Remarks by WHO Regional Director for Africa, Dr Matshidiso Moeti
Her Excellency, Mrs Antoinette Sassou Nguesso, the First Lady of the Republic of Congo,
Honorable Ministers of Health,
Partners co-hosting this event - Gavi-the vaccine alliance, Bill and Melinda Gates Foundation, and the Sabin Institute with Global HPV Consortium,
All partners and donors present,
Cervical cancer survivors,
Ladies and Gentlemen.
Good evening to you all.
We’ve gathered to discuss accelerating cervical cancer elimination in Africa.
Let me start with some figures – globally, every two minutes, a woman dies of cervical cancer; in Africa in 2022, more than 76,000 women died of cervical cancer – which is 23% of the global mortality burden.
Many of you were at the global cervical cancer elimination forum held in Cartegena de Indias, Columbia, in March this year. At that meeting, the global cervical cancer community focused on securing government commitments to eliminate a full category of cancer – cervical cancer – on a global scale.
Cervical cancer is of particular interest to me. At the Regional Committee session in Gaborone, Botswana, last year, I attended a meeting specifically for cervical cancer survivors and heard their inspiring stories.
I am delighted, again, to welcome cervical cancer survivors today, to learn from their first-hand experience, and to ensure that their voices are part of our push to accelerate the elimination of this disease.
I am going to reiterate what we all know – we can completely prevent cervical cancer through vaccination and screening.
We can cure cervical cancer by treating pre-cancerous lesions – but we must have the means to detect the cancer early – and to treat it appropriately.
That’s what we’ve gathered to discuss: How to overcome the major inequities in access to the HPV vaccination and to the high-performance HPV-DNA screening tests that are critical to prevention. And how to achieve a timely treatment of pre-cancerous lesions?
In 2021, the 71st session of the Regional Committee for Africa adopted the regional framework for the implementation of the global strategy to accelerate the elimination of cervical cancer as a public health problem in the WHO African Region.
Although we have not yet achieved the 2030 control targets of 90-70-90, we’ve made some progress. In 2023, the region achieved 40% vaccination coverage for the first dose, and 28 countries successfully introduced HPV vaccines into their national immunization schedules. In 2022, five countries achieved over 90% single-dose coverage.
Despite these major strides in HPV vaccination in the region, there is still a need for increased and equitable access to HPV vaccines, particularly in West and Central Africa and non-Gavi support-eligible countries.
Regarding screening, thirty-four countries in the region have established screening programmes. These countries use either PAP smear, visual inspection, or, in a few cases, HPV-DNA testing, or a combination of these methods.
Seventeen countries have introduced HPV-based screening, but only at the sub-national level and often in pilot sites.
We need to build on the momentum of these successful programmes and expand this access to HPV vaccines and screening through HPV-DNA testing – to every eligible girl and woman in our region.
There are two key components to this – the first is the integration of cervical cancer prevention, screening, and treatment into routine immunization schedules for the HPV vaccine and HPV-DNA testing into routine care for women.
This is already happening in Zimbabwe and Malawi, where cervical cancer screening is being offered as part of HIV services. In other countries, Burundi, Liberia, Sierra Leone, and Uganda, cervical cancer services are integrated into Sexual and Reproductive Health and Rights services.
We must expand this integration into all routine health services for women and adolescent girls.
HPV vaccines and HPV-DNA testing have been available at scale in the global north for many decades. We must ensure that the global south is not neglected.
The major issues are cost and access; we must resolve them.
I would like to leave you with these key messages. First, there is a high-level political commitment to eliminate this disease. This commitment needs to be translated into concrete actions to cut costs and increase access to the tools we know will achieve our aim.
Second, we must encourage partners to keep the same level of commitment in the fight against cervical cancer, especially those companies that have put effort and resources into producing life-saving vaccines and screening tests. This means finding innovative ways to cut costs – I look forward to your views and ideas around this.
Third, the WHO Regional Office for Africa remains fully committed to continuing the battle against this highly preventable disease, supporting our countries, and collaborating with partners.
I look forward to fruitful discussions, and we’ll work to implement them.