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Addressing the Rising Burden of Cervical Cancer in Botswana

Posted by On March 21, 2017

(L-R) Dr. Grover, Dr. Trimble and Amb. Miller at the cancer roundtable

 

By Toun Olateju, Country Program Manager at Pink Ribbon Red Ribbon . . . 

According to a 2016 study published by the Botswana-Harvard AIDS Institute, cancers have now overtaken tuberculosis as the leading cause of death in people living with HIV in Botswana. As deaths from tuberculosis are declining, cervical cancer cases are increasing, tripling over a ten-year period from 2003 to 2013 in the HIV-positive population.[1]

Cervical cancer control is a priority for the Government of Botswana, and the Ministry of Health and Wellness is proactive about cancer control. At the end of the Pink Ribbon Red Ribbon-supported two-year demonstration program, in 2015, Botswana began fully funding the nationwide HPV vaccination using its own resources.  This is in the third year of the nationwide vaccination with over 70,000 girls fully vaccinated. In spite of this huge investment, there is more left to be done to combat the increasing burden of cervical cancer.

On February 27, the U.S. Ambassador to Botswana, Earl Miller, hosted a cancer roundtable with Dr. Ted Trimble of the Center for Global Health at the U.S. National Cancer Institute. Drawing representatives from the University of Botswana’s medical and nursing schools, Ministry of Health represented by the National Cancer Control Coordinator, Baylor University/Texas Children’s Hospital, University of Pennsylvania, Botswana/Harvard AIDS Initiative, Jhpiego and Pink Ribbon Red Ribbon, and a survivor of one of the childhood cancers, the discussions centered around the commitment of the Government of Botswana to cancer control. Highlighted were the construction of the new university teaching hospital in Gaborone, and the recent ground-breaking ceremony of the pediatric oncology unit in collaboration with Bristol-Myers Squibb Foundation, a Pink Ribbon Red Ribbon partner, called Global HOPE.

The participants noted that as global donor funding is reducing, countries like Botswana should start adopting new models of financing including public-private partnerships, of which the Pink Ribbon Red Ribbon partnership is a stellar example.

Pink Ribbon Red Ribbon, represented by the Country Program Manager, Toun Olateju, and Jhpiego’s Country Director, Tracey Shissler, spoke of the ongoing support in cervical cancer prevention including the scaling-up for ‘see-and-treat’ to up to 20 sites in the country over the last year. Over 80 percent of women with large cervical pre-cancer lesions seen in the clinic sites we support are HIV-positive. This underscores the need for greater focus and expansion of cervical cancer screening using innovative methods to accelerate scaling up. This summer the Ministry of Health and Wellness, Pink Ribbon Red Ribbon, CDC-Botswana and Jhpiego plan to launch a demonstration program on HPV testing, leveraging the already existing GeneXpert assay technologies in the country. The study will focus on the acceptability and feasibility of introducing HPV testing in the country with the aim to improve the scalability and efficiency of the cervical cancer ‘see-and-treat’ method.

 

[1] Scott Dryden-Peterson; Gita Suneja; Heluf Medhin; Memory Bvochora-Nsingo; Mukendi K. Kayembe; Neo Tapela; Shahin Lockman. Cancer Versus Tuberculosis Mortality Among HIV-Infected Individuals in Botswana.