Australia could become first country to eradicate cervical cancer

Jeff Bezos semi-famously worded this as "Good intentions don't work- mechanisms do".

It has always seemed like Malthus simply made the mistake that a logistic function looks a lot like an exponential function early on during a transition to a new equilibrium.

Maybe he was saying that a decrease in fertility had to be an explicit goal, without realizing that decreases in fertility could be a side effect of other social developments.

> I think this shows that a technical solution trumps social solutions. If Australia had relied on telling children not to have unprotected sex, the HPV rate would not have moved much. Now, a simple vaccine is eradicating cervical HPV.

We know telling people to not have sex doesn't work (this is what most people hear, and for many young people is functionally the same, as don't have unprotected sex).

We have HSV, high teenage pregnancy rates, etc in countries that have pushed those approaches as would-be solutions.

Taking a very specific case of trying to suppress young human sex drive with words, and extrapolating that to the general case around technical hacks versus knowledge and informed decision making is a bit disingenuous.

And 'simple' vaccine?

We just last week got rid of the deputy Prime Minister who, at the time this was being debated (debated!) claimed that the proverbial 'some people' didn't like the idea of giving their twelve year old daughters a licence to be promiscuous. I shit thee nay.

Or in other words solutions that are applied have a possibility of working. The solution of no genital contact with others isn't inferior, it wasn't applied.

I find it interesting that, AFAIA HPV is a sexually transmitted disease but that, certainly in the UK, healthcare professionals seemingly lie (by omission at least) in order to further vaccination.

Also, that insistence on screening seems likely to have been a major cause of widespread infection (eg https://obpmedical.com/resource-center/blog/non-sexual-trans...), though I've never heard of this from a major news outlet?

It amazes me that until 2016 it seems no-one bother to check that sterilised reusable gynaecological instruments were actually sterile, mind-blowing.

Immunizing every child seems like a social solution to me.

Making the vaccine free is a social solution. Getting people to subsidize the vaccine is inherently political.

>>We need more "fire and forget" solutions. If we want to save our environment and slow down global warming, we need solutions that at most require people to do something relatively painless 1 time.

Yeah, make sure to let the world know when you figure out what that solution is, because it will win you Nobel Prizes in multiple categories.

> Malthus made a big deal how people should have fewer children and the population still grew.

The demographic transition long predates the pill. The pattern was marry early, have children all through marriage, marry late, have children all through marriage, marry late, show obvious signs of controlling fertility. The first definite case of the demographic transition is 1800s France.

And while Malthus was right as a historian, he was wrong as a futurist. Things have been getting better worldwide since the Industrial Revolution even as population increased.

I don't know that your conclusion really follows. Technical progress rarely happens in completely isolation form social mechanics. Things like government funding for research, subsidies for deploying or developing particular renewable energy technologies, and even the environment in which private innovative companies operate are entirely influenced by the government which in turn is ultimately influenced by social action. You're discussing a very particular kind of social action.

  If Australia had relied on telling children not to have unprotected sex, the HPV rate would not have moved much.

But HPV is only one of many infections that use unprotected sex as a vector. The one danger of this kind of policy-making is giving children an illusion of being protected from adverse effects of unprotected sex in general without combining it with advocacy of protection.

And yet we’re surrounded by complex social solutions to large problems: democracy, money, rule of law, families, religion, insurance, traffic lights, meat inspectors, patents, contracts, etc etc

The fact that Australia is close to achieving this, while many other countries are far off, also points at social factors playing a role. The vaccine works the same everywhere.

I learn great many things in this forum. If you find my comment below as an effort of trolling, it is not. I wanted to ask this question every time I see this idea of

> how vaccines and tech are decreasing population.

If it is statistically and empirically true, then it probably is true.If people smarter than me by any measure agree with it, then it probably is true after,all.

That said:

I don't doubt that, it works in a first world nation. But third world , at least India is a different thing, people like to have two kids around here, because it looks whole some. It doesn't matter what the financial situation is , people like to have at least two kids in India(I don't have any metric for it,just a casual observation). What if people see their kids don't die out of diseases and could take food ,education,electricity,clean water and clean air and a good public transport for granted and now want to make more babies? The decrease of population if you pump these resources seems counter intuitive to me. I am not suggesting if Bill Gates should pull out of Africa, I am just not getting the logic here.

Not amazing at all to me, considering that they are completely different populations.

The youngest subject at the start of that window dropped out of that population 7 years ago (3 years before the last survey). The figure doesn't count cures, or even reduced transmissions, among the original subjects.

That said, I find the quoted statistic suspect. First of all, the first vaccine wasn't even licensed until 2006, and there wasn't a vaccine that addressed more than 4 of the cancer-causing subtypes until 2014[0]. Second, they only targeted girls of age 12-13 (although they provided free vaccinations on manual request through age 19), leaving out girls in the upper 70% of the age range altogether from the survey population.

So, I don't take those numbers at face value, although I don't debate the safety or efficacy of these particular vaccines, being genetics-based. It's the profiteering by the planned-obsolescence model of the manufacturers that bothers me. If you're a parent and you followed the public-health experts' recommendations, and you wanted the full (nonavalent vaccine) functionality, you would have given a three-injection treatment of the bivalent spanning 6 months, then (later) a three-injection treatment of the quarivalent spanning 6 more months, then another cycle of the nonavalent vaccine... giving the manufacturers a lot of money out of your public health budget and a proof-of-concept for the drug companies to do this in lots of other vaccines and drugs in the future.

[0] http://apps.who.int/iris/bitstream/10665/255353/1/WER9219.pd...

Human papillomavirus vaccines: WHO position paper, May 2017

Same (possibly different ages) in Canada (Alberta at least), it's not mandatory, but offered in school, and most people go with it.

Australian parents lose their childs tax benefits if they refuse vaccination, it's an enormous incentive (thousands per year) for the average wage earner.

The article seems to not mention this.

Sadly it still doesn't stop entire communities of well-off antivaxxers forming, these particular areas are now ravaged by whooping cough outbreaks, a disease that was almost eliminated ten years ago.

Texas tried to make it mandatory in 2007, under Gov. Rick Perry no less. Unfortunately, a combination of anti-vaxxers and social conservatives sunk this initiative using a combination of innuendo and shaming. In 2011 [1], one observed the shameful debacle of him reversing himself while begging for votes for his first presidential run.

Nowadays, Texas shows up in the news for the converse reasons: alarming growth in maternal mortality during childbirth [2].

[1] https://www.washingtonpost.com/politics/rick-perry-reverses-... [2] http://time.com/5088014/maternal-mortality-pregnancy/

>... works best if given prior to any sexual activity,...

Not entirely correct. The HPV vaccine works best in the young for the best immune response. If I were a 40 year old virgin and wanted the shot, the vaccine probably wouldn't be effect as my immune system would not respond.

Yes the shot should be administered before sexual activity, and it just happens the best immune response happens in these youngish teenage years, far earlier than a lot of parents are comfortable.

This is as much a marketing press release as an interim report on the efficacy of HPV vaccinations. For the points you mention as well as the 70+ lifespan ahead of vaccine recipients.

90% is still a ginormous reduction over 0%. And as with most communicable diseases, once their incidence falls below a certain threshold, they fail to spread in effective numbers to keep themselves alive.

From your second article:

> There is some evidence that the bivalent and quadrivalent vaccines already provide some protection against additional strains of HPV. A recent paper in Clinical and Vaccine Immunology reporting on the clinical trial for Cervarix reported that the vaccine is more than 96 percent effective against disease associated with strains 16 and 18, and more than 50 percent effective against diseases associated with any HPV strain.

There are network effects in disease transmission. In order to catch a disease, not only do you have to be susceptible, but you have to catch it from someone. If you cut the risk of contracting HPV by 90%, then not only has the chance of a vaccinated person contracting the disease gone down by 90%, but the chance that an unvaccinated person will come in contact with a carrier goes down by 90%. Eliminate all the most prevalent strains and provide some protection against the remainder, and you can cut the virus's ability to replicate itself below the threshold needed to sustain itself in the population. Same reason that anti-vaxxers can get away without vaccinating their kids for measles as long as they don't come in contact with too many other unvaccinated people.

Please re-read your first link. "Most HPV infections of the cervix are cleared rapidly by the immune system and do not progress to cervical cancer (see below the Clearance subsection in Virology). Because the process of transforming normal cervical cells into cancerous ones is slow, cancer occurs in people having been infected with HPV for a long time, usually over a decade or more (persistent infection)." 1) Not every person with HPV gets cervical cancer. 2) Many people will get into a monogamous relationship, it will not spread further. 3) It is not necessarily spread in every sexual encounter.

Therefore eradication is definitely possible.

The spread of infectious disease is a dynamics problem, as is eradication.

It doesn't require 100% effective vaccines nor 100% coverage of vaccines to wipe out an infectious disease, typically it requires far less.

Break it down to the simplest terms. On average in an environment where nobody has immunity to disease an average infectious person will spread the disease to N other people, this is the "basic reproduction number" for that disease. If that number is more than 1 then in a simple model more people will get the disease over time, the disease has the ability to spread. If that number is less than 1 then fewer and fewer people will get the disease over time, leading eventually to eradication.

If you introduce immunity into the situation via vaccines then you change the whole scenario. If, an infectious person has a chance to infect some number of people but now most of those people are immune, the disease won't spread to them, it'll instead only spread to some of the people in the non-immune subset. Meaning that the effective reproduction number is reduced. And if that number is reduced below 1 due to immunization then on average the disease won't spread, it will die out. Infectious diseases rely on luck, and we can hurt their luck substantially with mass immunization programs. All that matters is pushing that effective reproduction numbers across the line from above 1 to below 1, and then ordinary population dynamics will play their part. This is how "herd immunity" works. It doesn't require 100% of people to be immune, it just requires enough immunity to flip the switch between a disease that is commonly circulating in the bulk of the population (measles, polio, HPV, etc.) to one that does not circulate and only a very small number of individuals may have at any time.

I believe they are discussing eradication of the HPV virus, which the article states causes 99.9% of cervical cancer.

We do have proof of humanity once before successfully eradicating a virus, namely smallpox: https://en.wikipedia.org/wiki/Smallpox#Eradication

They're talking about eradicating all reservoirs of HPV, akin to what several countries have successfully done with rabies. The headline is perfectly accurate.

It does sound too good to be true. But in this case, it is true.

HPV is probably the best example that exists of an infection being linked practically 1:1 to a cancer. See more information here[1].

If you have knowledge of any other significant sources of cervical cancer, please share them.

1. https://www.cancer.org/cancer/cervical-cancer.html