Poor nations are being lured into a debt trap

doi:10.1136/bmj.39563.529757.BE

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Jacob M Puliyel, consultant paediatrician and head of department,
Ashutosh Shrivastava, resident in paediatrics

¹St Stephen’s Hospital, Tis Hazari, Delhi 110054, India

puliyel{at}gmail.com

With regard to access to papillomavirus vaccine (Gardasil),1 let us assume that the vaccine covers all strains causing cervical cancer. In India 21m girls would have to be vaccinated each year to avoid 260 000 deaths at a cost for the vaccine alone of $8400m. The programme would have to be sustained for over 20 years. Even if it prevented all cervical cancers, it would reduce by only 2% the 10.9m deaths caused by infectious …