Raising Women’s Voices

Gardasil for boys and men?

Posted in Sexual health by raisingwomensvoices on March 27, 2009

There is currently debate over Gardasil, the vaccine that protects against certain strains of HPV proven to cause cervical cancer, being endorsed for use in boys and young men.  The vaccine has been available to girls and women ages nine and over since its FDA approval in 2006 and, in December 2008, Merck applied for FDA approval for use in boys and men ages nine to 26.  In men, Gardasil would aim to protect against genital warts and less common cancers, such as penile, anal, throat and mouth, that HPV can cause.

As the Washington Post reports, the discussion “illustrates the complex interplay of political, economic, scientific, regulatory and social factors that increasingly influence decisions about new types of medical care.”  The decision is primarily being based on a cost-benefit analysis of endorsing the vaccine, priced at $500 for a series of three shots, for both males and females.  The CDC committee overseeing the issue will meet again in June to review the findings.  The centrality of cost effectiveness, as opposed to public health benefits, in the decisionmaking is a point of controversy in itself.

Gregory Zimet, a professor of pediatrics and psychology at Indiana University, said that although the cost-effectiveness studies are “really important,” he does not believe they should be the “sole driver of public health policy.” He said Gardasil “principally benefits women’s health,” adding, “I wonder if it was the reverse, and there was a vaccine for women that helped prevent prostate cancer in men, this would be as much of an issue.”

For more in-depth analysis of the issue, see The Daily Women’s Health Policy Report.

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The Human Right to Health

Posted in Uncategorized by raisingwomensvoices on March 27, 2009

Ipas, an international sexual health and reproducive rights organization, believes that health care advocates and reform activists can find support for their work in the principles underlying health as a human right.

Accordingly, Ipas, in collaboration with the National Economic and Social Rights Initiative, the National Health Law Program, the National Latina Institute for Reproductive Health and the National Asian Pacific American Women’s Forum, published a new fact sheet on The Human Right to Health and Women’s Reproductive Health Policy.

Health has been recognized as a human right by the UN Commission on Human Rights since 1994.  While not all of the standards outlined by the UN are legally binding in the United States, they provide a conceptual framework for advocates in the field.  The right to health requires that health services, goods, facilities and the underlying determinants of health be available, accessible, acceptable and of good quality, equally to everyone.  The factsheet applies the UN framework for the international right to health to  women’s reproductive health policy:

Reproductive health facilities, goods and services, including trained medical professionals, medicines, and underlying determinants of health, must be adequately available to all women within a country. Policies that result in fewer abortion providers, such as onerous facilities requirements, curtail the right to health for women. Also, where providers are allowed to refuse to provide contraception or abortion, effectively making these services unavailable to certain women, a woman’s right to health is violated. According to the CEDAW Committee, in such places, policies must be in place to ensure that women are referred to alternative providers willing and able to provide contraceptive and abortion services.

• The same facilities, information, goods and services must be accessible to everyone without discrimination. Accessibility must be a reality in law and in fact, particularly for the most marginalized groups. For example, comprehensive reproductive health services must be accessible to everyone, regardless of socioeconomic status, race, national origin, language ability, immigration status or sexual orientation and gender identity. Services must also be physically accessible for everyone, with a focus on vulnerable groups such as older women, women in prison or detention, women with disabilities and women who live in rural areas. Economic accessibility is an essential component of the right to health. Reproductive health services such as contraception, prenatal care and abortion must be affordable to all. Policies such as the Hyde Amendment, which bans abortion funding, disproportionately affect particular groups of people, such as poor women of color, who are unable to afford certain reproductive health services. Therefore, their right to health is violated. The government also does not fulfill the right to health in situations where poor women lack health insurance, and health care is, in effect, inaccessible. Information on reproductive health issues must also be accessible to all. Policies that restrict information on condoms for adolescents, for example, violate the right to health. 

• Reproductive health services must be acceptable to all women, particularly those who are outside the dominant culture. Policies must ensure that reproductive health services are culturally competent and acceptable according to the needs and perspectives of particular communities. To fulfill the right to health of immigrant communities in the United States, policies must ensure that the health-care workforce is culturally competent and able to work in a language that women they serve can understand. Policies must also ensure that reproductive health services are confidential.

• Health facilities, goods and services must be of good quality and based on evidence where it is available. To generate appropriate evidence to improve quality, research on health care must better include women, children and people of color. One example of poor quality is is the funding of pregnancy prevention programs that are limited to abstinence-untilmarriage messages despite evidence that such programs fail to achieve their objectives.