Eliminating cervical cancer is within reach, thanks to new commitments by governments, donors and other partners, including pledges of almost $600 million, made at the first-ever global forum on cervical cancer in Cartagena de Indias in Colombia.

Every two minutes, a woman dies from cervical cancer, although vaccination against human papillomavirus (HPV), the leading cause of cervical cancer, can prevent the vast majority of cases. 

Cervical cancer is the fourth most common cancer in women worldwide, but disproportionately affects women and their families in low and middle-income countries (LMICs). 

Less than 5% of women in many LMICs are ever screened for cervical cancer, and over 90% of the 348 000 cervical cancer deaths in 2022 took place in LMICs. 

Furthermore, only one in five adolescent girls were vaccinated against HPV in 2022. 

Country commitments

However, a number of countries stepped up at the forum. These include the Democratic Republic of Congo (DRC), which has committed to introduce the HPV vaccine as early as possible, targeting girls aged 9 to 14 years.

Ethiopia aims to reach at least 95% of all 14-year-old girls with the HPV vaccine this year, and screen one million eligible women every year for cervical cancer and to treat 90% of those screened who present with positive precancerous lesions. 

Further, HPV single dose has been approved to be introduced this year and scaled up as part of the country’s Expanded Program on Immunization plans.

Africa’s most populous country, Nigeria, has committed to vaccinating 80% of girls 9 to 14 years old by 2026, including those who are no longer at school.

The nearly $600 million in new funding includes $180 million from the Bill and Melinda Gates Foundation, $10 million from UNICEF, and $400 million from the World Bank. 

Elimination of a cancer

“If these ambitions to expand vaccine coverage and strengthen screening and treatment programs are fully realized, the world could eliminate a cancer for the first time,” according to the World Health Organization (WHO).

In 2022, the WHO revised its HPV vaccination recommendation from two to one-dose of the HPV vaccine, making it much easier and cheaper for countries to reach those who need it.

The WHO Americas region made a similar recommendation 2023, and WHO’s African regional just followed suit with its own recommendation. 

“We have the knowledge and the tools to make cervical cancer history, but vaccination, screening and treatment programmes are still not reaching the scale required,” said Dr Tedros Adhanom Ghebreyesus, WHO Director-General. 

“This first global forum is an important opportunity for governments and partners to invest in the global elimination strategy and addressing the inequities that deny women and girls access to the life-saving tools they need.” 

However, many LMICs face an uphill battle. Malawian Minister of Health Kandodo Chiponda described the challenges her country faces at the forum’s opening plenary. 

Some 60% of Malawi’s population of over 20 million is under 35, and cervical cancer is the highest cancer burden, with the incidence rate as high as 70 per 100,000. Mortality figures are 52 per 100,000, said Chiponda, who also announced the opening of the first ever cancer center in Malawi. 

Chiponda noted that women have limited time and resources to seek care, limited access to screening and diagnostic services, and are subject to misinformation about vaccinations. 

She emphasized the need for cross-sector collaborations and the strengthening of primary healthcare to reach women and girls in remote areas.

‘Miracle of modern medicine’

“The HPV vaccine is one of the most impactful vaccines on the planet and has already helped save thousands of lives,” said Aurélia Nguyen, Gavi’s chief programme officer. 

Despite the efficiency and safety of the HPV vaccine, high costs, supply chain issues, and difficulties in reaching remote populations keep the vaccine out of reach for many.

“More girls urgently deserve the same protection, which is why in partnership with countries, Gavi has set an ambitious goal to help vaccinate 86 million adolescent girls by 2025. With bold commitment and decisive action, we can look forward to a future where cervical cancer has been eliminated for good.” 

Describing HPV vaccines as “a miracle of modern medicine”, Dr Chris Elias, the Bill and Melinda Gates Foundation’s president of global development, said that there is “no reason why women should die from cervical cancer.”

“Now is the time for governments and partners around the world to increase HPV vaccine access and protect future generations from cervical cancer.” 

Image Credits: Unsplash, IARC/WHO, Global Cervical Cancer Elimination Forum, GCCEF/WHO.