceptives challenge deep-rooted social structures. The HPV vaccine is a protection against the otherwise sexually transmitted virus, which in turn risks leading to cervical cancer. Both HPV vaccination and contraception thus signal freedom and rights. These are factors that in many of the world's countries are still not a matter of course. Carrying out this work therefore requires a certain amount of forethought. At the same time, it is equally important to remember that this work concerns girls and women's fundamental rights to good health.

These are questions that extend beyond social structures and outdated perceptions of women's limited right to and self-determination over their own bodies.

Nordström is different

Ambassador for Global Health

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