Translating a sub-Saharan African countries' experience in human papillomavirus vaccination to a single dose regimen

Abstract

Background: Human Papilloma Virus (HPV) is a sexually transmitted virus that is known to cause different types of cancer including cancer of the cervix. Cancer of cervix is common among women and most of the burden is from SSA countries. Moreover, most of these countries are not yet having HPV vaccination programs while low coverage is seen in some few countries which already had the programs. WHO recommends two doses of the HPV vaccine are effective to prevent girls against the HPV infection. However, there are many studies currently being conducted to prove the effectiveness of a single-dose regimen. Objectives: The aim of this study is to identify the most common lessons learned in the HPV programs in SSA countries and conduct the budget impact analysis of a single dose regimen for HPV vaccination in Tanzania as a way to determine the future cost. Methods: This is mixed-method study with a qualitative part covers a literature review of both published and unpublished documents, and reports of HPV demonstration programs from SSA countries while the quantitative part involves budget impact analysis by using secondary data. Published documents were obtained from PubMedicine while unpublished documents were obtained from the WHO website, HPV Information Centre as well as the websites of the ministry of health of respective countries. Results: 22 key lessons were reported in seven specific focus areas which included national policy and planning, service delivery, workforce, linkage with other interventions, monitoring and evaluation, financial support, and sustainability and scale-up. We also found out that there were similar lessons across eight SSA countries that had finished the HPV demonstration project however, there was a variation of the strength of the lessons. The economic and financial cost for HPV vaccination in Tanzania was determined and it was estimated that country could save about 5,927,820.57 USD per year on an average from the year 2015 to 2020 as an economic cost if single-dose regimen was to be used. Conclusion: SSA countries with no experience in the HPV vaccination program and those with reported low coverage should take advantage of studying best practices from other SSA countries. Also, although still there is no enough evidence for the single-dose regime of HPV vaccination, SSA countries should be prepared to move to a single dose regimen once evidence is gathered as it would reduce the budgetary burden.