As rates of cervical cancer and deaths rise at an alarming rate in the Region and countries grapple with the challenge of managing the disease in poorly-resourced settings, WHO warns that without an effective intervention, global cervical cancer deaths will increase to 460 000 by 2040 –and low- and middle-income countries (LMICs) will have the greatest relative increase.
We have developed guidance on how to prevent and control the disease across the various stages of the life course, through vaccination, screening and management of invasive cervical cancer as well as palliative care. We also work with countries and partners to develop and implement comprehensive programmes.
On World Cancer Day in 2019, WHO launched a new toolkit to guide countries on how to collect and use standardized cervical cancer data to help them fight the disease. Recognizing that the burden and prevention strategies vary between countries, we focused attention on the common questions, including how to measure screening and secondary prevention coverage, how to implement and strengthen systems to monitor patients and programmes, and how to estimate costs of screening and treatment programmes.
Having this high-quality data will help countries inform, plan, scale up and improve their cervical cancer programmes. For example, data on screening coverage and update will inform interventions that ensure no woman is left behind.
Elimination of cervical cancer as a public health problem is one of our flagship projects. In May 2018 we issued a global call to action towards achieving this goal, followed by a request from the Executive Board in January 2019 that the Director-General consult with Member States and other relevant stakeholders on the development of a global strategy specifying clear targets for 2020–2030. This effort to mobilize new political will to tackle this fast-growing challenge saw a zero Draft of the Global Strategy towards the Elimination of Cervical Cancer become a reality in July 2019. Further development is expected, with a view to the final version being ready for consideration by the Seventy-third World Health Assembly, through the Executive Board at its 146th Session in January 2020.
The global strategy sets the following targets for countries to achieve by 2030:
- 90% of girls must be fully vaccinated with the HPV vaccine by the time they turn 15
- 70% of women must be screened with a high-precision test 1 at 35 years of age, and then again at the age of 45 years
- 90% of women identified with cervical disease must receive treatment and care.
The document emphasizes that vaccination against HPV virus, screening and treatment of precancers, early detection and prompt treatment of invasive cancers and palliative care, are all proven, cost-effective strategies that, together, address cervical cancer across the care continuum.
Other key elements for ensuring the success of eliminating cervical cancer as a public health problem include the following:
- Member States and partners increase investment in this goal so as to secure sustainable financing for cervical cancer programmes, and jointly mobilize resources
- a framework that can track improvement processes by monitoring implementation and validating elimination is made available
- partners to expedite research outcomes with respect to innovations that will secure faster and more efficient elimination, and facilitate access to such innovations. Examples are cheaper HPV vaccine delivery mechanisms, and screening and treatment technologies that would promote access.
Status of the Cervical Cancer Elimination Initiative in WHO African Region