By Our Reporter
Global health agency Unitaid and its partners have developed and implemented a highly effective package of tools and strategies for cervical cancer prevention. Project sites in seven countries are already exceeding the WHO target to treat 90% of all women identified with pre-cancerous lesions by 2030, just two years after the launch of the WHO Cervical Cancer Elimination Strategy (17 November 2020).
Funded by Unitaid and implemented in partnership with the Clinton Health Access Initiative (CHAI) and the SUCCESS consortium (Expertise France, Jhpiego and the Union for International Cancer Control), the programmes in Burkina Faso, Côte d’Ivoire, Malawi, Nigeria, Philippines, Rwanda and Senegal are demonstrating a life-saving cervical cancer prevention model poised for broader – and urgent scale-up.
These models integrate a package of preventive care using high-performance HPV screening and portable devices for treating pre-cancerous lesions into existing health structures to increase coverage and awareness. Implemented widely, the models can achieve the WHO target for pre-cancer treatment and contribute to averting nearly 65 million deaths from cervical cancer over the next century.
The programmes are also progressing towards a second WHO target to reach 70% of women with high-performing screening by age 35 and again by 45, with more than 50% of women having received an HPV test. In addition, three in four women receiving HPV tests are opting for self-sampling, which circumvents pelvic examinations that can be a deterrent to screening, confirming this method’s promise to extend access to even more women.
HPV testing replaces a far less accurate, subjective screening method based on visual inspection of the cervix in countries that already have solid diagnostic network capacity. Hand-held, battery powered thermal ablation devices replace heavy cryotherapy containers that require compressed gas. These devices allow for treatment of pre-cancerous lesions in primary health centers and reduce treatment time to one to two minutes, compared to 15.
To facilitate uptake, pricing agreements secured by Unitaid and CHAI have reduced the cost of thermal ablation devices by nearly 45% and HPV tests by nearly 40%. However, field data from countries show that the overall cost of thermal ablation is nearly ten times less than cryotherapy per woman treated.
Cervical cancer is highly preventable when women have access to early detection and treatment. However, in low- and middle-income countries where nine out of 10 cervical cancer deaths occur, progress has been held back by a lack of awareness and financing, as well as high costs, ineffective screening methods, and poorly adapted treatment devices.
“Unitaid and partners have delivered the models and technologies to make cervical cancer elimination a reality,” said Dr Philippe Duneton, Executive Director of Unitaid. “Now it comes down to access for all women. We must see concerted urgent action from governments and partners to scale up these models and bring an end to cervical cancer for generations to come.”
“On this second anniversary of WHO’s cervical cancer elimination strategy, we applaud all those who are helping to make innovative technologies accessible, so that women everywhere can enjoy the fundamental right to healthcare that we all deserve,” said Dr Princess Nothemba (Nono) Simelela, WHO Assistant Director-General for Strategic Priorities and Special Advisor to the Director-General. “Unitaid and its partners are making a very important contribution to our collective mission – I hope even more supporters will take inspiration from the early progress and join us in the effort to scale up services.”
Unitaid is the largest funder of innovative tools to find and treat precancerous lesions in women living in low-resource settings with nearly US$70 million invested. Projects in 14 countries are developing models for cervical cancer prevention adapted to low- and middle-income countries’ needs.