Fatshimetrie: The Eradication of Cervical Cancer
Cervical cancer is an alarming reality that affects hundreds of thousands of women around the world each year. With more than 350,000 deaths and 660,000 new cases diagnosed, this disease causes irreparable losses within families and communities. However, what makes this situation even more tragic is that the majority of these deaths could be avoided.
Thanks to medical advances, we have powerful vaccines that can prevent infection with the human papillomavirus (HPV), which causes cervical cancer. In addition, early diagnostic tools and effective treatments are available to combat this disease. By combining these solutions, it is possible to stop the progression of cervical cancer and even consider its total elimination.
While some high-income countries are on the path to elimination, with fewer than four cases per 100,000 women, many low- and middle-income countries still lack access to these technologies. This explains why 94% of cervical cancer deaths occur in these regions.
The fight against cervical cancer is not just about public health, it is also about equity. That is why 17 November has been designated as the Global Day of Action to Eliminate Cervical Cancer, with vaccination campaigns, screenings and awareness-raising events taking place worldwide.
In 2018, the World Health Organization (WHO) launched a global call for the elimination of cervical cancer, followed in 2020 by the adoption of a Global Strategy to Accelerate the Elimination of Cervical Cancer as a Public Health Problem by all 194 WHO Member States. This strategy sets targets to be achieved by 2030: 90% of girls fully immunized against HPV, 70% of women receiving regular screening, and 90% of patients with precancerous lesions or cancer accessing treatment.
These goals are not utopian, they are achievable, even in low-income countries. For example, Bhutan has already achieved these goals, becoming the first country in the Southeast Asia region to do so.
Since the introduction of the HPV vaccine in 2011, Rwanda has achieved 90% vaccination coverage and has set a national target of reaching the 90-70-90 targets three years before the 2027 deadline. In two districts, Gicumbi and Karongi, the country has already achieved these targets.
Nigeria, which introduced the HPV vaccine in October last year, has already vaccinated 12.3 million girls.
We have the tools and the opportunity to eliminate cervical cancer. To realize this opportunity, determined political leadership is essential. As world leaders gather at the G20 Leaders’ Summit in Rio, we need their commitment to maximize access to the tools that can lead to elimination.
First, we call on G20 leaders to support access to HPV vaccines for all girls, in all countries. Since WHO’s global call in 2018, more than 60 countries have integrated HPV vaccines into their immunization schedules, bringing the total number of countries routinely protecting girls from cervical cancer as adults to 144.
Thanks to scientific advances, cervical cancer prevention is now possible with a single dose, a practice adopted by 60 countries.
Gavi, the Vaccine Alliance, is the largest provider of HPV vaccines for low- and middle-income countries, with a goal of vaccinating 120 million children by 2030. However, this requires continued investment in health. We also look to manufacturers to confirm and deliver on their commitments to provide HPV vaccines to low- and middle-income countries in the coming years, to avoid the supply constraints that have held back progress in the past.
However, vaccines must not be the only line of defense. To save lives now, it is imperative to scale up testing and treatment efforts in parallel with vaccination.
Second, we call on G20 leaders to support access to screening in all countries.
A few decades ago, as access to cervical smears increased in developed countries, cervical cancer mortality declined rapidly. Today, even more effective tests are available. More than 60 countries now include high-performance HPV screening tests in their programs.
Women can even collect their own samples for HPV testing, removing many barriers to accessing these lifesaving services. In Australia, on track to become one of the first countries to eliminate cervical cancer, more than a quarter of screening tests are now performed this way.
We urge leaders to move from casual screening to organised programmes that will support high coverage for the entire population. This is crucial to achieving the 70% target. However, high testing costs and provider profit margins remain major barriers to providing screening services to all.
Eliminating cervical cancer is an achievable undertaking if we pool our efforts and resources. It will require continued commitment from world leaders, but the results in lives saved and communities protected will be well worth itBy joining forces to fight cervical cancer, we can rewrite the story of women’s health globally.