Geneva – Cervical cancer is highly preventable when women have access to vaccination, early and effective screening and pre-cancer treatment. However, 90% of cervical cancer deaths occur in low- and middle-income countries, in large part due to a gap in vital preventive services. On Cervical Cancer Elimination Day of Action, Unitaid remains committed to improving equitable access to the tools and strategies that can save lives.
In November 2020, the World Health Organization (WHO) launched its strategy for the elimination of cervical cancer, marking the first time the world has committed to ending a cancer as a public health threat. The strategy is based on achieving three targets by 2030: to reach 90% of girls with the human papillomavirus (HPV) vaccine by the age of 15; to screen 70% of women with a high-performance test twice – at ages 35 and 45; and to treat 90% of women with pre-cancer and manage 90% of all cases of invasive cancer.
Nearly all instances of cervical cancer are caused by HPV, an extremely common sexually transmitted infection that, when left untreated, can develop into cancer. When young girls are vaccinated against HPV before being exposed to the virus, the vaccine can provide a high degree of protection from cervical cancer.
But it will take decades to reach the vaccine coverage levels needed to bring the rate of cervical cancer down, leaving hundreds of millions of women at risk of a preventable cancer in the meantime. Unitaid has been working since 2019 to advance a highly effective package of tools and strategies to improve screening and treatment of cervical pre-cancer in low- and middle-income countries.
Unitaid’s models integrate a package of preventive care using high-performance HPV tests – a highly sensitive method for identifying women at risk of cervical cancer – and portable devices for treating pre-cancerous lesions into existing health structures to increase coverage and awareness. Working in 14 countries across three continents, these efforts have already reached more than 1.4 million women with screening services, including more than 500,000 women who have received HPV tests.
These programs are laying the groundwork for cervical cancer elimination programs in low- and middle-income countries around the world but several barriers still threaten countries’ progress towards the WHO elimination targets. Many women are diagnosed late due to limited awareness about the disease and preventive measures, and insufficient availability of effective, affordable screening and treatment tools and services. Long distances to facilities and associated costs, a lack of trained staff and difficulties in screening follow-up and linkages to care further restrict access.
Community based self-collection programs – in which a woman can take her own sample at a place and time of her choosing and without the need for a pelvic exam that is a known to deter women from screening – have the potential to significantly increase coverage. But more funding is urgently needed to scale up effective models across countries.
The TogetHER report on funding for cervical cancer in low- and middle-income countries, published on 16 November 2023, places Unitaid among the leading supporters of cervical cancer secondary prevention globally. However, the report notes that, though programs enabling access to screen-and-treat programs are expanding, only about one in ten women in low- and middle-income countries has been screened for cervical cancer and overall funding for prevention efforts remains insufficient to reach WHO targets.
“We will not succeed in eliminating cervical cancer without concerted efforts to scale up vaccination of girls, screen women with high performing tests and treat any detected pre-cancers before it’s too late,” said Janet Ginnard, Unitaid’s Director of Strategy. “Unitaid has this year renewed its investment into improving access and addressing affordability of the tools and services that are critical in screening and treating cervical pre-cancer. At the same time, if we are to meet elimination targets, all partners – both domestic and global – need to increase commitments to bring these tools, treatments and strategies to scale.
“We know that civil society and community-driven efforts are essential to reaching the right people with the right interventions. We are encouraged and inspired by this movement, including the recent launch of the African Cervical Health Alliance – a step that will bring us all closer to making services relevant for women who need them.”
Unitaid’s cervical cancer elimination programs are implemented in partnership with the Clinton Health Access Initiative (CHAI) and the SUCCESS consortium through Expertise France, Jhpiego and the Union for International Cancer Control.
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