URC Designs HPV Vaccine Trial to Combat Cervical Cancer in Mongolia

Through the Implementation Support for Noncommunicable Diseases and Injuries project, URC supported the Mongolian government’s efforts to introduce the human papilloma virus (HPV) vaccine and combat the country’s high incidence of cervical cancer: Mongolia has the highest incidence of cervical cancer in Eastern Asia. The HPV vaccine has proven effective in preventing up to 70 percent of cervical cancer cases.

The project, which is funded by the Millennium Challenge Corporation, worked with the Millennium Challenge Account Implementing Unit and the Ministry of Health’s National Center for Communicable Diseases (NCCD) to design and implement an HPV vaccine trial. The trial vaccinated more than 9,000 girls ages 11–15 and reached 65 percent of the target population. This success makes the case for incorporating HPV vaccination into the country’s national immunization campaign.

Mongolia’s Cervical Cancer Burden

HPV is the leading cause of cervical cancer, one of the most common forms of cancer among women. Although treatable, it causes high levels of mortality and morbidity, especially in developing countries. Only 5 percent of Mongolia’s cervical cancer cases are detected at stage 1, contributing to a five-year survival rate below 35 percent.

Current detection rates indicate that Mongolia’s cervical cancer incidence is 10–20/100,000 persons, but evidence from short-term screening campaigns suggests the rate may be 30–60 times higher. This possibility points to a high rate of undiagnosed (and untreated) disease and to the need to improve early detection and treatment at the primary and secondary care levels. Also needed are better strategies to combat HPV, such as the HPV vaccine, which has proven effective in preventing up to 70 percent of cervical cancer cases.

The HPV Vaccine Trial

NCCD, which is responsible for the nation’s immunization program, led the trial with support from public and private schools and local health providers. URC helped NCCD develop the vaccine program and plan and organize the trial, including selecting locations and ensuring that the necessary infrastructure was in place. We also advised on the development of training materials for health care providers and educational materials for the girls, their parents, and their teachers. The Axios Foundation donated almost 6 million dollars’ worth of the vaccine (over 44,000 doses) through the Gardasil® Access Program, which enables organizations in low-income countries to gain operational experience designing and implementing HPV vaccine projects.

Vaccination teams administered the three-dose vaccine at schools in four selected districts (Selenge, Umungovi, Baganuur, and Bayangol) in 2012 . The teams typically included a family practitioner/ doctor, one or two vaccinators, a nurse, a school doctor, and a school social worker. NCCD provided the vaccinators with all the necessary supplies while local health centers or schools provided additional supplies, such as soap, masks, cotton swabs, and pain relievers.

Date 
November 07, 2013
Authors 
Kerrianne Monahan, URC Project Coordinator, and Niambi Wilder, URC Communications Specialist
Regions/ Countries