New coalition to increase access to cervical screening in sub-Saharan Africa

Source: Marie Stopes

The coalition, comprising a network of community and civil-society organisations, will work to identify the obstacles that limit uptake of screening for the disease, raise awareness of preventive measures, advocate for urgent action to accelerate progress towards achieving national elimination targets by 2030, and provide user-led feedback and preferences to inform development and scale-up of new testing technologies and strategies.

Insights from the coalition will shape Find’s broader strategy to increase access to cervical-cancer screening and accelerate elimination of this devastating yet preventable and treatable disease.

Find is working in partnership with ministries of health and affected communities to co-design solutions that start with communities and tie seamlessly into national cervical-cancer screening services to accelerate progress towards global elimination goals.

Identifying those most affected

Every two minutes, a woman dies of cervical cancer. Women living in lower-income countries are most affected, with mortality rates in sub-Saharan Africa up to 18 times higher than in other regions. Caused in most cases by HPV, cervical cancer is both preventable and curable – with some models showing that a combination of “twice-lifetime” screening (between 35 and 45 years of age) alongside HPV vaccination for girls and young women - and linkage to treatment - could reduce cervical cancer cases by up to 97%.

Effective prevention, screening and treatment approaches exist, and could make cervical cancer the first cancer to be eliminated, but these measures aren't reaching the regions with the highest burden of disease. Around 44% of women in low- and middle-income countries have never been screened, with limited availability of new high-performance tests, high prices, lack of public awareness and stigma all creating barriers to access.

Women living with HIV are at particularly high risk and need targeted testing strategies.

Understanding barriers to screening

Essential to the success of cervical-cancer elimination will be a deep understanding of the barriers that prevent women from getting screened and their preferences on screening services and approaches (where, how, and by whom).

The newly announced coalition benefits from an existing network that is already operating to drive action against cancer and HIV in high-burden countries in Africa and will expand coverage to reach all eligible women.

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For cervical cancer, 30 people in high-burden countries have already received training and education around the goals and strategies for disease elimination, including the role of HPV testing and self-collection of samples.

These individuals will conduct community focus-group discussions and surveys to gather insights from other women about their perceptions and preferences. They will also advocate for life-saving cervical-cancer screening to reduce stigma and increase demand for tests.

Addressing health inequalities

Angela Muriuki, newly appointed director of the women’s health programme at Find, and a passionate advocate for people-centred approaches to addressing the needs of women and girls, said: “Through this initiative, women-led community organisations are empowered to play an active role in co-creating scalable solutions to address health inequalities and expand access to care.

“These women, representing those bearing the heaviest burden of cervical cancer globally, should be shaping policies and driving action at national, regional and global levels so that policies are responsive to their needs and expectations.

“Find is committed to co-developing solutions that start with the community to empower their voice in shaping scalable approaches that will align with national priorities to drive equitable access to diagnostics and health services.”

Advancing progress in diagnostic testing

Benda Kithaka, executive director of Kilele Health Association, said: “Women in Africa face many challenges occasioned by inequity. Evidenced by inequity in accessing education, healthcare, employment, and many other social ills that plague women and girls. One thing that women in Africa have taught us is resilience in handling issues that affect them.

“Including women and communities in solutions for cervical health not only empowers them to take agency, but also to formulate solutions that are relatable, actionable and grounded in their lived experiences. The collaborative work with Find comes as a timely intervention, in advancing our plans to equip communities with knowledge, skills and agency to be active contributors to the elimination of cervical cancer.”

Find’s women’s health portfolio was launched in 2021 and is currently backed by new funding from the governments of Canada and the Netherlands, as part of their broader commitments to Find to advance progress in diagnostic testing.