Cancer Control Chronicles

Five ways USAID is advancing a cervical cancer free tomorrow

Students at Donge School in Zanzibar receive their HPV vaccine after an outreach day at school. /
Amy Cotter Fowler for USAID

Cervical cancer claims the lives of one woman every two minutes, with a significant impact felt in Africa. An overwhelming 90% of these deaths occur in low- and middle-income countries (LMICs), demanding urgent, targeted solutions for the women who are most at risk.

Despite being the fourth most common cancer in women, the good news is that cervical cancer is highly preventable and treatable. More than 95% of cervical cancer cases are linked to the Human Papillomavirus (HPV) infection and the HPV vaccine serves as a safe and potent tool, preventing over 90% of HPV-related cancers, including cervical cancer. HPV vaccination, alongside screening and treatment, forms the triad at the heart of the World Health Organization’s mission to swiftly eradicate cervical cancer.

Vaccinating girls before exposure to HPV is critical everywhere, but most especially in low-income countries where women often encounter barriers to quality healthcare and lack access to cancer screening and treatment services.

To address the urgent need for preventing cervical cancer, USAID is committed to partnering with governments and organizations to provide access to HPV vaccination and cancer screening and treatment services. Our multifaceted approach aims to provide equitable and timely access, empowering women not only to survive but also to drive the growth and prosperity of their families, communities, and countries.

Here are five ways USAID is making a significant impact in fighting cervical cancer.

At Donge School, in Zanzibar, health workers come to the classroom to educate students on preventing HPV and the importance of getting vaccinated for girls. / Amy Cotter Fowler for USAID

Accelerating the Introduction and Coverage of HPV Vaccination

1.USAID is committed to expanding global access to the HPV vaccine, a crucial step in preventing cervical cancer. USAID has a longstanding partnership with Gavi, the Vaccine Alliance (Gavi), with a recent annual contribution of $290 million.

With its aim to save lives and protect people’s health by ensuring access to essential vaccines in LMICs, Gavi has played a pivotal role in revitalizing its HPV vaccination program, especially in light of the disruptions caused by the COVID-19 pandemic. As of November 2023, 37 countries have introduced HPV to their routine immunization programs with Gavi support, most recently Nigeria and Bangladesh. Gavi’s efforts to date are instrumental in increasing HPV vaccine coverage in LMICs, effectively safeguarding millions of adolescent girls from cervical cancer.

A health worker administrates HPV vaccine in Mozambique. / Neide Guesela for USAID

Strengthening HPV Vaccination Programs with Technical Support

2.USAID provides essential technical assistance to enhance HPV vaccination programs at both global and country level, extending its reach to more adolescent girls. At the country level, USAID supports strengthening readiness to integrate the HPV vaccine into routine immunization. This involves a focused effort on building the capacity of national immunization program management, along with the training of health care providers, community health workers, and teachers. USAID also provides support to evidence-based social and behavior change programming to increase HPV vaccine demand and uptake.

On a global scale, USAID’s implementing partners — including MOMENTUM Country and Global Leadership, and Routine Immunization Transformation and Equity — contribute to testing and documenting lessons learned and best practices on reaching eligible populations with the HPV vaccine, both across and within different countries and contexts.

Mamofolo is a nurse at the Senkatana Centre of Excellence for cervical cancer prevention and HIV care and treatment in Maseru, Lesotho. The Centre was funded by USAID, in cooperation, with the Lesotho Ministry of Health and Elizabeth Glaser Pediatric AIDS Foundation. / Ilana Lapidos-Salaiz

Advancing Access to Cervical Cancer Screening and Preventive Treatment

3.Women living with HIV are six times more likely to develop cervical cancer compared to women without HIV. And women with any HPV infection have a twofold higher risk of acquiring HIV than women without HPV infection. USAID, through the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR), plays a key role in increasing access to cervical cancer screening and preventive treatment for these women through the Go Further Partnership to End AIDS and Cervical Cancer. Since 2018, USAID has supported programs that resulted in 2.7 million cervical cancer screenings for women with HIV.

In addition, USAID’s Partnerships for Enhanced Engagement in Research (PEER) program has helped advance access to cervical cancer screenings. In Mozambique and Malawi, PEER gave women the option to self-collect vaginal samples for cervical cancer screening with an HPV test. Researchers discovered that this approach was often preferable to collection by a medical professional as it avoids the need for a pelvic exam, which can feel invasive and deter women from seeking medical care.

USAID collaborated on a job aid for health workers in Uganda on how to prevent cervical cancer. / Uganda Ministry of Health

Engaging Communities and Health Systems

4.USAID’s support, through PEPFAR, extends beyond clinical services to inform communities, create demand for services, and strengthen health systems to reach women living with HIV at risk of cervical cancer. USAID collaborates with host country governments and partners to establish accurate and current guidelines and creates job aids for health workers to learn how to prevent and treat cervical cancer. To further promote prevention, screening, and treatment services, USAID has created innovative educational materials on the benefits of HPV vaccination and links women at risk of cervical cancer to essential vaccination, screening, and treatment services.

Students at Donge School, in Zanzibar, receive their HPV vaccine after an outreach day at school. / Amy Cotter Fowler for USAID

Improving Links Between Cervical Cancer Prevention and Other Services

5.USAID also supports increased collaboration with other cancer, adolescent health, family planning, and education initiatives in these countries. The aim: a better understanding of key factors that support strong, sustainable HPV vaccination programs in select countries. This approach ensures the seamless integration of cervical cancer prevention into broader health initiatives.

Additionally, the USAID PEER program conducted two clinical trials to generate evidence on the most effective and efficient ways to combine cervical cancer screening with voluntary family planning services. Lessons learned from these trials contribute to the continuous improvement of cervical cancer prevention efforts.

Enhancing access to vaccines and healthcare services is a multifaceted endeavor that demands strong political dedication from leaders both on the global and local fronts.

It also relies on fostering close partnerships with key champions, including community and cultural leaders, and deploying platforms that are adaptable to the unique requirements of adolescent girls and women.

USAID supports advancing equitable and high-quality access to cancer prevention, screening, and treatment services. Through these collaborative efforts, we are actively working towards a healthier and more inclusive future for all.

About the Author

USAID’s Office of Maternal and Child Health and Nutrition works to ensure that all women and children have the same chance of a healthy life, regardless of where they live or are born.