Health agencies are urging governments and civil society to step up action to eliminate cervical cancer, a vaccine-preventable disease that kills a woman every two minutes, mostly in low- and middle-income countries. 

“It is the fourth-most common cancer among women worldwide. It is also one of the few types of cancer that can be prevented by a vaccine,” said Herve Verhoosel, spokesperson for Unitaid, an organization that provides affordable lifesaving health products for people in low- and middle-income countries. 

“Vaccination against human papillomavirus, the leading cause of cervical cancer, together with HPV screening and treatment, is a proven path to elimination,” Verhoosel said Tuesday in advance of the first global forum on elimination of cervical cancer. 

The forum, which takes place from March 5 to 7 in Cartagena, Colombia, is hosted by Spain, Colombia and nine leading development and health agencies. 

348,000 women died in 2020

Verhoosel said, “The forum offers a watershed moment for the world to collectively accelerate progress on a groundbreaking promise made in 2020, when nearly 200 countries signed on to the WHO’s global strategy to eliminate cervical cancer.” 

The World Health Organization, Unitaid and other aid agencies provided the statistics on case rates. The WHO estimates 348,000 women died of cervical cancer in 2020, 90% of them from low- and middle-income countries. It warns annual deaths from cervical cancer will likely reach 410,000 by 2030 “if we do not change course.” 

To put countries on the path to elimination, the WHO has set three targets: It calls for 90% of girls to be vaccinated with the HPV vaccine by age 15; 70% of women to be screened with a high-performance test by age 35 and again at 45; and for 90% of women with cervical disease to receive treatment. 

The WHO says sub-Saharan Africa has the highest cervical cancer burden globally. It notes the HIV epidemic has worsened the situation because the common HPV virus is sexually transmitted. 

Prebo Barango, cross-cutting specialist on noncommunicable diseases and special initiatives at the WHO, explains that the prevalence of cervical cancer in some countries “demonstrates the inequity of access to prevention and health care as well as social and economic deprivation” in the affected communities. 

He stressed the importance of vaccinating young girls and making access to screening and early treatment for older women more widely available. 

“It is not an either-or approach,” he said. He notes, however, that “access to screening and treatment has been very, very low because most countries have no coverage for these procedures.” 

Barriers to vaccination

The WHO reports that only one in five adolescent girls has been vaccinated against HPV, despite the vaccine's proven efficacy. Barango explained that a key constraint related to its use is that the recommended age of 14 for receiving the vaccine “falls outside of the normal vaccination age for children.” 

Besides that, he said, “During COVID-19 there was a significant drop in the uptake of these vaccines because schools were closed” and many health facilities were focused on dealing with the pandemic. 

The World Health Organization says cost effective and evidence-based tools for screening and treatment are available. Despite this, it says barriers and inequities in the hardest-hit areas remain unacceptably high. The WHO notes that fewer than 5% of women in low- and middle-income countries are ever screened for cervical cancer. 

Unitaid spokesperson Verhoosel observed that the WHO’s recommendation of a one-dose HPV vaccine instead of the previous two-dose recommendation could prove to be a game changer. 

“A one-dose HPV vaccine opens new opportunities to reach more girls worldwide and will significantly reduce costs and logistical barriers,” he said. 

The nonprofit GAVI vaccine alliance is providing millions of low-cost HPV vaccine doses to developing countries at the affordable price of around $5.00 per dose. And Unitaid says that, together with its partners, it “has secured agreements that have reduced the price of HPV tests by nearly 40%.” (RJ/VOA)