Rapid growth of seaweed biotechnology provides opportunities for developing nations

591 10. Tao, L. et al. J. Clin. Exp. Pathol. 26, 397–401 (2010). 11. WHO Global Health Observatory Data Repository. (2012). 12. China National Health and Family Planning Commission. (2012). 13. Yip, W.C. et al. Lancet 379, 833–842 (2012). 14. Le Deu, F., Parekh, R., Zhang, F. & Zhou, G. Healthcare in China: Entering uncharted waters. (McKinsey & Co., 2012). 15. Insinga, R.P., Dasbach, E.J. & Elbasha, E.H. Pharmacoeconomics 23, 1107–1122 (2005). 16. Balabanova, D., McKee, M. & Mills, A. (eds.) ‘Good Health at Low Cost’ 25 Years On: What Makes a Successful Health System? (London, London School of Hygiene and Tropical Medicine, 2011). China’s healthcare spending is projected to grow from $357 billion in 2011 to $1 trillion in 2020 (ref. 14). We would argue that semi-mandatory HPV vaccination to initially cover low-income communities with high burdens of cervical cancer would be a good use of the resources made available in the healthcare reform package9,10,12,13. If the price of HPV vaccines continues to be prohibitory, a semi-mandatory vaccination strategy may also be attractive to other developing countries with a large HPV burden, such as India. It has been estimated that direct medical costs for HPV-related diseases are at least $4 billion annually in the United States15. We believe these costs are much higher in China owing to the much larger population and higher burden of HPV-related diseases (Table 1). Accordingly, introducing HPV vaccines in China, sooner rather than later, will undoubtedly have an immediate and dramatic impact on public health. In this context, adoption of our semi-mandatory HPV vaccination strategy may provide one good example of how to achieve “good health at low cost” in developing countries16.