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HPV Vaccination in Nicaragua: Pushing a Priority or Setting an Agenda?

Added on -2019-09-21

The Foundation plans to create a special fund to accelerate uptake of innovative technology to prevent, detect and treat cancers of the cervix in low- and middle-income countries. Nicaragua was selected as an initial investment site for an HPV vaccination campaign. Learn about the relevance of economic evaluation and decision analysis approaches in public health policy making with the case of HPV vaccination in Nicaragua.
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Pushing a priority or setting an agenda? HPV vaccination in NicaraguaIntroductionThe following case is one option of two cases that will inform live session discussions and course homework assignments due in live sessions 5, 6, 7 and 9. You should review the following learning objectives, case narrative and additional resources before live session 2. Additional guidance for each of the homework assignments will be provided and reviewed during the upcoming live sessions.Learning objectives of case and related course assignmentsUnderstand the relevance of economic evaluation and other decision analysis approaches in the broader context of public health policy makingUnderstand the types of costs and health effects considered in an economic evaluation of vaccinesUnderstand how to apply the basic principles of an economic evaluation to a real-world decisionproblem: cost the intervention, measure the health effects, generate an incremental cost-effectiveness ratioUnderstand how to reflect or deal with uncertainty in an analysis planDevelop an understanding of different simple modeling approaches for economic evaluations (Markov and decision tree)Case noteA large philanthropic organization has joined the global health community in a pledge to significantly reduce death and suffering due to cervical cancer among women by 2050. The philanthropic organization plans to create a special fund from its multibillion dollar endowment to accelerate uptake of innovative technology to prevent, detect and treat cancers of the cervix in low- and middle-income countries (LMIC), where 81% of cervical cancer cases occur. The new Fund for Cervical Cancer Control (F3C) has not been announced publically yet. However, the organization (called Foundation from here forward) has initiated talks with governments selected as pilot sites. Cervical cancer is the consequence of long-term, persistent infection from human papillomavirus (HPV), the most common viral infection of the reproductive tract. There are 13 known high-risk HPV cancer-causing types of the more than 100 genotypes. Two of these types, 16 and 18, are responsible for 70% of cervical cancers and precancerous cervical lesions. Additional risk types have links to cancers of the anus, vulva, vagina and penis as well as genital warts. For the Foundation’s CEO, the global prevalence ofhigh-risk HPV is more than a concerning statistic. She lost her eldest daughter to a persistent HPV infection that went undetected and progressed to late-stage cervical cancer in her early 30s.According to the World Health Organization (WHO), more than one million women globally are currentlyliving with cervical cancer. High-income countries have successfully reduced the cervical cancer burden among women with large-scale routine screening to ensure early detection and treatment of pre-cancerous lesions of the cervix. Weak health systems plagued by scarce investment in much of the rest of the world have limited the reach and effectiveness of screening programs. In addition, the prohibitive

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