Cervical Cancer Elimination

A Global Vision Requiring a Coordinated Effort

Cervical cancer is preventable and treatable.

For the first time ever, we can end a specific cancer.

The WHO’s Global Strategy for the Elimination of Cervical Cancer a Public Health Problem provides a roadmap, through the following 90-70-90 targets for 2030:

  • 90% of girls fully vaccinated with the HPV vaccine by age 15
  • 70% of women are screened with a high-performance test by 35 and 45 years of age
  • 90% of women identified with cervical disease receive treatment (90% of women with pre-cancer treated; 90% of women with invasive cancer managed)

Civil society will play a crucial role to help meet these targets: we must work together and advocate for accessible and affordable cervical cancer prevention and treatment services, and to increase awareness of cervical cancer prevention within our communities to help put our countries on the path to elimination.

Investing in cervical cancer prevention and control now will not only improve health and save lives, it will also have a multiplier effect that can help countries advance other human and social development objectives for generations to come.

The WHO global strategy

As the fourth most common cancer among women, cervical cancer kills more than 300,000 women every year. These women are dying of a preventable, treatable cancer at the prime of their lives. Across the globe, current vaccination and screening programs are not being implemented to their maximum potential to prevent cervical cancer and accelerate progress to elimination. Globally, only 15% of vaccine age-eligible girls are fully vaccinated against HPV. Similarly, in low- and middle-income countries (LMICs), it is estimated that fewer than 20% of women have been screened for cervical cancer, compared with 60% in high-income countries. Urgent action is needed to scale up the implementation of these proven cost-effective measures.

Against this backdrop, in 2018 the WHO Director-General called for the elimination of cervical cancer, sparking a series of consultations that led to the development of WHO’s global strategy to achieve one goal: accelerate the elimination of cervical cancer as a public health problem. With three key strategies and clear 2030 targets—an increase of HPV vaccination to 90%, twice-lifetime cervical screening to 70%, and treatment of pre-invasive lesions and invasive cancer to 90% (also known as the 90-70-90 targets)—this global call-to-action provides a roadmap to eliminate cervical cancer.

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Achieving this vision and each of the elimination targets will require a whole-of-society and multisectoral approach to ensure health systems prioritize women and girls, leveraging natural points of integration—including sexual and reproductive health and rights (SHRH), HIV/AIDS, non-communicable diseases (NCDs), and maternal health. Individuals, families, communities, , civil society, and government agencies at all levels have a role to play in championing greater awareness, education, and social support.

At this critical juncture, we must empower women and rally our neighbors, community leaders, and governments worldwide to take action and save millions of lives. If widespread, high coverage of these interventions can be achieved by 2030 and maintained, research predicts cervical cancer can be eliminated in most countries globally by 2120—avoiding over 63 million deaths of women globally.

Together, let’s commit to women everywhere—especially women in marginalized communities—to end cervical cancer.

What does it mean to eliminate cervical cancer?

WHO defines cervical cancer elimination as reducing the number of cervical cancer cases in each country to 4 per 100,000 women or lower. When this is achieved, cervical cancer will be ‘eliminated as a public health problem’. No country has achieved elimination yet.

The Case for Investment

Taking action to meet the 90-70-90 targets will not only save millions of lives, it also offers immense economic and societal benefits. Beyond the toll on health and mortality, cervical cancer imposes a significant burden on national economies as well as social and human development. Cervical cancer is not only robbing families of mothers, daughters, sisters, and grandmothers, it also reduces productivity, limits economic growth, and may trap families in poverty.

Investment in the scale-up of cervical cancer prevention and treatment services has a multiplier effect that can help countries advance achievement of other national strategic priorities and the Sustainable Development Goals (SGDs). Eliminating cervical cancer would contribute to several SDG Goals, including; eliminating poverty (SDG 1), good health and well-being (SDG 3), reducing by one third the premature mortality from noncommunicable diseases (SDG 3.4), ensuring universal access to sexual and reproductive health care services (SDG 3.7), gender equality (SDG 5), and reducing inequalities (SDG 10).

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Globally, by investing to meet the 90-70-90 targets, an estimated 250,000 women would remain productive members of society, adding an estimated $28 billion to the world’s economy through 2050 ($700 million directly through increased workforce participation and over $27 billion through the indirect socioeconomic benefits of good health).

Investing in cervical cancer prevention and control makes sense. For every dollar invested in cervical cancer prevention and treatment, at least $3.20 will be returned to the economy through 2050. 

Investing in cervical cancer prevention and control now improves health, saves lives, improves workforce participation and productivity, limits the financial burden of unexpected health costs from cancer on individuals and families, and has co-benefits that can help countries advance other human and social development objectives.

Different Paths to Elimination

We have all the tools to eliminate cervical cancer, but there is no single path to elimination. Different countries are using different strategies to accelerate progress towards cervical cancer elimination.
A Global Call to Action

“This is a call to action to eliminate cervical cancer… When we have all the weapons at hand, failure should not be an option.”

-Dr Tedros Adhanom Ghebreyesus, Director-General, World Health Organization

 

 

Australia: leading the path

In Australia, elimination is in reach and on track for 2028. Experts attribute their rapid success to a combination of widespread vaccination of girls with HPV and optimization of their screening process to HPV testing.

 

 

 

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Photo courtesy of USAID
Rwanda: mobilizing society

In 2011, Rwanda launched a strong effort to vaccinate girls against HPV and introduce cervical screening for women.  Within the first year of the efforts, Rwanda reached nine out every 10 girls eligible for the vaccine; a result that experts still cite as a model for success.  To achieve these impressive results, these efforts have had to overcome many barriers, including dispelling the myth that cervical cancer is a result of witchcraft, and have engaged many different members of society, including community leaders, churches, village elders, health workers, schools and the media.

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Encouraging Developments

Our knowledge is evolving each day, helping us advance toward elimination more quickly.  This includes:

  • New vaccine manufacturers who are entering the market in countries like China and India
  • Research to explore the feasibility of one dose of the HPV Vaccine
  • New technologies for cervical cancer screening
ONE DOSE HPV VACCINE
By: Pixabay

The cost and logistical difficulties of vaccinating girls with the recommended multiple-doses has been a significant barrier to achieving high rates of HPV vaccination amongst target aged girls. Encouraging advancements around the efficacy of moving to one-dose of HPV vaccine could result in lower-cost vaccination programmes and more girls receiving the vaccine in the future.

Learn More
NEW VACCINE MANUFACTURES
By: Pixabay

To date we’ve faced a shortage in supply of the HPV vaccine, which has significantly limited the number of girls that could be reached. This would have continued for many more years if it wasn’t for the new manufacturing commitments. Forecasts have increased from 50 million girls having access to the vaccine, to 84 million girls in the period 2021-2025.

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SELF-SAMPLING HPV SCREENING
By: Pixabay

In some countries, conventional screening technologies face significant cultural and psychological barriers, including embarrassment during pelvic examination and fear of a positive diagnosis. New woman-centred technologies, such as HPV- self sampling, are helping overcome these barriers.

Learn More
ONE DOSE HPV VACCINE
NEW VACCINE MANUFACTURES
SELF-SAMPLING HPV SCREENING
By: Pixabay
By: Pixabay
By: Pixabay

The cost and logistical difficulties of vaccinating girls with the recommended multiple-doses has been a significant barrier to achieving high rates of HPV vaccination amongst target aged girls. Encouraging advancements around the efficacy of moving to one-dose of HPV vaccine could result in lower-cost vaccination programmes and more girls receiving the vaccine in the future.

Learn More

To date we’ve faced a shortage in supply of the HPV vaccine, which has significantly limited the number of girls that could be reached. This would have continued for many more years if it wasn’t for the new manufacturing commitments. Forecasts have increased from 50 million girls having access to the vaccine, to 84 million girls in the period 2021-2025.

Learn More

In some countries, conventional screening technologies face significant cultural and psychological barriers, including embarrassment during pelvic examination and fear of a positive diagnosis. New woman-centred technologies, such as HPV- self sampling, are helping overcome these barriers.

Learn More