In 2023, the glaring absence of the HPV vaccine in India’s National Immunization Program stands not just as a mere oversight but as a monumental failure—a testament to the colossal disregard for women’s health in our supposedly progressive nation. It’s more than a lack of awareness; it’s a systemic neglect, a cultural blindfold suppressing our fight against cervical cancer—a battle that demands urgent, unyielding attention.

According to the 2023 report1 by The International Agency for Research on Cancer (IARC), approximately 511.4 million Indian women aged 15 and older face the risk of developing cervical cancer. Annually, 123,907 women receive a cervical cancer diagnosis, and tragically, 77,348 succumb to this disease.

80% of cancers caused by the Human Papillomavirus (HPV) could be prevented through the HPV vaccine. Globally, a significant number of cancer cases, tallying 570,000 in women and 60,000 in men, are directly linked to HPV, afflicting predominantly low and middle-income countries. In Asia4 alone, nearly half of these global HPV-related cancer cases—275,429 in women and 29,324 in men—loom as a dark shadow of concern.

Zooming into India’s reality, a country housing one-sixth of the world’s population, the distressing truth emerges: Cervical cancer ranks as the second most frequent cancer among Indian women aged 15 to 44. It contributes a staggering 25% to the global burden of disease in terms of mortality and morbidity. These aren’t just statistics; they are blaring emergency sirens indicating our indifference. 

The situation exacerbates when we confront the absence of HPV vaccines within India’s National Immunization program. These crucial vaccines remain locked behind the gates of private prescriptions, available only from age 9 and priced exorbitantly at around INR 3,000 per dose. Misinformation clouds the truth about their safety and efficacy, while cultural biases act as significant roadblocks to their adoption.

This contrasts starkly with the global strategy outlined by the World Health Organization (WHO) to eradicate cervical cancer as a public health menace. The WHO envisions a plan where 90% of girls receive vaccination by age 15, 70% of women undergo biennial screenings, and 90% of diagnosed women receive adequate treatment. However, the reality in India remains starkly different, with only opportunistic screenings offered within the National Programme for Prevention and Control of Cancer, Diabetes, Cardiovascular Diseases, and Stroke (NPCDCS).

Let’s unmask the culprit—the Human Papillomavirus (HPV), the insidious root of this preventable menace. It stealthily prowls the reproductive tracts globally, infecting a staggering majority at some point in their lives, yet public awareness and advocacy for the HPV vaccine remain shockingly muted. The HPV family hosts over 150 viral genotypes, of which are identified as high-risk or carcinogenic. Persistent infections, coupled with lifestyle factors, fuel over 90% of cervical, anal, oropharyngeal, penile, vaginal, and vulvar cancers.

In response to these stark statistics, a groundbreaking online petition spearheaded by the Her Adhikaar Foundation and the distinguished medical doctor, Dr. Tanaya—also known as Dr.

Cuterus—has rallied almost 30,000 signatures. Notably, this campaign has garnered endorsements from a diverse spectrum of Members of Parliament in India, transcending political affiliations.

Esteemed MPs like Dr. Amar Patnaik of Odisha, Sanjeev Arora representing Ludhiana, Supriya Sule from Baramati, and Dr. T Sumathy based in Chennai have thrown their weight behind this cause. Their collective backing underscores the urgent need for a comprehensive nationwide strategy to combat cervical cancer effectively. This petition isn’t mere symbolism; it’s a direct plea to Minister of Health and Family Welfare, Mansukh Mandaviya.

In India’s battle against cervical cancer, past initiatives have been commendable but insufficiently impactful. The 1975 launch of the National Cancer Control Program was an earnest attempt, yet cervical cancer rates persist. The evolution into the expansive National Program for Prevention and Control of Cancer, Diabetes, Cardiovascular Diseases, and Stroke (NPCDCS) in 2010 signified a broader approach, addressing lifestyle factors like smoking, diet, and alcohol consumption. Despite these strides, screening deficiencies persist, and late-stage diagnoses continue to plague our health systems.

Additionally, the Indian Ministry of National and Family Welfare introduced a specialized mobile technology platform in 2016 dedicated to cervical cancer screening. This innovative
platform aimed to strengthen support and monitoring for screening programs in every state of India. However, despite the government’s multifaceted efforts, screening coverage remains inadequate nationwide, revealing inefficiencies within the system.

Within India’s cultural fabric, inclusion of the HPV vaccine in the national immunization program faces an uphill battle, entrenched by deep-rooted taboos and societal norms. Taboos regarding premarital sex, sexual orientation, and sex work create formidable barriers, seemingly rendering crucial interventions impractical. These cultural intricacies perpetuate stigma around sexual health and women’s autonomy, amplified by patriarchal structures and skewed birth sex ratios. This landscape intensifies the battle against HPV and cervical cancer, leaving women not only grappling with societal shame but also encountering discrimination, notably within healthcare settings when seeking support for their sexual and reproductive health rights. 

The prevailing lack of awareness about cervical cancer in communities, exacerbated by societal taboos surrounding sexual activity, hinders parental willingness to vaccinate their children against HPV. Many perceive the vaccine as unnecessary for sexually inactive youth, fearing it might inadvertently encourage promiscuity. These deep-seated perceptions act as obstacles to HPV vaccine awareness, compelling an urgent need for government intervention to foster acceptance

The integration of the HPV vaccine into the national immunization program signifies more than just a healthcare upgrade—it symbolizes a pivotal cultural transformation, breaking down taboos and safeguarding the well-being of women across India. This petition isn’t a mere document; it’s an impassioned call for a future where women are liberated from preventable diseases. It demands immediate action to place women’s health at the forefront of our national priorities.

It’s a resounding voice advocating for justice and equitable healthcare. It envisions a future where cervical cancer isn’t a fatal sentence but a preventable concern. The time has come to acknowledge the urgency of this preventive measure and empower women with access to life-saving vaccines.