Universal HPV vaccination - a global prerogative

Worldwide cancer incidence is increasing, with viral infections including human papillomavirus (HPV) responsible for a significantly higher number of cancer deaths in low- and middle-income countries (LMICs) when compared to high income countries. Globally, in 2015, there were 72 national HPV vaccination programmes, and 39 demonstration or pilot programmes. Despite HPV’s impact on both sexes, for examples in malignancies such as oropharyngeal cancer (whose incidence is increasing across the world) few countries have a gender-neutral vaccination policy. Herd protection and cost-effectiveness are important considerations in potential extension of vaccination to males and while there is some suggestion that a targeted vaccination programmes for “high risk” groups, such as men-who-have-sex-with-men (MSM) may be preferable, a universal vaccination approach is the best solution to protect both men and women from HPV-related cancer and sexually transmitted disease. Higher incidence of certain HPV-related male cancers, lack of effective treatment, high prevalence of HIV, attitudes to MSM and sexual orientation, all support a universal vaccination strategy for LMICs. Thus, policy-makers and healthcare providers in LMICs need to take timely decisions to “prevent the preventable” by providing vaccination for both girls and boys.