WHO's bold step towards a cancer-free future

analysis: Cervical cancer is preventable and treatable, and in August 2020, the World Health Assembly adopted the Global Strategy to End Cervical Cancer. Yes, that's right. Although there may never be a cure-all for cancer, some cancers can be prevented with vaccines. The WHO strategy is a collective call to arms to eradicate cervical cancer.

The HPV vaccine became available in 2006. It is based on the legendary discovery by Ian Fraser, who led the research that led to the development of this incredibly effective vaccine that prevents not only cervical cancer, but also genital, oral, and other cancers. And the throat.

WHO's bold initiative comes after years of concerted efforts by the medical and public health communities to curb the incidence of this preventable disease. The goal is ambitious, but quite achievable. The report calls on countries to achieve three key goals by 2030. Viral vaccination for 90% of girls by age 15; screening of 70% of women by age 35 and again at age 45; 90% is cured. It's a simple recipe. 90% vaccination, 70% screening, and 90% treatment. But what about the ingredients? Political will, accessible healthcare, and a little community magic. This frameworkIf implemented worldwide, millions of lives could be saved.

Why cervical cancer?

Cervical cancer begins in cells on the surface of the cervix. The current narrative around cervical cancer has a plot that only poverty can portray, and although it is now a preventable disease, it remains prevalent in the areas where help is hardest to reach. . The main cause of cervical cancer is persistent infection with high-risk strains of the HPV virus that cannot be prevented by vaccination. And ultimately they are excluded from the community. As with other viruses, once vaccination rates in a community are high enough, it can no longer be transmitted. In other words, it's game over for the virus. Cervical cancer is not only preventable, but also curable if detected early.

And yet…more than 600,000 women are diagnosed and more than 300,000 die each year worldwide, with most of these deaths occurring in resource-poor settings. These numbers are especially tragic given that effective vaccines and screening methods already exist.

Rwanda and Scotland show us how.

Here are some facts that may come in handy on quiz night. Rwanda and Scotland are leading the way in eradicating cervical cancer.

Rwanda, often cited as a world leader in HPV vaccination, was the first low-income country to roll out a national HPV vaccination program, offering free vaccines to girls as young as 12 in 2011. The results were remarkable, with more than 93 percent of girls vaccinated. The HPV vaccine is administered in Rwanda. Rwanda's achievements reflect strong political will, community engagement and a successful partnership with the World Health Organization. Who would have thought? Rwanda is an example of success achieved not through GDP but through grit and community determination.

A similar success story can be seen and told in Scotland, albeit in a different, more familiar context. Scotland, with its foggy highlands and high vaccination rates, is rewriting the story. The villain, cervical abnormalities, is falling like midges in the cold. Since introducing the National HPV Vaccination Program in 2008, the country has achieved vaccination coverage of over 90 percent.

Studies have shown that the program reduced precancerous cervical abnormalities by 90 percent in vaccinated women. If Rwanda shows what can be done with low GDP, Scotland is on track to be one of the first countries to eliminate cervical cancer, and how strong vaccination and screening programs can be achieved in high-income settings. This shows that the burden of disease can be significantly reduced even if the disease is present.

What about us?

New Zealand has an established cervical cancer screening program that began in 1990, and as a result, cervical cancer incidence has decreased significantly over the past 30 years. This trend further accelerated with the introduction of the HPV vaccine in 2008, which is now part of the national immunization schedule and provided free of charge to all boys and girls aged 9 to 26 years.

Men and boys may not have a cervix or vulva, but they can still catch and transmit the virus. There is also a direct benefit, as the vaccine prevents other HPV-related cancers, such as penile, anal, and oropharyngeal cancer. And don't forget about genital warts, which affect both men and women.

There are also challenges. New Zealand has not yet met WHO targets for HPV vaccination and cervical cancer screening uptake. One of the key obstacles is disparities in access to health services, particularly for Māori and Pacific women, who continue to have higher rates of cervical cancer than non-Māori. Systemic inequalities in the health system mean these groups are less likely to participate in cervical cancer screening programs and may face barriers such as cost, cultural bias, and geographic isolation. I will.

Low HPV vaccination coverage is another concern. New Zealand is not performing well compared to many other countries. We have yet to reach nearly 90 per cent of the target set by the WHO. It's about 65 per cent for one dose, compared to 58 per cent for Māori. Overcoming vaccination hesitancy and improving access to health services in underserved areas remain major challenges. It makes sense to take the vaccine, right? But here we are wrestling with a hydra-headed beast called Hesitation.

What's stopping us?

A story about Hydra. If we want to eliminate cervical cancer in New Zealand, we need to take a multi-pronged approach, with a focus on ensuring all women have fair access to health care.

Improving vaccination rates, particularly among Māori and Pacific peoples, is a key priority. Public health campaigns tailored to these communities are needed, combined with efforts to make vaccination more accessible.

We also need to get more women involved in national cervical cancer screening programs. New Zealand recently moved to a new primary screening test, the HPV test. It is more effective than traditional pap smears and can detect high-risk viral strains before cancer develops, allowing for earlier and more effective treatment. And New Zealand introduced a self-testing option last year that could increase testing rates, especially for women who don't have easy access to a health care provider.

global efforts

The WHO declaration is a call to action not only for governments but also for communities, health workers and individuals. Cervical cancer is one of the few cancers that can be removed, and countries like Rwanda and Scotland are showing that it can be done.

Progress has been made in New Zealand, but we need to do more to ensure all women benefit from these lifesaving interventions. By continuing to tackle health inequalities, improving vaccination rates and expanding access to screening, New Zealand can move closer to the WHO goal of eliminating cervical cancer.

The concept of “eradicating cancer” may have once sounded like a pipe dream, but the WHO's efforts provide a rare reality check, with some good futures within reach. That means it's there. Making disease history in public health is a rare opportunity, and the WHO declaration gives us a blueprint to achieve it. Cervical cancer is a tragedy of the past, not a permanent threat of the future.