Experts discuss challenges of eliminating cervical cancer in low and middle income countries, including lack of funding, staffing, and infrastructure. The difficulties of rolling out HPV vaccination and the impact of vaccine hesitancy are examined. The importance of targeting adolescents for vaccination and integrating health interventions is emphasized, as well as the significance of government understanding, reliable data, and advocating for prioritizing adolescent health in addressing cervical cancer.
Implementing cervical cancer screening in low and middle-income countries is hindered by a lack of infrastructure, trained personnel, and a strong connection between screening and treatment.
Rolling out HPV vaccination in low and middle-income countries requires collaboration between government, education, and health sectors, along with political commitment, and school-based vaccination has proven effective.
Deep dives
Challenges of implementing cervical cancer screening in low and middle-income countries
Implementing cervical cancer screening, such as pap smears, in low and middle-income countries has been challenging due to the lack of infrastructure and trained personnel to perform and interpret the tests. The complexity of getting the test results back to the women and arranging for treatment further hinders successful screening programs. The need for a strong connection between screening and treatment is a key challenge in these countries.
Challenges and strategies for HPV vaccination in low and middle-income countries
Rolling out HPV vaccination in low and middle-income countries faces various challenges. In India, there is hesitancy around HPV vaccination due to concerns about the vaccine's association with sexual activity, as well as uncertainty about the appropriate age for vaccination. In South Africa, the COVID-19 pandemic severely impacted vaccination coverage. However, successful vaccination programs have been observed in countries like Rwanda and Bhutan. Collaboration between government, education, and health sectors, along with political commitment, is essential. School-based vaccination has been effective and is recommended for reaching a high coverage rate.
Importance of political support and evidence-based communication
Encouraging governments to prioritize the elimination of cervical cancer requires understanding the cost-saving benefits of prevention, such as contributing to the economy and reducing the loss of productive women. Governments need to be presented with accurate scientific evidence, specific to their cultural context, to persuade them to prioritize the issue. Additionally, prioritizing adolescent health and highlighting the long-term benefits of investing in this population can help governments recognize the value of prevention and the potential for a healthier workforce.
Cervical cancer is both treatable and preventable, and the WHO has called for countries to come together to to eliminate the disease in the next century.
However the disease still kills over 300,000 people each year, and levels of screening, treatment and vaccination need to be stepped up in order to achieve this goal.
These challenges are particularly stark in low- and middle-income countries, where a lack of funding, staffing and infrastructure are obstacles. Vaccine hesitancy, especially in light of the COVID-19 pandemic, is also a key problem.
In this Podcast Extra, two experts share their thoughts on how best to overcome these obstacles, and make elimination of cervical cancer a reality.