In the early 1990s an Australian medical research team headed by Dr Ian Frazer at the University of Queensland made an amazing breakthrough in the fight against cancer. Dr Frazer's team created a vaccine for one of the most aggressive cancers amongst women. We are now all familiar with it as Gardasil, the name given it by Merck, the drug company behind the project.
Final trials of Gardasil show it to be 100 per cent effective against the most common strains of human papilloma virus (HPV) which cause an estimated 70 per cent of cervical cancers. This, I repeat, is exciting medical research, the first successful vaccine against any form of cancer.
My enthusiasm is tempered by misgivings, however, when I consider the nature of the disease and how the remedy will be dispensed. I don't want to sound like a grumpy old man, but the facts of this medical discovery have to be seen against the social background of the need for the vaccine.
The genital HPV in question can only be transmitted through sexual contact. Therefore, the vaccine is only relevant for people who have sexual contact outside of marriage, or for those who marry partners who have had such contact and who might bring the virus into the marriage relationship. Aside from the possibility of being assaulted by an HPV carrier, no one else who leads a sexually moral life needs to be at risk of this particular cause of cervical cancer.
Incidentally, although the vaccine protects against cervical cancer, it does not protect women from many of the other common STDs, such as chlamydia, gonorrhoea, hepatitis B or HIV/AIDS.
Starting this year, however, the Australian Commonwealth government is funding an HPV vaccination programme for all girls and women aged 12 to 26. The rationale is that the vaccine is most effective when given before a woman becomes sexually active, and the cost is expected to be around $436 million over the next three years.
To a school principal struggling to provide the best possible education for his students, half a billion dollars is a lot of money. But money is not my concern. What troubles me is that the vaccination programme for girls is to be delivered through schools, and we have been informed that Emmanuel College will be among the first to participate. We have been press-ganged into this technical strategy for addressing a moral problem.
An unnecessary gamble
It is not even clear how necessary mass vaccination is. Sigrid Fry-Revere, Director of Bioethics Studies at the Cato Institute, recently wrote in the New York Times expressing doubts about the vaccination programme in the state of New York, where all girls from 11 years old are to be vaccinated. She said:
"Gardasil is not all it's cracked up to be. A recent study published in the Journal of the American Medical Association found that among women aged 14 to 24, the rate of all 37 types of sexually transmitted HPV combined is 33.8 percent — much lower than the 50 percent figure quoted on Merck's web site. More important, the rates for HPV 16 and 18 – the two types responsible for 70 percent of all cervical cancers – are astronomically lower: only 1.5 percent and 0.8 percent, respectively…
It's worth noting that the American Cancer Society sees its fight against cervical cancer as a success story even without Gardasil. When the disease is detected early through Pap testing, the survival rate is more than 90 percent." (NY Times, March 25, 2007)
Fry-Revere also questions the wisdom of government committing an entire generation of young women to exposure to a drug which is still very new, and whose long term side effects we cannot possibly know. But even if it turns out to be as safe and effective as the drug companies say, how safe will it be for our children's moral character?
Here in Queensland, Australia — and there is strong support at our national government level — state school canteens are required by law to restrict the sale of pies and chocolate because they "might" (not "will") make some children fat. Every school in the nation must, by law, display a poster listing the Commonwealth Government's list of Values in Australian Schools. We must display a poster advising that we subscribe to something called the national "Safe Schools Framework". To fail in these things is to risk losing Commonwealth funding support for our schools.
'No' costs less – in every way
Am I the only one who sees an inconsistency here? Our society seems to be unwilling to teach young people to say "no". When it comes to something as insubstantial as a meat pie, we legislate to prevent young people engaging in "risky" behaviour. When it comes to life-threatening, socially and emotionally damaging sexual behaviour, we develop "safe sex" programmes which encourage immoral behaviour, and then spend billions of dollars protecting them from the harmful results of that behaviour.
The HPV virus is a public health problem. But, given the moral issues involved, instead of arranging mass vaccinations though schools, a better solution would surely be to make the vaccine available at no cost through a local medical practitioner for those who wish to take advantage of it.
There has been no thought to the invidious position in which this mass programme places a school principal. He or she must tell a 12 year old girl that she ought to have a vaccine which cannot be guaranteed to have no side effects, in order to protect her from the liberal sexual contacts that we expect her to have. As a school principal, I would rather tell my students about the values of living a chaste life until marriage, and that during the next few years I expect them to engage in academic work, sport and music.
As an educator and as a parent, I believe firmly in the principle of teaching young people from an early age to say "no" to things that may harm them. Only then will our young people refuse to get into cars with drunk or irresponsible drivers, or participate in other peer-encouraged risky behaviour. We repeatedly see tragic news stories of bereaved parents blaming the police, the Prime Minister, the roads, the government, the schools and so on because their child died in a tragic speed chase by a police car, or in a drug overdose. How often do we hear a parent admit that they fell down on the job of forming the character of their child?
I am well aware that no-one is perfect, and "There but for the grace of God, go I". But surely there is a place for schools which teach young people that responsibility can be spelt "response-ability". The Hollywood set might regard drug intervention as a reasonable safety-valve for their immoral and personally faithless and superficial lifestyle. In my school we expect more of our students.
Each of us is capable of making a response to each and every life situation. How we respond is usually our own choice. The safest choices have high price tags at the time of making the choice — we risk friends, popularity, "a good time". The wrong choices have extraordinarily high price tags at the end of the line: illness, relationship failures, crippling financial costs, quadriplegia and even death.
In my school, it is my intention not to give up requiring children to make choices. And then to wear the cost of having made the choice. It used to be called being a good parent. I have a sneaking suspicion that most of our parents support this approach.
Graham Leo is the principal of Emmanuel College on the Gold Coast of Australia.