Every year, 660,000 women are diagnosed with cervical cancer and more than 350,000 die from it. As a result, children are orphaned, families are impoverished and communities are weakened because they lose mothers, wives, daughters and sisters.
And yet, unlike most other cancers, cervical cancer cases and deaths are almost all preventable. We have highly effective vaccines that prevent infection with human papillomavirus (HPV), which causes cervical cancer; we have diagnostic tools for early detection; and we have treatments for women who are affected. With these tools, cervical cancer can not only be stopped, but could also be the first cancer eliminated. In some high-income countries, elimination is already close, with fewer than four cases per 100,000 women.
However, 94% of cervical cancer deaths occur in low- and middle-income countries because these tools are still not available there. Cervical cancer is a double tragedy because it is not only a health issue but also an equity issue.
Yesterday we celebrated the “Day of Action to Eliminate Cervical Cancer” around the world, and vaccination campaigns, screening campaigns and awareness-raising activities were organized on this occasion. occasion. Iconic landmarks were lit up in dark cyan, including the Christ the Redeemer statue in Rio de Janeiro, the city that hosted world leaders as they arrived for the G20 summit.
In 2018, WHO launched a global call for action to eliminate cervical cancer, and in 2020, WHO’s 194 Member States adopted a Global Strategy to Accelerate Cervical Cancer. elimination of cervical cancer as a public health problem. This strategy calls on countries to achieve three targets by 2030: 90% of girls are fully vaccinated against HPV; 70% of women benefit from timely screening; and 90% of women with precancerous lesions or cancer are treated.
These targets are not only ambitious, but can be achieved even in low- and middle-income countries. Bhutan has already achieved them. It is the first country in the South-East Asia Region to achieve this. Since the introduction of the HPV vaccine in 2011, Rwanda has achieved 90% vaccination coverage and announced today that it plans to achieve all three targets set in the strategy by 2027, i.e. three years earlier than expected. These targets have already been achieved in two districts of Rwanda – Gicumbi and Karongi. In Nigeria, where the HPV vaccine was introduced in October last year, 12.3 million girls have already been vaccinated.
We have the opportunity to eliminate cervical cancer and we have the tools to do it. For this to happen, leaders must demonstrate political determination. As world leaders arrive in Rio de Janeiro today for the G20 Summit, we need them to commit to expanding access as much as possible to the tools that help eliminate cervical cancer. uterus.
First, we call on G20 leaders to support access to HPV vaccines for all girls, in all countries.
Since WHO issued the global call to action in 2018, more than 60 countries have introduced the HPV vaccine into their immunization programs, bringing the total number of countries routinely protecting girls to 144 against cervical cancer. Thanks to advances in science, we can now prevent cervical cancer with a single dose of vaccine, which 60 countries now do.
The main supplier of HPV vaccines to low- and middle-income countries is Gavi, the Vaccine Alliance, which plans to vaccinate 120 million children by 2030. But for this to be possible, these investments in health benefits must be sustainable. We are also counting on manufacturers to confirm and honor their commitments to supply HPV vaccines to low- and middle-income countries in the coming years, to avoid the supply issues that have hampered progress in the past.
But we cannot rely on vaccines alone. The effects of rapid scale-up of vaccination will only be seen decades later, when girls reach adulthood, at which time cervical cancer typically occurs. To save lives now, scaling up vaccination must be accompanied by scaling up screening and treatment.
Secondly, we therefore call on G20 leaders to support access to screening in all countries.
Several decades ago, mortality associated with cervical cancer fell rapidly as more and more women gained access to Pap smears in developed countries. Today, even better tests are available. More than 60 countries now include high-performance HPV detection tests in their screening programs. Women can even collect their own samples for HPV testing, further removing barriers to accessing vital services. In Australia, which is on track to become one of the first countries in the world to eliminate cervical cancer, more than a quarter of screening tests are now carried out this way.
We call on leaders to move beyond one-off, opportunistic testing by investing in organized screening programs that will achieve high coverage for the entire population. This is essential to reaching the 70% target. However, high test prices and supplier margins also remain an obstacle.
Several countries are also exploring the use of artificial intelligence to improve screening accuracy when resources are limited. In the event of precancerous lesions, many women are now treated with portable battery-powered devices, which can be used in isolated locations.
Third, we call on G20 leaders to support expanding access to treatment in all countries. Women with advanced cancer should be referred for surgery, radiotherapy or palliative care. In many cases, women with cervical cancer die simply because they cannot access treatments used in high-income countries. In countries where radiotherapy equipment is broken, women wait while their tumors grow. No woman should have to travel abroad for treatment, or die because the equipment needed to heal her is not available at home.
The COVID-19 pandemic has shown that vaccines, tests and treatments are extremely effective in saving lives, but also that inequalities in access lead to preventable deaths.
On the Global Day of Action to End Cervical Cancer, we urge all leaders, sectors and communities to join us in end cervical cancer once and for all.
