If it’s hard to sell a potentially dangerous vaccine in the U.S., take it on the road

 

Perilous export

Jeannette Kagame, the First Lady of Rwanda, is thrilled. Merck has promised to donate two million Gardasil doses to the government of Rwanda over the next three years. And you can’t blame her. More Rwandan women die from cervical cancer than any other cancer.

But if she genuinely believes that millions of Gardasil doses will solve her country’s cervical cancer crisis, she should brace herself for a huge disappointment and make sure her country has a solid system for reporting adverse events.

Just a few days ago, Ms. Kagame told the press, “Starting this week, thousands of young Rwandan girls and women will have an opportunity to live their lives without the threat of what has been a potentially fatal illness.”

The heartbreaking reality is that young girls and women who receive the vaccine WILL still live with the threat of the potentially fatal illness. They just won’t know it.

As I’ve mentioned many (many) times, Gardasil is designed to prevent HPV, the virus that can cause cervical cancer. But its effectiveness remains largely unproven. And since no vaccine is 100 percent effective, some of the girls will still contract HPV, and some may develop cervical cancer. Others will discover that cervical cancer can occur without any HPV infection at all.

In other words, Gardasil does not create a magic cocoon that repels cervical cancer.

From what we know about Gardasil, we CAN predict that some of those girls currently being vaccinated may endure a living hell of side effects that could include seizures, muscle spasms, paralysis, pelvic pain, joint pain, vision loss, hair loss, enlarged liver, migraines, painful menstruation, and slurred speech.

What’s far worse, of course, is that some may die. But their families will probably never suspect that the miracle vaccine from America could be to blame.

Making a slow buck

Meanwhile, Merck is setting up a nice little revenue stream.

They start by donating two million doses. Each dose costs about $130 each, so that’s $260 million total. Do you suppose there’s the slightest chance that there will be a tax break figuring into this humanitarian act?

And I can’t help but wonder if there’s any chance, with Gardasil sales dipping, those two million doses are nearing their expiration dates and need to be used quickly.

But here’s the most important question: What happens in three years when all two million doses have been delivered?

Mark Feinberg, Merck’s vice president of medical affairs and policy, told Reuters that when the three-year introductory period is over, Rwanda is committed to paying for the vaccine at a “dramatically” reduced price.

I guess we’ll have to wait to find out just how dramatic that price reduction really is. But for now, the word that jumps out is “committed.”

What exactly is Rwanda’s commitment? Have they signed, say, a 10-year contract? If so, what happens in three years, or five years, or 10 years, if cervical cancer rates are still high, and dozens of young women are experiencing horrible side effects? Will Rwanda still be obligated to purchase bulk quantities of Gardasil every year?

Feinberg told Reuters that Merck is in talks with other African countries about setting up similar vaccine programs. I just bet they are! As long as Merck reps are in Africa, they might as well stick around and generate as many bulk-purchasing customers as possible.

There is one genuine plus in Rwanda’s new cervical cancer prevention program. Qiagen, a German diagnostics firm, is making a donation of 250,000 HPV tests. Now THAT donation could actually make an important difference because diligent testing is the best way to prevent and successfully treat HPV.

Too bad it’s a package deal. If Rwanda could take the HPV tests and pass on the vaccine, they would start reducing cervical cancer risk today without putting hundreds of thousands of young girls at risk.

Sources:
“Merck, Qiagen launch Rwandan cervical cancer deal” Reuters, 4/25/11, health.yahoo.net
“Rwanda: First Lady Leads Campaign Against Cervical Cancer” Edwin Musoni, All Africa, 4/27/11, allafrica.com