By Doris Obinna
Incommemoration of the 2023 Cervical Cancer Elimination Day of Action, experts highlighted progress towards ending cervical cancer through vaccination.
On November 17 2020, the World Health Organisation (WHO) launched the ‘Global Strategy to Accelerate the Elimination of Cervical Cancer by 2030.’ This year, 2023, marks the third year since 194 countries committed to accelerating theelimination of cervical cancer as a public health problem.
Commemorating the Cervical Cancer Elimination Day of Action, Merck Sharp and Dohme (MSD) a global research-intensive biopharmaceutical company held a virtual media eventthemed: “Progress towards HPV Vaccination in Sub-Saharan Africa.”
The event was an avenue to present the latest data on progress made in HPV immunisation in countries in East, West and Southern Africa, and towards the 90:70:90 cervical cancer elimination targets set out by WHO.
Experts disclosed that under the 90:70:90 targets of the WHO aims to end cervical cancer through vaccination of 90 per cent of girls, ensure that 70 percent of women are screened and also see to it that 90 per cent of women receive treatment.
Inher presentation titled: “Understanding HPV and the burden of HPV diseases inSub-Saharan Africa Countries” Director of the Agency of Preventive Medicine, headquartered in Abidjan, Côte d’Ivoire, Dr. Alima Essoh, stated that while cervical canceris the fourth most common cancer among women globally, it is the second leadingcause of female cancer in Africa, adding that the cervical cancer incidence rate in Africa is higher than the world average.
She further stated that 90 per cent of new cases and deaths occur in low- and middle-income countries.
Further highlighting statistics, she stated that 425.68 million women aged 15 years andabove are at risk of developing cervical cancer; with 117,316 women being diagnosed, leading to 76,745 deaths.
She noted that 34 out of every 100,000 women are diagnosed with cervical cancerwhile 23 out of every 100,000 women die from cervical cancer annually.
According to her, elimination of cervical cancer is possible if all countries reach and maintain an incidence rate of below 4 cases per 100,000 women. She highlighted two prevention methods which are the primary and secondary prevention methods.
Essoh said that primary prevention involves the administration of human papillomavirus (HPV) vaccines primarily targeted at girls aged between 9 and 14in low- and middle-income countries, and both boys and girls within the same 9to 14 age-range in developed countries.
She emphasizes that HPV vaccines are effective and safe to prevent cervical cancer. “Secondary prevention methods involve screening to detect and treatpre-cancerous lesions. The vaccine clinical development expert further stated that cervical precancerous lesions can be treated through various treatment methods.”
Speaking on “Progress towards 2030 Cervical Cancer Elimination targets in Sub-SaharanAfrica countries” the Senior Health Adviser for Immunization at the UNICEF Headquarters, Dr. Phionah Atuhebwe, highlighted the cervical cancer elimination initiative which was introduced by WHO, geared towards eliminating cervicalcancer.
The initiative according to her is categorised into three targets which are the primary, secondary and tertiary targets.
“The primary target is that 90 per cent of all girls should be fully vaccinated with the HPV vaccines by the age of 15. The secondary target is that 70 per cent of women should be screened with two high-performance screening tests, first, when they attain the age of 35, and secondly, when they attain the age of 45. The tertiary target is that 90 per cent of women at the pre-cancerous stage receive treatment, while 90 per cent of women who have been diagnosed with invasive cancer are managed for their pain.”
Reiterating that over 90 per cent of cervical cancer cases are recorded in Africa and that acceptance of HPV vaccines can reverse the high cervical cancer recurrence, she said: “We do not want to see the high rate of cervical cancer occurrence again because this is one of the two cancers that is preventable by the HPV vaccines.The vaccines are highly effective and efficacious and can stop 90 per cent of cervical cancers. There is no reason why we should not be able to eliminate this disease. We want to have all countries having less than four cases of cervical cancer per 100,000 women.”
While speaking on the progress made in Africa, she identified that Nigeria is the 27th country in Sub-Sahaan Africa to introduce the HPV vaccine; she added that the HPV vaccine acceptance was moderate in West Africa and high in Eastern and Southern Africa. “Cameroon and Sao Tome and Principe are the only in Central Africa have introduced the vaccine.”
Atuhebwe,on the global impact and acceptance of the HPV vaccines, said, “HPV vaccinescontinue to show an excellent safety profile and after 15 years of use of the vaccine, there is real-life evidence that vaccination prevents invasive cervical cancer.”
Professor, Public Health and Deputy Vice-Chancellor for Research and Innovation at the University of KwaZulu-Natal, South Africa, Mosa Moshabela in his presentation identified barriers to the successful implementation of HPVvaccination programs in sub-Saharan Africa.
According to him, some of the obstacles are socio-cultural, vaccine supply constraints, safety concerns and efficacy as well as costs and sustainability amongst others.
Hesaid: “There are concerns around safety and effectiveness of the vaccines. When this barrier has been overcome, you have issues of trust related to scientists and governments and pharmaceutical companies; and that mistrust often influences whether people will accept vaccines or not.
“That is why you see that issues of vaccines become quite political, and we cannot neglect the fact that health is political. We have to embrace and work with that challenge.”
Moshabela disclosed that the availability, affordability, distribution and cultural and religious belief as hurdles which also have to be overcome for a successful vaccination process.
Also present is the Expanded Programme on Immunisation (EPI) Manager for Rwanda, Dr. Sibomana Hassan.