Zambia

Zambia has the fourth-highest incidence rate of cervical cancer in the world. The highest mortality rate of all cancers in Zambia is from cervical cancer, which is the most-common cancer among Zambian women (36.7% of newly developed cancers in women in 2012). Forty percent of women who present with advanced stage cervical cancer are under 35.

Breast cancer is the second-most-common cancer among Zambian women (13% of newly developed cancers in women in 2012).

Country targets supported by Pink Ribbon Red Ribbon:  

  • Launch a nationwide program to vaccinate girls against the human papillomavirus (HPV).
  • Develop a plan for the long-term sustainability of “See-and-Treat” program, including the sites and services.
  • Screen 80 percent of women aged 25-49 years for cervical cancer at least once in five years

Please view our road map for more information about our programs in Zambia.

Zambia Road Map

 

Click here to view a detailed map of PRRR sites in the country. 

HISTORY

HPV vaccination campaign

Zambia has one of the highest incidence rates of cervical cancer in the world. In response, in 2006, the Government of Zambia launched the Cervical-Cancer Prevention Programme (CCPPZ), one of the first of its kind in sub-Saharan Africa.

Pink Ribbon Red Ribbon and our partners have supported the CCPPZ since 2011, starting with a pledge from the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) of US$ 3 million. In 2013, Pink Ribbon Red Ribbon partners provided technical assistance to draft the country’s national cancer prevention and control strategy, providing a framework for future activities to reduce cervical cancer and breast cancer in Zambia.  The National Cancer Control Strategic Plan was formally launched on World Cancer Day, February 2017.

With support from Merck, Pink Ribbon Red Ribbon launched three targeted HPV vaccination demonstrations to reach close to 50,000 girls from 2013-2016. Zambia is eligible for support from Gavi, the Vaccine Alliance, and will be submitting an application in May 2017 for the nationwide roll-out of the HPV vaccine with support from the Center for Infectious Disease Research in Zambia (CIDRZ) and PATH. Merck has also supported a variety of women’s cancer-awareness and vaccine-introduction activities in partnership with Susan G. Komen®. In 2016, to promote the third round of the HPV vaccine, Komen sponsored the Churches Health Association of Zambia (CHAZ) and media company Media365 to conduct multi-channel communications campaigns. CHAZ trained personnel to educate parents through Parent Teacher Associations and conduct door-to-door sensitization on HPV and the HPV vaccine. CHAZ also created mass campaign materials; staged drama performances; and trained journalists and contributed to radio and television programming to answer audience questions. Meanwhile, Media365 ran a concurrent social media campaign, using blogs, Facebook, and Whatsapp to engage younger audiences, reflecting their realities, culture, and shared values with similar messaging about HPV, the HPV vaccine, and cervical cancer.

Pink Ribbon Red Ribbon currently supports screening in every province in the country. In partnership with the Government of Zambia, and with support from CIDRZ, Project Concern International (PCI) and Jhpiego have trained health staff to perform cervical cancer screenings and treatment. Many of these same health workers also received training in clinical breast examination in 2013. Some of them perform screenings at the Ngungu and Mosi-Oa-Tunya clinics in Zambia, facilities that the George W. Bush Institute (GWBI) and Pink Ribbon Red Ribbon partners refurbished in 2012 and 2013, respectively.

Pink Ribbon Red Ribbon screens women for breast cancer, alongside other health services, in two clinics that have received support from Susan G. Komen®. The National Breast Cancer Foundation supports a Health Promotion Manager who leads a team that works with community and traditional leaders to generate awareness of breast and cervical cancer. Pink Ribbon Red Ribbon has recently launched partnerships with World Vision and Project Concern International to expand “Screen-and-Treat” services to hard-to-reach areas.

ACHIEVEMENTS

In September 2015, Ambassador Deborah Birx, the U.S. Global AIDS Coordinator, announced an additional US$ 3.5 million from PEPFAR for a sustainability plan for Pink Ribbon Red Ribbon programs in Zambia.

A CDC Foundation-led consortium, “Improving Data for Decision-Making in Global Cervical Cancer Programs” (IDCCP), led a workshop to discuss findings and recommendations from an assessment of the existing system to monitor and evaluate the CCPPZ, as part of a process to develop global standards, tools, and guidance to enhance interventions against cervical cancer.

The Global Fund to Fight AIDS, Tuberculosis, and Malaria approved the reallocation of $US 625,000 in savings to expand cervical cancer control activities through the Ministry of Health, after consultations with Pink Ribbon Red Ribbon and partners.

The University of Texas M.D. Anderson Cancer Center hosts exchange visits with Zambian physicians and provides telemedicine support through a “Virtual Tumor Board” with Cancer Diseases Hospital in Lusaka.

Local leadership has been integral to the success of the cervical cancer program in Zambia, and Pink Ribbon Red Ribbon has been proud to work with Their Excellencies First Ladies Christine Kaseba-Sata and Esther Lungu as they championed the fight against women’s cancers in their country.

Progress of PRRR Collaboration in Zambia (December 2011 – December 2016)

  • Girls vaccinated against HPV:
    • Demonstration project:
      • 2015-2016: 14,285 (Doses 1-3)
      • 2014: 17,045 (Doses 1-3)
      • 2013: 16,688 (Doses 1-3)
  • Sites that currently offer:
    • VIA and cryotherapy (fixed sites): 73
    • VIA and cryotherapy (mobile sites): 73
    • Loop Electrosurgical Excision Procedure (LEEP): 24
  • Health staff trained in cervical cancer screening and treatment: 203
  • Women Screened with VIA: 238,125
    • Of Women Screened, Number VIA-Positive: 28,292
      • Of Women VIA-Positive, Number Treated with Cryotherapy or LEEP: 15,527
  • Women screened for breast cancer: 9,302

Contributions from Pink Ribbon Red Ribbon Partners

  • U.S. Government: US$ 3 million from 2011 to 2015 through PEPFAR to CIDRZ, PCI and Jhpiego to scale up “Screen-and-Treat,” train healthcare providers and procure equipment; an additional US$ 3.5 million from 2016 to 2018; US $475,000 from HHS/NIH/NCI for four years of funding for the director of the National Cancer Registry and other technical assistance and activities related to the Leadership Forum in Cancer Control Planning in Lusaka.
  • Merck: Donation of 210,000 doses of quadrivalent GARDASIL® HPV vaccine.
  • Merck, in partnership with Susan G. Komen®: over US $1 million for support of the introduction of HPV vaccination, breast cancer assessment in Zambia, training health professionals on breast cancer, the formation of the Cancer Prevention Alliance of Zambia, funding for the African Centre of Excellence for Women’s Cancer Control, and program support.
  • NBCF: US$ 500,000 over five years to hire national health-promotion manager at the Zambian MoH and support the coordination efforts of the PRRR Secretariat.

A Zambian girl receives the HPV vaccine

  • Susan G. Komen®: US $400,000 for training of health professionals on breast cancer, support of the social mobilization component of the HPV vaccine campaign, and in-kind technical assistance and program support.
  • BMGF: US$ 125,000 for technical support in planning for cervical cancer.
  • PRRR Secretariat: US$ 50,000 for development of “e-hub” facility to enable real-time consultations between nurses in the field and doctors in Lusaka; four-month consultancy (US$ 35,000) to develop a national cancer strategy.
  • Airborne Lifeline: Air transportation of equipment and supplies worth US $15,800.
  • GWBI: Rehabilitation of Ngungu and Mosi-Oa-Tunya clinics.
  • MD Anderson Cancer Center: Hosting of exchange visits of Zambian physicians, and a “Virtual Tumor Board” with Cancer Diseases Hospital in Lusaka.
  • BMGF/CDC Foundation/IU: Situational assessment of data system for cervical cancer under IDCCP project. 

2017 Pink Ribbon Red Ribbon Priorities

  1. Implement sustainability plan for a defined set of “screen-and-treat” activities to be gradually transferred to the Zambian Government’s budget, with all ongoing cervical cancer services and costs to be absorbed by the national government by 2020;
  2. Ensure submission of an application to Gavi in May 2017 for the nationwide roll-out of the HPV vaccine;
  3. Launch pilots for HPV diagnostic testing or other innovative technologies;
  4. Scale up “Screen-and-Treat” sites in rural, underserved areas in partnership with World Vision and PCI;
  5. Consolidate the twinning relationship between MD Anderson Cancer Center and CDH in Lusaka;
  6. Conclude the installation of and training on an electronic medical pathway for cervical cancer;
  7. Scale up breast cancer activities, including through a consensus meeting of various stakeholders in Zambia to coordinate and enhance current programming.