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Political Will Backs the Fight against Cervical Cancer in Botswana

Posted by On October 9, 2015
By Toun Olateju, MD, MPH Securing political will at the highest levels of national government is critical to success, accountability, ownership and sustainability of global health programs in partner countries. In September 2015, the Honorable Minister of Health of Botswana, Dorcas Magkato, demonstrated Botswana’s political will at the national launch of the “see-and-treat” approach for cervical cancer. The event signified progress, by marking the official addition to national health policy of the highly effective, low-cost method to screen women between the ages of 30 and 49 for cervical cancer.  Pink Ribbon Red Ribbon remains is committed to our partnership with Botswana in the fight against cervical cancer, because we share the conviction that it is possible to eliminate the disease in this generation. In Botswana, cervical cancer is the most common female cancer, and it is the leading cause of cancer-related deaths among women. Prior to the beginning of Pink Ribbon Red Ribbon’s partnership with Botswana in 2012, the national policy limited screening for cervical cancer to Pap smears. Though women were undergoing screening, technical challenges in the national laboratory system meant that a large number of unread slides accumulated, and few women received their results. But with the assistance of one of Pink Ribbon Red Ribbon’s partners, the American Society for Clinical Pathology (ASCP), the backlog of over 3,500 Pap smear specimens was cleared last year.  For more on this story, please click here. Through Pink Ribbon Red Ribbon, the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) funded the scaling up of the program in Botswana to detect and deal with cervical pre-cancer through the “see-and-treat” technique, which uses visual inspection with acetic acid (household vinegar) to find lesions that can be treated with cryotherapy, often on the spot, or with the loop electrosurgical excision procedure (LEEP) later. Over the past three years, the partnership has established “see-and-treat” services at eight sites in the country, located in Francistown, Gaborone, Lobatse, Mahalapye, Maun and Selibe Phikwe. Using this approach, health workers have screened over 13,000 women for pre-cancerous cervical lesions and treated about 4,000 of them. The Botswana-University of Pennsylvania Partnership (BUP) and Jhpiego have been providing training and technical support to the Botswana Ministry of Health and the screening and treatment sites as part of Pink Ribbon Red Ribbon.
The Honorable Dorcas Magkato, Minister of Health of the Republic of Botswana, and the Honorable Earl Miller, U.S. Ambassador to Botswana, at the "see-and-treat" launch in Lobatse, Botswana ©Courtesy of Meg Bertram, U.S. National Cancer Institute
The Honorable Dorcas Magkato, Minister of Health of the Republic of Botswana, and the Honorable Earl Miller, U.S. Ambassador to Botswana, at the “see-and-treat” launch in Lobatse, Botswana
©Courtesy of Meg Bertram, U.S. National Cancer Institute
These results have propelled the Government of Botswana to start putting in place appropriate systems and dedicating national financial resources to ensure that these screening services are entrenched in its national cervical cancer prevention strategy for the long-term, even after funding from Pink Ribbon Red Ribbon through PEPFAR has run out. In demonstration of this commitment, the Government is assuming support of the cervical cancer screening clinic in Lobatse, where the national launch of “”screen-and-treat” took place, and plans to take over responsibility gradually for all the cervical cancer screening clinics in the country that have received assistance from Pink Ribbon Red Ribbon. Also in September, Botswana began the nationwide administration of the second dose of vaccination against the human papillomavirus (HPV), which causes most cervical cancer, for all in-school and out-of-school girls between the ages of 9 – 13. After two years of a demonstration program supported by Pink Ribbon Red Ribbon, including through a donation of vaccine by Merck, the Government of Botswana is fully funding this expansion, which further represents its commitment to take its national program to prevent cervical cancer to full scale across the continuum of care. The launch of the screening and treatment program and the nationwide delivery of HPV vaccination are giant leaps in the right direction to win the fight against cervical cancer in Botswana, and Pink Ribbon Red Ribbon is proud to partner with the Ministry of Health and our other implementers, including BUP, Jhpiego and ASCP. We were pleased to highlight the country’s achievements under Pink Ribbon Red Ribbon at the recently concluded Global Women’s Network, which took place on 21 and 22 September 2015 at the George W. Bush Institute in Dallas, Texas. Toun Olateju, MD, MPH is a Manager of Country Programs for Pink Ribbon Red Ribbon.