AFRICA: Cervical cancer vaults to WHO priority list

With cervical cancer cases rising across Sub-Saharan Africa, and 80 percent of women diagnosed too late to stop the cancer’s deadly spread, the World Health Organization (WHO) is recommending screening and vaccination programmes throughout the region.

“WHO is going to strongly advocate with donors and decision-makers to list cervical cancer as a public health priority…because with a vaccine we can save lives by preventing cervical cancer.” said Jean Gabriel Wango, head of family health at WHO in Ouagadougou.

The vaccine will help fight the Human Papilloma Virus (HPV), which if left untreated, can develop into cervical cancer.

A silent killer’s spread

"There is little investment in this disease and many of our women are unaware of it…so they die in silence,” said Sita Kaboré, president of Kimi, an association that runs cervical cancer screening campaigns in Burkina Faso.

A cancer physician at the UK-based Oxford University, David Kerr, says by 2020, 70 percent of the 15 million new cases of cancer diagnosed every year will be contracted in the developing world.

Cervical cancer is the most common tumour for African women, according to WHO. In Uganda, 80 percent of female cancer survivors suffer from cervical cancer, says Dan Murokora, a Uganda-based gynecologist.

But weak record keeping has hampered governments’ efforts to find out the disease’s morbidity rates; WHO advises governments to focus on record keeping in developing their prevention plans.

Screening

Cervical cancer is largely preventable but women need to be screened every three to five years to halt the deadly disease, according to Charlemagne Ouédraogo, a Ouagadougou-based gynecologist.

But in Sub-Saharan Africa, which lacks diagnostic equipment and national prevention programmes, only 5 percent of women are regularly screened for cervical cancer, according to WHO’s Boureima Hama Sambo, relegating most cases to late-stage, hard-to-cure diagnoses.

WHO is urging health ministries to make the HPV vaccine available in their national health plans to all 10 to 13-year- old girls in order to prevent the disease.

Reducing vaccine costs

The vaccine’s three doses cost a total of US$300, in a region where the average annual salary is about US$550, according to the UN Children’s Fund, UNICEF.

The Geneva-based Global Alliance for Vaccines and Immunization is expected to negotiate with pharmaceutical companies to bring the price down, while the UN, Program for Adaptation of Technologies in Health (PATH), and World Bank have pledged to help with costs so patients only pay US$45 for the vaccine.

Hurdling the cost barrier

For some of Africa’s health officials, this price reduction is key to their governments’ participation. "It is a good idea to integrate the HPV vaccine into programmes, but it remains too expensive. WHO and its partners need to assist countries to buy the vaccine first." says gynecologist Caroline Leite from Cape Verde.

WHO’s Sambo dismisses these cost concerns, and says the vaccine should be widely available soon. “We think that there is an expression of political will and we think that very soon we’ll be able to roll out the vaccine for these populations,” he concluded.

IRIN