It is being discussed again whether the HPV vaccine will be included in Turkey's National Immunization Program. Previous Minister of Health Fahrettin Koca and current Minister Kemal Memişoğlu announced that the vaccine would be administered free of charge. However, Memişoğlu stated on August 15, 2026 that Turkey's HPV rates and HPV-related cancer profile are different from other countries and that scientific evaluations are continuing.
SCIENTIFIC EVIDENCE AND TRANSPARENCY
Epidemiological data should of course be taken into account, and health policies should be based on scientific evidence. However, if it is said that "Turkey's HPV profile is different", the data showing this should be shared with the public: Which studies, which sample? Which HPV types? Which cancer incidence? What cost-effectiveness analyses? Health policies cannot be established with the sentence "Some scientists said so." Data, methods, evidence and transparency are required.
As it is known, HPV is one of the important causes of preventable cancers. Approximately 99 percent of cervical cancers are HPV-related and largely preventable with vaccination, screening and treatment. The World Health Organization defines the elimination of cervical cancer as an achievable public health goal. HPV is also associated with cancers of the vulva, vagina, penis, anus and mouth and throat. Therefore, it is important for girls and boys to be vaccinated together.
According to 2019 estimates, HPV caused cancer in approximately 620 thousand women and 70 thousand men. In a study examining samples taken from 4 thousand 267 women in Ankara between 2017 and 2020, HPV16 was detected at 2.4 percent, HPV18 at 0.7 percent, and other high-risk types at a rate of 8.8 percent in total. According to the current data of the Ministry of Health, approximately 70 percent of cervical cancers in Turkey are related to HPV16 or HPV18.
Of course, it is necessary to examine data specific to Turkey. However, the claim of a different HPV profile does not by itself mean that the vaccine is unnecessary.
VACCINATION, SCREENING AND TREATMENT
WHO's strategy to eliminate cervical cancer, namely the 90-70-90 target; It envisages that 90 percent of girls by the age of 15 will be fully vaccinated against HPV, 70 percent of women will be screened with high-performance tests at the ages of 35 and 45, and 90 percent of women diagnosed with the disease will have access to appropriate treatment.
This approach; It treats vaccination, screening and treatment as parts of the same preventive health chain. Turkey's need is an integrated preventive health policy. We don't have to choose between vaccinating a child today and screening a woman tomorrow; both are necessary.
INEQUALITY IN HEALTH
Today, one of the most important factors determining access to vaccines is economic power. Families who can afford to vaccinate their children can vaccinate their children; families who cannot afford it are forced to wait, postpone or give up in the face of a preventable risk.
However, protecting a child against cancer cannot be a consumption choice. Health care cannot be distributed based on purchasing power. The right to health is not only having access to treatment when sick, but also having equal access to services that will prevent getting sick. The responsibility of the state is to provide preventive health services to everyone, regardless of income level.
The HPV debate also brings up the issue of gendered priorities in health policies. I wonder if the majority of these cancers were seen in men, would it be accepted as easily to leave an effective vaccine for years and debate whether it should be included in the national immunization program? We cannot know the exact answer, but this question needs to be asked.
LANGUAGE BASED ON SEXUALITY
Another important dimension of the HPV debate is the language based on sexuality. HPV is a sexually transmitted infection. But this knowledge should not be turned into a moral framework that controls women's sexual lives or holds them responsible for disease.
To protect a girl from HPV, there is no need to control her future sexual life, but to ensure her right to health today. The main purpose of recommending vaccination during adolescence is to provide protection before encountering HPV.
The right approach to HPV is not to scare, blame or moralize; to provide accurate information and make preventive health services accessible.
We do not fulfill our social responsibility by portraying the female body as the carrier of the risk of disease and telling women, "You should get scanned, get checked, protect yourself." The responsibility of protection, like many other burdens, should not be left solely on women's shoulders; Men, families, the education system and the health system should also be part of this responsibility.
It is also wrong to define HPV vaccination as a service specific to women. Vaccination of boys both protects them from HPV-related diseases and contributes to the reduction of HPV circulation in the society. Our goal should be to protect girls and boys together.
IS PREVENTABLE TREATMENT A PRIVILEGE?
Scientific knowledge in the world also supports this approach. There were no deaths due to cervical cancer in the 20-24 age group in England between 2020-2024. Researchers estimate that the vaccination program will prevent around 200 deaths by the end of 2024. For those vaccinated at the age of 12-13, the risk of dying from cervical cancer before the age of 30 decreases to almost zero.
While we have the ability to prevent preventable cancer, are we going to leave health care a privilege still tied to purchasing power? Turkey's need is a health policy that protects girls and boys against HPV, includes vaccines free of charge in the National Immunization Program, carries out vaccination and screening together, and makes access to health services independent of income level.
Women's health is not an area that is more controversial because it is less important. Health is a right. HPV vaccine should be free and included in the National Immunization Program as soon as possible.
DAMZE BURCU GÜL
DENTIST
