In 2010, MSD and the Australian Cervical Cancer Foundation (ACCF) partnered with the Royal Government of Bhutan to establish the first ever national HPV vaccination program in a lower-middle-income country (LMIC). MSD donated GARDASIL^®  [Human Papillomavirus Quadrivalent (Types 6, 11, 16 and 18) Vaccine, Recombinant] for the first year of the six-year program and over 130,000 doses were administered, with approximately 90% of eligible 12 to 18-year-old females receiving the complete regimen. After the first year, ACCF provided partial financial support to the Royal Government of Bhutan to secure doses of GARDASIL at the access price offered by MSD.

Today, Bhutan continues to demonstrate one of the highest coverage rates for HPV vaccination in the world and it is beginning to demonstrate impact. A recent publication revealed that among women younger than 27 years who were targeted by the vaccination program, the overall and indirect adjusted vaccine efficacy was 93% (CI, 87% to 97%) and 88% (CI, 69% to 95%), respectively. No impact on nonvaccine HPV types was detectable. (Baussano, Tshomo, et al).

Bhutan continues its global leadership in HPV vaccination. The Bhutan Ministry of Health has also expanded HPV vaccination for males, became one of the very first LMICs to do so and has shown high coverage rates in par with their female program.