Aprender com o Ruanda

GENEBRA – Como é que o Ruanda, um dos países mais pobres do mundo – e ainda a recuperar de uma guerra civil brutal – consegue proteger as suas raparigas adolescentes contra o cancro mais eficazmente do que os países do G-8? Depois de apenas um ano, o Ruanda relatou vacinar mais de 93% das suas raparigas adolescentes contra o vírus do papiloma humano (VPH) – de longe, a maior causa do cancro do colo do útero. A cobertura da vacina nos países mais ricos do mundo é variável, mas em alguns locais é inferior a 30%.

De facto, a baixa cobertura nos países mais ricos do mundo não deveria provocar grande surpresa, especialmente se considerarmos as características demográficas daquelas que não estão a ser vacinadas. Quando disponíveis, as provas sugerem que estas são principalmente raparigas no escalão mais baixo do espectro socioeconómico – muitas vezes membros de minorias étnicas sem cobertura de cuidados de saúde. Isto implica que aquelas que estão em maior risco não estão a ser protegidas.

É uma história conhecida, consistente com o padrão global para esta doença terrível, que ceifa uma vida a cada dois minutos: as que mais necessitam de protecção são as que têm menor acesso a ela. Das 275.000 mulheres e raparigas que morrem de cancro do colo do útero todos os anos, 88% vivem em países em desenvolvimento, onde as taxas de mortalidade podem ser 20 vezes mais elevadas que em França, Itália, ou nos Estados Unidos. Isso não acontece apenas porque as vacinas não estão disponíveis: é também porque as mulheres nestes países têm acesso limitado à triagem e ao tratamento. Sem prevenção, não terão opções se ficarem doentes.

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