HPV Vaccination in Africa: A Game-changer for Women’s and Girls’ Health, CPHIA 2023

Submitted by kiawoinr@who.int on Fri, 01/12/2023 - 11:03

Remarks by WHO Regional Director for Africa, Dr Matshidiso Moeti

Dr Sylvia Masebo, the Honourable Minister of Health of Zambia,

Dr Jean Kaseya, the Director General of Africa CDC,

Ms Etleva Kadilli, UNICEF Regional Director for East and Southern Africa,

Professor Helen Rees, Chair of the African Regional Immunization Technical Advisory Group (RITAG),

Dr Nathan Bakyaita, WHO Representative to Zambia,

Distinguished guests and partners,

We’ve gathered this afternoon to discuss how we can accelerate progress towards eliminating the no. 1 cancer killer of African women from the continent. 

Cervical cancer reflects health and gender inequalities. In 2020, in the African Region, 100 000 women developed it, and about 70 000 of them died. This makes up 21% of cervical cancer mortality globally.

We know that more than half of the cases in our region occur among HIV-positive women – who are six times more likely to develop this disease. And this reflects the inequities that still drive the risk of HIV acquisition. 

The stark numbers testify to gaps in access to vaccination, screening, diagnosis, and treatment driving this high burden.

There’s a huge urgency to address gaps in prevention, screening, and cancer management; and it is pressing to ensure that all women and girls benefit from life-saving interventions.

We have a cost-effective and efficient way of preventing cervical cancer - the HPV vaccination.

Ladies and gentlemen, colleagues, 

When we integrate and scale up HPV vaccination programmes, we launch a game-changer; we give new impetus to our drive to eliminate the disease.

Although our campaign is not where we’d like it to be, we’ve made some progress. 

I rejoice that twenty-seven African countries have introduced HPV vaccines into their national immunization programmes.

I’m so pleased that thirty-four countries in Africa have cervical cancer screening programmes. Among these, 14 have introduced HPV DNA testing, recommended by WHO.

In 2021, the WHO Regional Committee adopted a Regional Framework for eliminating cervical cancer in the WHO African Region. The Framework is a priority for me and our AFRO team, and we will leave no stone unturned to support our Member States in achieving its targets. 

Let us accelerate our efforts for the HPV vaccine by implementing WHO’s recommendation for a single-dose schedule. 

Gavi—the Vaccine Alliance’s HPV revitalization programme, over the next three years, will enable us to get the vaccine to 86 million adolescent girls in low- and middle-income countries. Let’s embrace and implement it. By doing so, we’ll ease supply constraints and introduce new lower-cost suppliers. 

The time has come to take up the prevention, screening, and treatment of cervical cancer in Africa; to unleash its potential to unlock broader health opportunities for our young women; to integrate sexual and reproductive health and rights, HIV prevention, menstrual hygiene, and non-communicable diseases.

I must commend Botswana, which continues to provide screenings through Pap Smear, Visual Inspection with Acetic acid (VIA) and HPV testing. More VIA sites are currently being established. The provision of 40 thermal ablation equipment by WHO has contributed to the expansion of screenings and treatment. The Government’s commitment, as well as the incorporation of cervical screening into HIV, are useful lessons.

In Kenya, with our support, community-based HPV DNA testing through self-sampling has taken root. Community health workers champion it; and women can access screening for cervical cancer without travelling to larger centres. 

Turning to Malawi, the introduction of rapid HPV DNA testing at primary healthcare facilities is making a difference. It has reduced the number of patients previously unattended to.

Over half of the WHO Member States in Africa have successfully introduced HPV vaccines into their immunization schedules. They have successfully delivered the first dose to 33% of girls aged 9-14 in 2022. 

The journey continues; the introduction of the single-dose regimen will improve these numbers. Nine countries in the African Region have already announced plans to adopt a single-dose HPV vaccine.

These are tremendous achievements. However, we must increase equitable access to HPV vaccination, particularly in West and Central Africa and those countries not eligible for Gavi support.

Our challenges may be grand. The instruments with which we meet them may be innovative. But those resources upon which our success depends – partnerships (with the private sector, communities, education sector), advocacy, and resource mobilization - must not be lacking. 

We’ve supported five countries (Ghana, Mozambique, Tanzania, Zambia, and Zimbabwe) in developing Global Fund proposals.

With the International Agency for Research on Cancer, Côte d’Ivoire, Kenya and South Africa have launched collaborative centers to promote national capacity building in cancer surveillance; and improve data collection.

This is encouraging progress; we’re learning, adapting, overcoming obstacles. 

Ladies and gentlemen,

Let our children’s children say that we did our best to prevent cervical cancer in Africa.

Let them say that we used various interventions, from vaccines to treatment. 

And let them say that our partnership was unbreakable and our collaboration rock solid.

I am convinced our efforts today will lead to a continent where no woman or girl dies of cervical cancer. My team and I are committed to this.

Thank you.