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22 However, current studies in under-resourced countries show that communities Resminostat are broadly supportive of national HPV vaccination programmes and do not share the widespread anxiety shown in the USA when the vaccine was first introduced.23 The studies found, however, that knowledge linking HPV to cervical cancer remains poor. It is possible, therefore, that without adequate information, opposition to the vaccine from parents and guardians will increase with the fear that the vaccine will lead to greater promiscuity among the immunised population.24 Successful introduction of the HPV vaccine in under-resourced countries depends, therefore, on a strong educational effort aimed at all members of the community, especially parents. The lack of systematic research about acceptability by the target population in under-resourced countries is critical, as it is in those under-resourced regions that a primary prevention campaign will have the greatest impact. The specific issue of the point and timing of delivery of the vaccine also needs to be carefully assessed. School-based delivery is often favoured for adolescent vaccination. However, in India find more the most practical approach. With regard to timing, the vaccine should be given before coitarche, which poses a problem in countries that have little or no data on the subject. At a cost of several hundreds of dollars for the three doses of each vaccine, HPV vaccines are among the most expensive vaccines on the market and this is likely to present a major barrier to introduction of the vaccine in under-resourced regions. Indeed, under-resourced countries may need to obtain prices as low as US$2 per vaccine to make immunisation an affordable operation.26 Different funding strategies for the HPV vaccine, such as bulk purchasing, tiered pricing and multidisciplinary partnerships will be essential in delivering the vaccine Selleckchem Baf-A1 to the populations in greatest need. The Pan American Health Organization Revolving Fund and UNICEF are on the frontline of tackling the issue of HPV vaccine availability for under-resourced countries. The Global Alliance for Vaccines and Immunisations (GAVI) is another global health actor and will most certainly play a crucial role in the delivery of HPV vaccines to under-resourced countries. Cervical cancer is a major cause of death among women in under-resourced countries. The emergence of new methods of prevention, however, provides hope for the future. Human papillomavirus DNA testing is an effective prevention tool, but is yet to be proven as a sustainable method.