“After just one year, Rwanda reported vaccinating more than 93 percent of its adolescent girls against the human papillomavirus (HPV) — by far the largest cause of cervical cancer,” GAVI Alliance Chief Executive Officer Seth Berkley writes in a Project Syndicate opinion piece, noting, “Vaccine coverage in the world’s richest countries varies, but in some places it is less than 30 percent.” He asks, “How is it that Rwanda, among the world’s poorest countries — and still recovering from a brutal civil war — is able to protect its teenage girls against cancer more effectively than the G8 countries?”

“Alarmingly, in some of the wealthy countries, where both screening and treatment should be readily available, vaccine coverage now appears to be declining, raising a real danger that socioeconomically disadvantaged girls there will face a similar fate,” Berkley writes. Though “[i]t is still not clear why this is happening,” he continues, “Whatever the reason, unless coverage for all three doses increases, cervical cancer and pre-cancer rates will increase.” Berkley adds, “So it is worth remembering that even in wealthy countries, there is an urgent need to overcome challenges in protecting the hardest-to-reach girls, who often are at high risk of HPV infection” (10/29).