Cervical cancer poses a serious public health threat in Africa

by ANURADHA GUPTA

After two grueling years of the pandemic, it is rare to hear good news about the health of women and girls – who have suffered disproportionately from the social and economic impacts of Covid-19.

A landmark declaration in the fight against cervical cancer has given us something tangible to celebrate, especially for women and girls on the African continent.

The World Health Organization’s Strategic Immunization Experts Group (SAGE) announced on April 6 that a single dose of the HPV vaccine – instead of the traditional two or two doses – provides strong protection against HPV, the leading cause of cervical cancer.

Why is this important? In 2020, nearly 350,000 women died of cervical cancer, and about 90 percent of these deaths occur in low- and middle-income countries.

The relative lack of cervical cancer screening and treatment in many low-income countries makes prevention through immunization even more important.

Despite this, currently less than a third of the world’s population of girls between the ages of 9 and 14 live in countries that provide the HPV vaccine; And within countries, the populations with the highest risk but the least access to health care may still be denied this vaccine.

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monopoly of supply

For women on the African continent, cervical cancer represents a major public health threat. All but one of the top 20 countries in the world with the highest cervical cancer burden in 2018, were in Africa, where cervical cancer is a leading cause of cancer death for women – leaving an irreparable gap in the lives of their families, communities and societies.

But if only one strike is needed to save lives, we have the opportunity to protect more African women and girls from this deadly disease.

Vaccine equity has been a constant issue since the first HPV vaccines became available in 2006. Supply restrictions, combined with high-income countries’ monopoly on supply, mean that global distribution of HPV vaccines is unfair across geography, income, and burden the disease.

Fewer than 25 percent of low-income countries and less than 30 percent of low-middle-income countries have had the vaccine, compared to 85 percent of high-income countries. Therefore, this SAGE decision is a game changer, which means there will be more supplies.

At a time when African countries have had to spend precious domestic money responding to the Covid-19 pandemic (not to mention coping with the effects of the global economic slowdown), a single dose of HPV vaccination means every dollar invested in protecting girls from cervical cancer can You go twice the distance.

Through its market shaping effort, Gavi, the Vaccine Alliance has been able to secure affordable prices for low-income countries to obtain the HPV vaccine at $4.50 per dose, compared to $100 in high-income countries.

To date, Gavi has supported 24 countries – including 16 African countries – to deliver the HPV vaccine, reaching more than seven million girls globally with this safe and effective vaccine. With yesterday’s SAGE recommendation, we can reach millions more.

Immunization at school

So with all this good news, what’s standing in our way? Unfortunately, the Covid-19 pandemic, and prolonged school closures, has severely impacted HPV vaccine delivery – even in countries that have already offered it – putting even more girls at risk.

Since the HPV vaccine is generally provided in schools to girls between the ages of 9 and 14, this is often the first time teenage girls have reconnected to the health system since childhood.

Maintaining immunization at school can also be a challenge, as most other vaccines are given through health centres. This means that regulations and approaches must be adapted to the specific country context to reach these girls, enabling them to protect themselves from cervical cancer – as well as protecting their health and well-being.

Given the disproportionate effects of the pandemic on women and girls, we must seize this opportunity to prioritize their health and save their lives with the HPV vaccine.

We must move quickly to ensure that national, regional and global health strategies are up to date; Inform healthcare workers of new protocols; that health service delivery systems are adapted; Vaccine manufacturers remain committed and flexible.

With only one HPV vaccine needed, today we are one step closer to a world in which cervical cancer is being eradicated as a public health problem.

A world where every year hundreds of thousands of mothers, daughters, partners and sisters do not die from this preventable disease. A world in which every girl has equitable access to immunization is a world we all want to live in.

Anuradha Gupta is the Executive Vice President of the Gavi Vaccine Alliance. email: [email protected]

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