A young Zambian girl smiles after receiving a dose of the HPV vaccine, which prevents cervical cancer
January marks Cervical Cancer Awareness Month, a month to remember the thousands of women who have battled cervical cancer and re-dedicate our collective efforts to ending preventable deaths from the disease.
Over 90% of cervical cancer cases occur in low and middle-income countries, proving that the cervical cancer burden falls heavily on women in poorer countries. There are many reasons why this disparity exists, from the lack of resources to insufficient technical training. Nonetheless, no woman should die because she cannot access care, especially from a preventable disease. When considering the link between HIV and cervical cancer, the disparity becomes even more apparent. Since HIV significantly weakens the immune system, women living with HIV are four to five times more likely to develop cervical cancer than HIV-negative women. Women are surviving HIV diagnoses only to succumb to cervical cancer. At Pink Ribbon Red Ribbon, we believe that vaccination, screening, treatment, and policy development can reverse the course of cervical cancer in low and middle-income countries. Through our partnership model, we have achieved results to confirm this.
Knowing that almost 70% of cervical cancer cases are caused by HPV types 16/18, one of PRRR’s main goals is to vaccinate girls against HPV. HPV is sexually transmitted, so our model aims to vaccinate girls between the ages of 9 and 13, before they are likely to have experienced their sexual debut. The HPV vaccine is safe and effective: both Gardasil and Cervarix have been proven to prevent against close to 100% of HPV-16 and HPV-18 strains – the strains that cause cervical cancer. Since the inception of the PRRR partnership, 147,497 girls have completed the required doses of HPV vaccination in Botswana, Zambia, and Ethiopia through PRRR and Gavi-supported programs, almost eliminating their risk for cervical cancer later in life.
Screening and Treatment
Women in Sub-Saharan Africa are more likely to die from cervical cancer than women in the U.S. However, modeling shows that in low-income countries, almost half of all cervical cancer deaths could be averted with a one-time screening. PRRR programs in Botswana, Ethiopia, Tanzania, and Zambia have cumulatively supported the screening of 465,243 women for cervical cancer, of whom 379,214 were screened for the first time. By incorporating HIV-positive women in our screening campaigns, we are also addressing the cervical cancer link to HIV. Of all the women screened through PRRR programs, 110,763 were HIV-positive. PRRR also treats women for cervical pre-cancer with low-cost, simple methods: cryotherapy and the loop electrosurgical excision procedure (LEEP). The PRRR partnership has treated 29,827 women for cervical pre-cancer to date, and referred 7,085 women on suspicion of cervical cancer. We are continuing to explore various screening and treatment models to impact more women.
Policy Development and Sustainability
PRRR has consistently worked with national Governments in our partner countries to support the development of nationally adopted strategic plans to combat cervical cancer. At the same time, we have aimed to encourage the sustainability of our programs by promoting innovative models that incorporate country-level resources and platforms. We have worked with our partners to empower national Governments and their partners to lead, design, and own their country-driven goals and programs for cervical cancer prevention and care. Specifically, PRRR worked with the Governments of Zambia and Botswana, implementing partners, and the Office of the U.S. Global AIDS Coordinator to begin transitioning PRRR-supported activities to government-level management. The partnership also assisted the Governments of Zambia and Namibia in drafting National Cancer Control Plans. Finally, for the first time since Tanzania began working in partnership with PRRR, the Government set aside its own funds to procure 100 cryotherapy machines and nine LEEP machines, and plans to scale up screening to 100 new health facilities.
Pink Ribbon Red Ribbon leads coordinated action through a public-private partnership to combat cervical cancer in Sub-Saharan Africa. We know that building on existing programs by leveraging partnerships and existing resources can save lives. It is possible to end preventable deaths from cervical cancer by accelerating vaccination, making screening options accessible, scaling up treatment options, and prioritizing policy development and sustainability measures.