Ian Frazer: The man behind the HPV vaccine

“RUBBISH!” IS Prof. Ian Frazer’s succinct reply to a question on whether he gives credence to claims linking vaccines to autism. A transplanted Scotsman who moved to Australia in 1980 to pursue further studies in viral immunology, Frazer is blunt and outspoken, and gives short shrift to superstitions or unfounded myths regarding health, especially women’s health and particularly cervical cancer.

When I tell him that my daughter found the injection of HPV vaccine (which protects from infection from the virus that causes majority of cervical cancer cases) quite painful afterwards, he looks at me skeptically and remarks: “Well, ask her if she wants to get cervical cancer instead.”

Frazer’s stance is understandable. He is, after all, the leader of the team based in the University of Queensland that developed the HPV vaccine, the second cancer-preventing vaccine (after the Hepa B vaccine which prevents hepatitis B that has been linked to liver cancer) and the first vaccine designed to prevent a cancer.

In fact, asked what makes him happy these days, Frazer breaks into a smile and says that it’s the fact that “60 million women have been immunized in the past four years around the world.” That’s no small accomplishment: protecting 60 million women from the second biggest cancer killer of women in the world today. It also means saving them from what many physicians describe as a “slow and painful death,” one which toward the end results in social isolation and shame.

And yet, despite its being what Frazer calls “a rare consequence of a common infection,” around the world one woman dies every two minutes from cervical cancer, most of them in developing countries. In the Philippines, it’s estimated that 12 women die from cervical cancer each day, with one in three dying within one year from diagnosis.

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FRAZER’S VISIT was courtesy of the Australian Embassy in observance of May being Cervical Cancer Awareness Month.

During his visit, Frazer and his wife visited the site of an outreach program in Muntinlupa (sponsored by the city government and Mayor Aldrin San Pedro, the Cervical Prevention Network or Cecap, the Department of Health and the Australian Embassy) in which some 70 women were screened for cervical cancer, and he talked before groups of medical practitioners and concerned lay people on cervical cancer prevention and care. He also introduced the film “Catching Cancer,” which explores the many tantalizing links between infectious agents (bacteria and viruses) and certain types of cancer.

In the 1970s, a German immunologist by the name of Harald zur Hausen first proposed the link between HPV and cervical cancer, which went against the grain of dominant scientific thought at that time. It took more than 10 years for zur Hausen and his team to definitively establish the link between two types of HPV—16 and 18—and cervical cancer, and in 2008 zur Hausen received the Nobel Prize for Physiology and Medicine.

In 1980, Frazer became intrigued “by the body’s defenses against infection,” mainly the susceptibility of people living with HIV to anal cancers. Moving to Australia which was on the cutting edge of immunologic research, Frazer was led to further study “chronic infection with viruses,” asking himself, “What is actually going wrong with our immune systems?” This in turn led him to study HPV since it is a “persistent infection” of HPV that leads to cervical cancer. HPV infection itself, he observes, is very common and most women’s immune systems would be able to spontaneously get rid of the infection without need of treatment.

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IT WOULD take Frazer and his colleagues some 15 years to finally develop and test the HPV vaccine, which now comes by two brand names Gardasil and Cervarix.

The vaccine, says Frazer, should be made available to “all women who want it” and so far, he adds, China is the only country in the world that has yet to license the vaccine, most probably because Chinese scientists are trying to develop their own versions of the vaccine.

“No woman should have to die of cervical cancer in the 21st century,” Frazer declared at the “Catching Cancer” forum held at the Edsa Shangri-la. The scientific and medical community has already gathered the body of knowledge needed to prevent and treat the disease before it becomes fatal. What is now needed is “to evaluate the effect of programs on the ground.” The “burden” of cervical cancer deaths and disease, after all, has yet to be significantly eased in “low resource” countries, with vaccination out of reach to most women because of cost, and screening inaccessible because of flawed health systems.

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IT WAS for this reason that in 2007 Frazer left his lab and classrooms in Australia to work on research and dissemination studies in the island-nation of Vanuatu, where one in 10 women has cervical cancer.

Depicted in the film, Frazer joined a team of researchers and nurses to provide screening to women in Vanuatu to determine the most cost-efficient method to adopt in their setting, and then to bring vaccination programs to schools and communities. When one community refused to have their daughters vaccinated, Frazer seemed to take it in good humor, asserting that it was right for people to demand for more information first before taking “a group of strangers” at their word.

For the moment, said Frazer, they are looking forward to developing a “therapeutic” vaccine that could cure those already with persistent HPV infection, as well as vaccines for diseases like dengue. The world’s hope is that he pursues these goals with the same tenacity and spirit of inquiry that led him to the HPV vaccine and to saving women’s lives.