Sandalia Genus is a PhD student in Social Anthropology at the University of Edinburgh. She has an MA and BSc. in Anthropology. For her MA, she conducted qualitative research on the human papillomavirus (HPV) vaccine in North America. Her PhD research will continue the focus on this pharmaceutical product and examine the provision and promotion of the HPV vaccine to girls in Tanzania as a national HPV vaccination program is implemented across the country.
The HPV Vaccine in Tanzania: Immunological Promise in an Unequal World?
This paper will explore prospective research examining the promotion and provision of the human papillomavirus (HPV) vaccine Gardasil in Tanzania. Gardasil protects against two strains of sexually transmitted HPV that cause 70% of cervical cancer cases. Worldwide, cervical cancer kills a quarter of a million women yearly with poor and marginalized women disproportionately afflicted by the disease, due largely to a lack of access to medical care and for some, vulnerability from the Human Immunodeficiency Virus (HIV) infection. Gardasil is viewed as an effective prevention against ever increasing cases of cervical cancer around the world. Tanzania has one of the highest rates of cervical cancer in the world and Merck, the manufacturer of Gardasil, has donated 3.6 million doses of the vaccine to be distributed in Tanzania from 2011 to 2014 in order to vaccinate girls aged 9 to 13, the most widespread HPV vaccination program in the 'developing' world. The introduction of Gardasil in Tanzania raises questions for society, health policy, vaccine users and communities. The vaccination program reconfigures the meaning of bodily healthy and anticipates that all Tanzanian women are equally at risk for cervical cancer. This vertical intervention ignores broader social dimensions, such as class, violence and a lack of comprehensive medical care, which affect the prevalence of cervical cancer in Tanzania. Future ethnographic research will trace the heterogeneous “social life” of Gardasil as it is provided in Tanzania in order to demonstrate how Gardasil is understood and discussed in different contexts. This paper will review the debates around vertical interventions, the political economy for young women in Tanzania and the role of corporations, charities and non-governmental organizations in determining the health care priorities of less 'developed' nations. The paper will also explore future research in Tanzania, looking at research questions, field sites, methodology and ethical considerations.