Better spent elsewhere?

The Ministry of Health report 'Looking Upstream' gives an insight into how we die. High-ranking causes of death include poor diet (linked to 30 percent of deaths), smoking (linked to 18 percent of deaths) and physical inactivity (linked to 10 percent of deaths). Infectious diseases are comparatively low on the list.

Critics of our National Immunisation Schedule argue the money for the Gardasil campaign could be better spent elsewhere. For example, the Immunisation Awareness Society's Sue Claridge notes 52 out of every 100,000 women die from heart disease every year - while only 3 die from cervical cancer: "In regards to public health expenditure, there are way more important things than cervical cancer."

The Ministry says the comparison doesn't take into account years of life lost: "Most women who get cervical cancer are relatively young so years of life lost is greater than years of life lost to heart disease."

It's also argued that there are better ways of dealing with specific diseases like Meningococcal B and cervical cancer than immunisation. For instance, Meningococcal B is a disease associated with poor and over-crowded housing. So why wasn't $222 million spent on improving housing in South Auckland? Better housing would reduce the rate of Meningococcal B - and other infectious diseases.

WHO says that better nutrition, less crowded living conditions, the development of antibiotics and lower birth rates have all contributed to a reduction in the incidence of infectious diseases. However, it also says that vaccines have had a significant impact on keeping the rate of infectious diseases in check.

Can we fix it?

The size of a health issue is only one factor; our ability to fix it is another question altogether.

Improving our nation's diet is difficult. But if Gardasil is as effective as studies indicate, then reducing the rate of cervical cancer and genital warts may only take three jabs in combination with ongoing smear tests. That's why organisations like Family Planning have pressed for the vaccine.

Chiropractor Tat Loo disagrees. He says that with more effort improving our diet might be no harder than developing a vaccine. "Take into account that the procedures and systems for getting a new vaccine into schools are now well-established mechanisms. The mechanisms to get healthy food into our schools have comparatively much less investment and development, so of course it looks harder."

Paediatrician Diana Lennon agrees that better housing may have helped stop the Meningococcal epidemic - but it would've taken too long. Even the development of a vaccine took far too long: "My view was that the advocacy for action took so long that the actual decay of the epidemic had started to occur. So there were many unnecessary cases [of Meningococcal B] because of political and Ministry of Health intransigence from 1996 onwards."