The World Health Assembly is adopting a global strategy to accelerate the elimination of cervical cancer

The World Health Assembly has adopted a global strategy to accelerate the removal of cervical cancer as a public health problem.

Cervical cancer is a disease that can be prevented and cured, as long as it is detected early and effectively managed. It is, after all the fourth most common form of cancer among women worldwide, i the most common cancer among women living with HIV, who are six times more likely to develop cervical cancer. In 2018, the disease took lives more than 300,000 women.

Cervical cancer is also a disease that reflects global inequality. Its burden is greatest in low- and middle-income countries, where access to public health services is limited and screening and treatment of the disease are not widely implemented. In 2018, almost 90% of all deaths in the world occurred in low- and middle-income countries. Furthermore, the proportion of women suffering from cervical cancer who die from this disease is higher than 60% in these countries, which is more than twice as high in many high-income countries, where it is lower than 30%.

Human papilloma virus (HPV) is a major cause of cervical cancer, and the HPV vaccine is a safe and effective way to protect women from HPV infection. But since 2020, less than a quarter of low-income countries have introduced the HPV vaccine into their national immunization schemes, while more than 85% of high-income countries have done so. Similar differences have been observed in the establishment of cervical cancer screening programs.

“Most of these women are not diagnosed early enough and lack access to lifelong treatment,” Dr. Tedros Adhanom Ghebreyesus, WHO Director-General, said when he issued the 2018 Call to Action. “These women are raising children, caring for their families and contributing to the social and economic fabric of their communities. If we don’t act, deaths from cervical cancer will increase by almost 50% by 2040“. With the adoption of the removal strategy by the World Health Assembly, Dr. Princess Nothemba Simelela, assistant director general of the World Health Organization for strategic program priorities, said the resolution represents an opportunity for leaders and advocates to “end injustice and restore women’s dignity.”

The path to cervical cancer removal

To eliminate cervical cancer, all countries must reach and maintain an incidence rate below four per 100,000 women. Achieving this goal requires strategic action, and the WHO outlines the necessary actions in its global strategy, envisioning a world in which cervical cancer is being eliminated as a public health problem and keeping the 2030 agenda on SDGs.

WHO’s removal strategy rests on three main pillars:

• vaccination prevention
• screening and treatment of precancerous lesions
• treatment and palliative care in invasive cervical cancer

All three pillars must be implemented jointly and to scale in order to achieve the removal objective. HPV vaccination offers long-term protection against cervical cancer. Screening and treatment of precancerous lesions can prevent precancerous lesions from developing into cancer. For those identified with invasive cancer, timely care and treatment save lives, while palliative care can greatly reduce pain and suffering.

Based on the three key pillars of the global strategy, the WHO recommends a series of goals or milestones that each country should meet by 2030 to embark on the path to cervical cancer removal in the century:

• 90% of girls are fully vaccinated with the HPV vaccine by age 15;
• 70% of women were tested by high-performance studies by age 35 and again by age 45; and
• 90% of women identified with cervical disease receive treatment (90% of women who have been treated for cancer and 90% of women with invasive cancer succeed).

Projections show that achieving the 90-70-90 targets by 2030 can reduce the median incidence rates of cervical cancer by 10% by 2030, and by 2120, 70 million cases can be prevented. In addition, by 2120, 62 million cervical cancer deaths could be prevented. Meanwhile, implementing the strategy today will save lives.

A robust monitoring system, including population-based cancer registries, is key to tracking progress and making course adjustments.

Elimination of cervical cancer would also result in positive economic and social outcomes. By 2030, about 250,000 women will remain productive members of the workforce, adding an estimated global economy of about $ 28 billion: $ 700 million as a direct result of increased labor participation and about $ 27 billion as an indirect benefit of good health.

COVID-19 could disrupt efforts to achieve the goals set out in the global strategy. In the midst of a pandemic, access to life-saving treatments remains crucial. It is crucial to ensure the continuation of basic health services, while taking all appropriate precautions so that more women do not die from this preventable disease.

Elimination of cervical cancer is at your fingertips

Cervical cancer is one of the world’s biggest public health shortcomings, but with strong action and coordinated intervention, elimination is within reach of all countries. Technology and tools exist to prevent this disease, with proven measures of early diagnosis and treatment.

“Through cost-effective evidence-based interventions, including vaccinating girls against papillomavirus, screening and treating precancerous lesions, and improving access to the diagnosis and treatment of invasive cancers, we can eliminate cervical cancer as a public health problem of the past,” Dr. Tedros said.

The time has come for an ambitious, coordinated and inclusive strategy to accelerate the removal of cervical cancer as a global public health problem. Our collective responsibility is to make it a fruit: policymakers, health workers, civil society, the research community and the private sector have an important role to play.

Now is the time to act.