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Human Papillomavirus vaccine: one that can prevent a cancer

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This article has been written as a fervent plea to the parents of little girls of the eligible age group. Please make sure that your precious daughters get this vaccine. It will be an investment for their happiness in the future.

By Dr B. J. C. Perera

All vaccines by definition are substances that are used to stimulate immunity against a particular infectious disease or a specific causative organism. Such vaccines are used to prevent the occurrence of the said diseases in humans and animals. Several vaccines have been introduced to combat such infectious diseases over the last few decades. In some countries, the use of some of these vaccines has led to the elimination of dreaded diseases like Diphtheria, Tetanus, Whooping Cough or Pertussis, Polio, Measles, German Measles or Rubella, just to name a few.

Sri Lanka has a very efficient and inherently equitable system that looks after the Expanded Programme of Immunisation (EPI) for children and young people. In general, we have been extremely successful in this programme and can boast of over 90 per cent coverage for the vaccination of all children. We have successfully eliminated polio, the last case being confirmed as far back as 1993, and we are free of diphtheria, tetanus, measles and German measles or rubella. The success of the EPI is due to many factors that include government commitment, the unstinted dedication of parents, the promotion of the programme through all media channels and the dedicated work of all grades of healthcare personnel. The very high literacy rate of the populace of our country enables all information regarding vaccination to be most conveniently conveyed to the population. Sri Lanka has been hailed as a country that has achieved so much in this field, but with so few resources. It has been cited as a model to the entire Asian region as well as even the world.

In addition to their undoubted effectiveness in protecting against infective microorganisms, some of these vaccines have other bonus effects. At least two of the vaccines in use today have telling effects in preventing certain cancers. One is the Hepatitis B vaccine. It provides protection against liver cancer. The other is the more recent Human Papillomavirus vaccine (HPV vaccine) which protects females against cancer of the neck of the womb, which is also referred to as the cervix of the womb. That disease is generally referred to as Cervical Cancer.

The Human Papillomavirus (HPV) is sexually transmitted and most people become infected sometime during their lifetime. In the majority, it is soon after becoming sexually active. Most infections are asymptomatic and usually clear up spontaneously, accounting for remission in 90% within two years. Only 10% of persistent HPV infections with certain genotypes of HPV can persist and progress to changes in the cervix. If infection from cancer-causing HPV types persists over 10-15 years, women can go on to develop precancerous lesions that, if left untreated, develop into cervical cancer. This process takes an average of 20-30 years from infection to the development of cervical cancer.

In 1995, Dr Anne Szarewski, a renowned researcher from the United Kingdom, led a team who outlined the role of human papillomavirus in uterine cervical cancer detection and screening. Then the researchers began work on an HPV vaccine. Szarewski was also a chief investigator, principal investigator and author of key HPV vaccine trials and publications, who helped to develop the bivalent HPV vaccine. The word bivalent is used to indicate that it contains two strains of HPV. HPV infections are very common, often with minimal symptoms, but high-risk HPV strains can go on to cause other medical conditions, particularly cervical cancer.

In 2006, the first vaccine for Human Papillomavirus (HPV) to be used globally was approved. HPV vaccination has now gone on to become a key part of the effort to eliminate cervical cancer. According to the available research results, HPV vaccination could reduce the lifetime risk of cervical cancer by 35–80%; the rather wide range being due to several studies with different methods. The vaccine was initially promptly snapped up in the West, especially in the Scandinavian countries. In Sweden, the coverage of the vaccine is over 80 per cent. However, according to the data put out by the World Health Organization (WHO) in November 2022, the human papillomavirus vaccine against cervical cancer has been introduced in just 41 per cent of low-income countries, even though they represent much of the disease burden, compared to 83% of high-income countries. We have a set of 10-year data on the benefits of the vaccine and in certain Western countries, a significant drop in the morbidity and mortality rates of cervical cancer is already evident.

In Sri Lanka, the National Vaccine Summit in January 2015 recommended the usage of the HPV vaccine and the government introduced it in 2017 for girls within the age range of 10 to 13 years. That age group was decided on the premise that to get the best results, we need to introduce the vaccine before sexual activity starts. The vaccine was to be administered to the selected age groups in the schools free of charge and in the fee-levying private sector. To date, the vaccine is not available through the Immunisation Clinics of the Provinces and the MOH Clinics.

NOW HERE IS THE REAL CRUX OF THE MATTER. For a variety of reasons, the coverage of the HPV vaccine in the entire cohort of eligible girls in Sri Lanka is somewhere between 30 and 40 per cent. This is woefully inadequate coverage to get the best possible results, especially when looked upon in the light of over 90 per cent coverage of the other vaccines in the National Expanded Programme of Immunisation. Cervical cancer ranks among the five commonest cancers in women in Sri Lanka. HPV vaccine is just one of two vaccines that can prevent cancers. All children have had the Hepatitis B vaccine which protects against liver cancer, as it is given through the National Programme of Immunisation. But, and this is a BIG BUT, the only other vaccine, the HPV vaccine that can prevent cervical cancer, shows a rather low uptake.

We do need to escalate the uptake rate of the HPV vaccine to at least around 80 per cent to get reasonable benefits in the reduction of the morbidity and mortality that is currently seen in cervical cancer. I think we have to admit that due to very many reasons, the message has not gone through to the general population in the country. When inquiries are made from the mothers of eligible girls, the vast majority of them are not even aware of the existence of this vaccine and more importantly, the future beneficial potential of this endeavour. The age group selected is a rather tricky cohort. They get upset at the drop of a hat. The last thing they want is an injection. They will run away, as fast as possible, to avoid it. Some are so frightened that it is not uncommon to see them faint even at the sight of the syringe and the needle. One way of getting the cooperation of these little girls is to allow either the mother or the father to be present to hold her hand most reassuringly when the vaccine is administered. An additional initiative would be to make it widely available through the Immunisation Clinics for it to be administered to all those who have missed it when it was given in the school. This is particularly important as the vaccine is quite expensive when administered in the private sector.



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Counting cats, naming giants: Inside the unofficial science redefining Sri Lanka’s Leopards and Tuskers

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For decades, Sri Lanka’s leopard numbers have been debated, estimated, and contested, often based on assumptions few outside academic circles ever questioned.

One of the most fundamental was that a leopard’s spots never change. That belief, long accepted as scientific fact, began to unravel not in a laboratory or lecture hall, but through thousands of photographs taken patiently in the wilds of Yala. At the centre of that quiet disruption stands Milinda Wattegedara.

Sri Lanka’s wilderness has always inspired photographers. Far fewer, however, have transformed photography into a data-driven challenge to established conservation science. Wattegedara—an MBA graduate by training and a wildlife researcher by pursuit—has done precisely that, building one of the most comprehensive independent identification databases of leopards and tuskers in the country.

“I consider myself privileged to have been born and raised in Sri Lanka,” Wattegedara says. “This island is extraordinary in its biodiversity. But admiration alone doesn’t protect wildlife. Accuracy does.”

Raised in Kandy, and educated at Kingswood College, where he captained cricket teams, up to the First XI, Wattegedara’s early years were shaped by discipline and long hours of practice—traits that would later define his approach to field research.

Though his formal education culminated in a Master’s degree in Business Administration from Cardiff Metropolitan University, his professional life gradually shifted toward Sri Lanka’s forests, grasslands, and coastal fringes.

From childhood, two species held his attention: the Sri Lankan leopard and the Asian elephant tusker. Both are icons. Both are elusive. And both, he argues, have been inadequately understood.

His response was methodical. Using high-resolution photography, Wattegedara began documenting individual animals, focusing on repeat sightings, behavioural traits, territorial ranges, and physical markers.

This effort formalised into two platforms—Yala Leopard Diary and Wild Tuskers of Sri Lanka—which function today as tightly moderated research communities rather than casual social media pages.

“My goal was never popularity,” he explains. “It was reliability. Every identification had to stand scrutiny.”

The results are difficult to dismiss. Through collaborative verification and long-term monitoring, his teams have identified over 200 individual leopards across Yala and Kumana National Parks and 280 tuskers across Sri Lanka.

Each animal—whether Jessica YF52 patrolling Mahaseelawa beach or Mahasen T037, the longest tusker bearer recorded in the wild—is catalogued with photographic evidence and movement history.

It was within this growing body of data that a critical inconsistency emerged.

“As injuries accumulated over time, we noticed subtle but consistent changes in rosette and spot patterns,” Wattegedara says. “This directly contradicted the assumption that these markings remain unchanged for life.”

That observation, later corroborated through structured analysis, had serious implications. If leopards were being identified using a limited set of spot references, population estimates risked duplication and inflation.

The findings led to the development of the Multipoint Leopard Identification Method, now internationally published, which uses multiple reference points rather than fixed pattern assumptions. “This wasn’t about academic debate,” Wattegedara notes. “It was about ensuring we weren’t miscounting an endangered species.”

The implications extend beyond Sri Lanka. Overestimated populations can lead to reduced protection, misplaced policy decisions, and weakened conservation urgency.

Yet much of this work has occurred outside formal state institutions.

“There’s a misconception that meaningful research only comes from official channels,” Wattegedara says. “But conservation gaps don’t wait for bureaucracy.”

That philosophy informed his role as co-founder of the Yala Leopard Centre, the world’s first facility dedicated solely to leopard education and identification. The Centre serves as a bridge between researchers, wildlife enthusiasts, and the general public, offering access to verified knowledge rather than speculation.

In a further step toward transparency, Artificial Intelligence has been introduced for automatic leopard identification, freely accessible via the Centre and the Yala Leopard Diary website. “Technology allows consistency,” he explains. “And consistency is everything in long-term studies.”

His work with tuskers mirrors the same precision. From Minneriya to Galgamuwa, Udawalawe to Kala Wewa, Wattegedara has documented generations of bull elephants—Arjuna T008, Kawanthissa T075, Aravinda T112—not merely as photographic subjects, but as individuals with lineage, temperament, and territory.

This depth of observation has also earned him recognition in wildlife photography, including top honours from the Photographic Society of Sri Lanka and accolades from Sanctuary Asia’s Call of the Wild. Still, he is quick to downplay awards.

“Photographs are only valuable if they contribute to understanding,” he says.

Today, Wattegedara’s co-authored identification guides on Yala leopards and Kala Wewa tuskers are increasingly referenced by researchers and field naturalists alike. His work challenges a long-standing divide between citizen science and formal research.

“Wildlife doesn’t care who publishes first,” he reflects. “It only responds to how accurately we observe it.”

In an era when Sri Lanka’s protected areas face mounting pressure—from tourism, infrastructure, and climate stress—the question of who counts wildlife, and how, has never been more urgent.

By insisting on precision, patience, and proof, Milinda Wattegedara has quietly reframed that conversation—one leopard, one tusker, and one verified photograph at a time.

By Ifham Nizam ✍️

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AI in Schools: Preparing the Nation for the Next Technological Leap

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This summary document is based on an exemplary webinar conducted by the Bandaranaike Academy for Leadership & Public Policy ((https://www.youtube.com/watch?v=TqZGjlaMC08). I participated in the session, which featured multiple speakers with exceptional knowledge and experience who discussed various aspects of incorporating artificial intelligence (AI) into the education system and other sectors.

There was strong consensus that this issue must be addressed early, before the nation becomes vulnerable to external actors seeking to exploit AI for their own advantage. Given her educational background, the Education Minister—and the Prime Minister—are likely to be fully aware of this need. This article is intended to support ongoing efforts in educational reform, including the introduction of AI education in schools for those institutions willing to adopt it.

Artificial intelligence is no longer a futuristic concept. Today, it processes vast amounts of global data and makes calculated decisions, often to the benefit of its creators. However, most users remain unaware of the information AI gathers or the extent of its influence on decision-making. Experts warn that without informed and responsible use, nations risk becoming increasingly vulnerable to external forces that may exploit AI.

The Need for Immediate Action

AI is evolving rapidly, leaving traditional educational models struggling to keep pace. By the time new curricula are finalised, they risk becoming outdated, leaving both students and teachers behind. Experts advocate immediate government-led initiatives, including pilot AI education programs in willing schools and nationwide teacher training.

“AI is already with us,” experts note. “We must ensure our nation is on this ‘AI bus’—unlike past technological revolutions, such as IT, microchips, and nanotechnology, which we were slow to embrace.”

Training Teachers and Students

Equipping teachers to introduce AI, at least at the secondary school level, is a crucial first step. AI can enhance creativity, summarise materials, generate lesson plans, provide personalised learning experiences, and even support administrative tasks. Our neighbouring country, India, has already begun this process.

Current data show that student use of AI far exceeds that of instructors—a gap that must be addressed to prevent misuse and educational malpractice. Specialists recommend piloting AI courses as electives, gathering feedback, and continuously refining the curriculum to prepare students for an AI-driven future.

Benefits of AI in Education

AI in schools offers numerous advantages:

· Fosters critical thinking, creativity, and problem-solving skills

· Enhances digital literacy and ethical awareness

· Bridges the digital divide by promoting equitable AI literacy

· Supports interdisciplinary learning in medicine, climate science, and linguistics

· Provides personalised feedback and learning experiences

· Assists students with disabilities through adaptive technologies like text-to-speech and visual recognition

AI can also automate administrative tasks, freeing teachers to focus on student engagement and social-emotional development—a key factor in academic success.

Risks and Challenges

Despite its potential, AI presents challenges:

· Data privacy concerns and misuse of personal information

· Over-reliance on technology, reducing teacher-student interactions

· Algorithmic biases affecting educational outcomes

· Increased opportunities for academic dishonesty if assessments rely on rote memorisation

Experts emphasise understanding these risks to ensure the responsible and ethical use of AI.

Global and Local Perspectives

In India, the Central Board of Secondary Education plans to introduce AI and computational thinking from Grades 3 to 12 by 2026. Sri Lanka faces a similar challenge. Many university students and academics already rely on AI, highlighting the urgent need for a structured yet rapidly evolving national curriculum that incorporates AI responsibly.

The Way Forward

Experts urge swift action:

· Launch pilot programs in select schools immediately.

· Provide teacher training and seed funding to participating educational institutions.

· Engage universities to develop short AI and innovation training programs.

“Waiting for others to lead risks leaving us behind,” experts warn. “It’s time to embrace AI thoughtfully, responsibly, and inclusively—ensuring the whole nation benefits from its opportunities.”

As AI reshapes our world, introducing it in schools is not merely an educational initiative—it is a national imperative.

BY Chula Goonasekera ✍️
on behalf of LEADS forum admin@srilankaleads.com

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The Paradox of Trump Power: Contested Authoritarian at Home, Uncontested Bully Abroad

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Protests and a vigil have been held in Minneapolis, Minnesota, where the shooting of Renee Nicole Good occurred on Wednesday (photo courtesy BBC)

The Trump paradox is easily explained at one level. The US President unleashes American superpower and tariff power abroad with impunity and without contestation. But he cannot exercise unconstitutional executive power including tariff power without checks and challenges within America. No American President after World War II has exercised his authority overseas so brazenly and without any congressional referral as Donald Trump is getting accustomed to doing now. And no American President in history has benefited from a pliant Congress and an equally pliant Supreme Court as has Donald Trump in his second term as president.

Yet he is not having his way in his own country the way he is bullying around the world. People are out on the streets protesting against the wannabe king. This week’s killing of 37 year old Renee Good by immigration agents in Minneapolis has brought the City to its edge five years after the police killing of George Floyd. The lower courts are checking the president relentlessly in spite of the Supreme Court, if not in defiance of it. There are cracks in the Trump’s MAGA world, disillusioned by his neglect of the economy and his costly distractions overseas. His ratings are slowly but surely falling. And in an electoral harbinger, New York has elected as its new mayor, Zoran Mamdani – a wholesale antithesis of Donald Trump you can ever find.

Outside America it is a different picture. The world is too divided and too cautious to stand up to Trump as he recklessly dismantles the very world order that his predecessors have been assiduously imposing on the world for nearly a hundred years. A few recent events dramatically illustrate the Trump paradox – his constraints at home and his freewheeling abroad.

Restive America

Two days before Christmas, the US Supreme Court delivered a rare rebuke to the Trump Administration. After a host of rulings that favoured Trump by putting on hold, without full hearing, lower court strictures against the Administration, the Supreme Court by a 6-3 majority decided to leave in place a Federal Court ruling that barred Trump from deploying National Guard troops in Chicago. Trump quietly raised the white flag and before Christmas withdrew the federal troops he had controversially deployed in Chicago, Portland and Los Angeles – all large cities run by Democrats.

But three days after the New Year, Trump airlifted the might of the US Army to encircle Venezuela’s capital Caracas and spirit away the country’s President Nicolás Maduro, and his wife Celia Flores, all the way to New York to stand trial in an American Court. What is not permissible in any American City was carried out with absolute impunity in a foreign capital. It turns out the Administration has no plan for Venezuela after taking out Maduro, other than Trump’s cavalier assertion, “We’re going to run it, essentially.” Essentially, the Trump Administration has let Maduro’s regime without Maduro to run the country but with the US in total control of Venezuela’s oil.

Next on the brazen list is Greenland, and Secretary of State Marco Rubio who manipulated Maduro’s ouster is off to Copenhagen for discussions with the Danish government over the future of Greenland, a semi-autonomous part of Denmark. Military option is not off the table if a simple real estate purchase or a treaty arrangement were to prove infeasible or too complicated. That is the American position as it is now customarily announced from the White House podium by the Administration’s Press Secretary Karolyn Leavitt, a 28 year old Catholic woman from New Hampshire, who reportedly conducts a team prayer for divine help before appearing at the lectern to lecture.

After the Supreme Court ruling and the Venezuela adventure, the third US development relevant to my argument is the shooting and killing of a 37 year old white American woman by a US Immigration and Customs Enforcement (ICE) officer in Minneapolis, at 9:30 in the morning, Wednesday, January 7th. Immediately, the Administration went into pre-emptive attack mode calling the victim a “deranged leftist” and a “domestic terrorist,” and asserting that the ICE officer was acting in self-defense. That line and the description are contrary to what many people know of the victim, as well as what people saw and captured on their phones and cameras.

The victim, Renee Nicole Good, was a mother of three and a prize-winning poet who self-described herself a “poet, writer, wife and mom.” A newcomer to Minneapolis from Colorado, she was active in the community and was a designated “legal observer of Immigration and Customs Enforcement (ICE) activities,” to monitor interactions between ICE agents and civilian protesters that have become the norm in large immigrant cities in America. Renee Good was at the scene in her vehicle to observe ICE operations and community protesters.

In video postings that last a matter of nine seconds, two ICE officers are seen approaching Good’s vehicle and one of them trying to open her door; a bystander is heard screaming “No” as Good is seen trying to drive away; and a third ICE officer is seen standing in front of her moving vehicle, firing twice in the direction of the driver, moving to a side and firing a third time from the side. Good’s car is seen going out of control, careening and coming to a stop on a snowbank. Yet America is being bombarded with two irreconcilable narratives – one manufactured by Trump’s Administration and the other by those at the scene and everyone opposed to the regime.

It adds to the explosiveness of the situation that Good was shot and killed not far from where George Folyd was killed, also in Minneapolis, on 25th May, 2020, choked under the knee of a heartless policeman. And within 48 hours of Good’s killing, two Americans were shot and injured by two federal immigration agents, in Portland, Oregon, on the Westcoast. Trump’s attack on immigrants and the highhanded methods used by ICE agents have become the biggest flashpoint in the political opposition to the Trump presidency. People are organizing protests in places where ICE agents are apprehending immigrants because those who are being aggressively and violently apprehended have long been neighbours, colleagues, small business owners and students in their communities.

Deportation of illegal immigrants is not something that began under Trump. It has been going on in large numbers under all recent presidents including Obama and Biden. But it has never been so cruel and vicious as it is now under Trump. He has turned it into a television spectacle and hired large number of new ICE agents who are politically prejudiced and deployed them without proper training. They raid private homes and public buildings, including schools, looking for immigrants. When faced with protesters they get into clashes rather than deescalating the situation as professional police are trained to do. There is also the fear that the Administration may want to escalate confrontations with protesters to create a pretext for declaring martial law and disrupt the midterm congressional elections in November this year.

But the momentum that Trump was enjoying when he began his second term and started imposing his executive authority, has all but vanished and all within just one year in office. By the time this piece appears in print, the Supreme Court ruling on Trump’s tariffs (expected on Friday) may be out, and if as expected the ruling goes against Trump that will be a massive body blow to the Administration. Trump will of course use a negative court ruling as the reason for all the economic woes under his presidency, but by then even more Americans would have become tired of his perpetually recycled lies and boasts.

An Obliging World

To get back to my starting argument, it is in this increasingly hostile domestic backdrop that Trump has started looking abroad to assert his power without facing any resistance. And the world is obliging. The western leaders in Europe, Canada and Australia are like the three wise monkeys who will see no evil, hear no evil and speak no evil – of anything that Trump does or fails to do. Their biggest fear is about the Trump tariffs – that if they say anything critical of Trump he will magnify the tariffs against their exports to the US. That is an understandable concern and it would be interesting to see if anything will change if the US Supreme Court were to rule against Trump and reject his tariff powers.

Outside the West, and with the exception of China, there is no other country that can stand up to Trump’s bullying and erratic wielding of power. They are also not in a position to oppose Trump and face increased tariffs on their exports to the US. Putin is in his own space and appears to be assured that Trump will not hurt him for whatever reason – and there are many of them, real and speculative. The case of the Latin American countries is different as they are part of the Western Hemisphere, where Trump believes he is monarch of all he surveys.

After more than a hundred years of despising America, many communities, not just regimes, in the region seem to be warming up to Trump. The timing of Trump’s sequestering of Venezuela is coinciding with a rising right wing wave and regime change in the region. An October opinion poll showed 53% of Latin American respondents reacting positively to a then potential US intervention in Venezuela while only 18% of US respondents were in favour of intervention. While there were condemnations by Latin American left leaders, seven Latin American countries with right wing governments gave full throated support to Trump’s ouster of Maduro.

The reasons are not difficult to see. The spread of crime induced by the commerce of cocaine has become the number one concern for most Latin Americans. The socio-religious backdrop to this is the evangelisation of Christianity at the expense of the traditional Catholic Church throughout Latin America. And taking a leaf from Trump, Latin Americans have also embraced the bogey of immigration, mainly influenced by the influx of Venezuelans fleeing in large numbers to escape the horrors of the Maduro regime.

But the current changes in Latin America are not necessarily indicative of a durable ideological shift. The traditional left’s base in the subcontinent is still robust and the recent regime changes are perhaps more due to incumbency fatigue than shifts in political orientations. The left has been in power for the greater part of this century and has not been able to provide answers to the real questions that preoccupied the people – economic affordability, crime and cocaine. It has not been electorally smart for the left to ignore the basic questions of the people and focus on grand projects for the intelligentsia. Exhibit #1 is the grand constitutional project in Chile under outgoing President Gabriel Borich, but it is not the only one. More romantic than realistic, Boric’s project titillated liberal constitutionalists the world over, but was roundly rejected by Chileans.

More importantly, and sooner than later, Trump’s intervention in Venezuela and his intended takeover of the country’s oil business will produce lasting backlashes, once the initial right wing euphoria starts subsiding. Apart from the bully force of Trump’s personality, the mastermind behind the intervention in Venezuela and policy approach towards Latin America in general, is Secretary of State Marco Rubio, the former Cuban American Senator from Florida and the principal leader of the group of Cuban neocons in the US. His ultimate objective is said to be achieving regime change in Cuba – apparently a psychological settling of scores on behalf Cuban Americans who have been dead set against Castro’s Cuba after the overthrow of their beloved Batista.

Mr. Rubio is American born and his parents had left Cuba years before Fidel Castro displaced Fulgencio Batista, but the family stories he apparently grew up hearing in Florida have been a large part of his self-acknowledged political makeup. Even so, Secretary Rubio could never have foreseen a situation such as an externally uncontested Trump presidency in which he would be able to play an exceptionally influential role in shaping American policy for Latin America. But as the old Burns’ poem rhymes, “The best-laid plans of men and mice often go awry.”

by Rajan Philips ✍️

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