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Bush's Legacy -- Women's Health? Bush's Legacy -- Women's Health?

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Bush's Legacy -- Women's Health?

Former U.S. President George W. Bush:Taking on women's health in Latin America and Africa;

photo of Margot Sanger-Katz
September 13, 2011

In his first big initiative since leaving the White House, former President George W. Bush announced the launch of a major public health project on Tuesday, one focused on providing cancer screening and treatment for women in the developing world, possibly including HPV vaccines to prevent cervical cancer.

The timing couldn’t have been more ironic--Rep. Michele Bachmann, R-Minn., made headlines on Monday night when she criticized the HPV vaccine during the GOP presidential debate. But Bush’s initiative has been in the works for some time.

The program will build on structures that were established during Bush’s administration to test and treat patients for the AIDS virus. With $10 million from the State Department, private funds, and donations of medicine, the Pink Ribbon Red Ribbon program will use existing clinics in Africa and Latin America to offer screening and treatment for cervical cancer. It will also educate women about breast cancer. Between public and private sources, the Bush Institute has secured $75 million in pledges for the project.

 

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Both makers of HPV vaccines have signed on. Merck announced it will donate $3 million and 3.6 million doses of Gardasil, which is enough to fully protect 1.2 million girls. GlaxoSmithKline, which makes a similar vaccine called Cervarix, pledged enough doses to vaccinate 10,000 girls. The program doesn't call for vaccination yet, but instead will focus on screening and treatment.

As president, Bush established the President’s Emergency Plan for AIDs Relief, or PEPFAR, with a budget of $48 billion to fight AIDS, tuberculosis, and malaria in its first five years. So far, the program has paid for AIDS drugs for more than 3.2 million people, and prevention counseling for tens of millions more. This initiative builds on that record by using existing clinics and providers to tackle another public-health challenge for similar populations.

Bush announced the initiative as part of a global health summit in Washington. Partners in the program include PEPFAR, the Joint United Nations Program on HIV/AIDs, and the breast cancer advocacy group Susan G. Komen for the Cure.

Cervical cancer is caused by the sexually transmitted human papillomavirus (HPV), and HIV-positive women are four to five times more likely to develop the cancer and are more likely to develop aggressive cases. Dr. Eric Bing, the director of global health for the Bush Institute, said that the organization has chosen to focus on cervical cancer because it is a major public health concern that can be cheaply easily addressed through the existing PEPFAR clinics.

“We have effective and feasible treatments for cervical pre-cancer all over the place,” Bing said.

 In the U.S., women are tested for abnormal cells using the Pap test, which studies show has reduced deaths from the disease by 99 percent in screened populations. Clinicians funded by the program will use a less expensive test that is still able to catch early signs of cancer. The goal, according to the institute, is to lower the rates of cervical cancer death by 25 percent in screened and treated populations.

Clinicians in the developing world will be able to do less for patients at risk for breast cancer, but the program will also support patient education about breast-cancer detection and treatment. “In some ways, where we are in breast cancer in many of these places is where we were with HIV many years ago: The infrastructure isn’t there,” Bing said.

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