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Health Officer Says Health Care's Future is in Prevention, Not Treatment

Posted on: Tuesday, 17 April 2007, 21:00 CDT

EDMONTON (CP) - The future of health care is rapidly changing, with vaccines and preventive treatments on the horizon for everything from diabetes to heart disease, says Canada's longest-serving medical officer of health.

To keep up, governments will have to drastically change how they think about health-care funding - and the first test will be how they fund a vaccine that could help wipe out cervical cancer, says Dr. John Blatherwick, who has served as Vancouver's medical officer of health since 1984.

Blatherwick is strongly in favour of the HPV vaccine, which targets some of the strains of a virus that can cause cervical cancer.

He says he's going to do everything he can to make sure it's being given to girls in British Columbia starting this September.

"For me, it's one of the next big leaps in public health - that we can actually prevent a cancer," he said after a talk to public health officials in Edmonton.

Critics of the vaccine have decried it as too expensive. But Blatherwick says once it's being given on a mass scale, the price will drop.

And he says the money that various levels of government have spent on preparing for a possible influenza pandemic would be better served going to such preventive treatments.

It isn't logical, he said, "to spend millions of dollars on a treatment that we don't even know is going to work for the influenza, if it comes."

"The capsules will melt in five years - so the stock in British Columbia now has 2½ years left and it will all have melted.

"It just shows the wrong direction."

Colleagues have told him to just accept the funding, since any government money is good, he said.

"Well, government should give us money for things that are necessary, that are proven, and make a difference," he said, adding he'd spend the money on the HPV vaccine, AIDS prevention, and supervised injection sites.

Blatherwick admits that the HPV vaccine isn't perfect. He acknowledges critics who say no one knows how long protection will last and that it won't be easy to administer the three doses at the appropriate intervals.

"It'll take a while for us to actually find out whether it's working," he said. "Let's face it, this is one of those long-term faith things."

But it's such leaps of faith that lead to concrete changes in people's lives, he said.

"There's some other things they're looking at that perhaps can be prevented. There's a lot of things in diabetes that we're looking at - can we find alternatives to people injecting themselves every day?"

Similar advances are coming in heart disease, with doctors studying whether an underlying "inflammatory cause" can be isolated and treated.

"There's a whole list of things that people are playing around with, and I think that will be the future," he said.

Often the effect of these preventive treatments takes 20 years to show up, and there's often no guarantee, Blatherwick conceded.

Canada's National Advisory Committee on Immunization has recommended the HPV vaccine be given to all girls between age nine and 13 before they become sexually active.

The committee said females aged 14 to 26 should also be vaccinated, even if they are already sexually active or have had previous Pap smear abnormalities or a previous HPV infection.

The federal government announced in its recent budget that $300 million would be provided to provincial and territorial governments to enable them to introduce cervical cancer immunization programs.

But according to an article in the Canadian Medical Association Journal, treating the five million Canadian girls aged nine to 13 would cost over $2 billion just for the vaccine, so other sources of funding will be needed.

Jean Riverin, a spokesman for the Public Health Agency of Canada, agrees with Blatherwick that the fact that the vaccine has only been tested for five years isn't a reason to avoid funding it immediately.

"What's important is that now there is something available to fight cancer for a good period," he said.

Source: Canadian Press

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