Every year, another 660,000 are diagnosed with cervical cancer. These losses orphan their children, impoverish their families, and hit communities hard, depriving them of mothers, wives, daughters, and sisters. However, unlike most other cancers, almost all of these cases and deaths can be prevented. We have powerful vaccines that prevent infection with the human papillomavirus that causes this cancer, as well as diagnostic means to detect it early and treatments for those affected. With these tools it is not only possible to control this disease, but we could eliminate cancer for the first time. Some high-income countries are already close to achieving this, having managed to reduce the incidence to fewer than four cases per 100,000 women.
However, many low- and middle-income countries still do not have these resources, which is why they concentrate the . The double tragedy of this disease is that it is a problem not only of health, but also of lack of equity.
Every November we celebrate the Day of Action to Eliminate Cervical Cancer around the world, for which vaccination and screening campaigns and awareness-raising events are organized. On this occasion, several emblematic places were illuminated in bluish green, including the iconic Christ the Redeemer monument in Rio de Janeiro, where the G20 Summit is being held until Tuesday.
Many low- and middle-income countries still do not have these resources, which is why they account for 94% of deaths from cervical cancer.
In 2018, the WHO took action to eliminate cervical cancer, leading its 194 Member States to adopt in 2020 the Global Strategy to Accelerate the Elimination of Cervical Cancer as a Public Health Problem. It calls on all countries to achieve three goals by 2030: 90% vaccination coverage of girls against human papillomavirus, 70% timely screening coverage of women, and 90% access to treatment. % of women with precancerous lesions and diagnosed cancer.
These goals are not impossible, but within reach, even in low- and middle-income countries. For example, Bhutan has already achieved this: it is the first country in the Southeast Asia Region to achieve this. In the case of Rwanda, after the introduction of the vaccine in 2011, coverage is already 90% and today the national objective of realizing the three WHO goals three years ahead of schedule was announced. For its part, Nigeria introduced the vaccine in October last year and has already vaccinated 12.3 million girls.
We have the resources and the possibility to eliminate cervical cancer. But to turn this aspiration into reality, strong political leadership is needed.
We have the resources and the possibility to eliminate cervical cancer. But turning this aspiration into reality requires strong political leadership. We need world leaders gathered in Brazil for the G20 Summit to commit to maximizing access to the tools needed to achieve this.
First, we ask you to support access to human papillomavirus vaccines for all girls, in all countries. Since the WHO launched the global call to action in 2018, more than 60 countries have started administering this vaccine in their immunization programs and 144 are now consistently preventing girls from developing cervical cancer later in life. life. Thanks to scientific advances, we can now immunize against this disease with a single dose, something that 60 countries are already doing.
The largest supplier of these vaccines to low- and middle-income countries is Gavi, the Global Vaccine Alliance, which plans to . However, this plan needs sustained investment in health. Likewise, we are counting on manufacturers to confirm and fulfill their commitments to supply vaccines to these countries in the coming years to avoid the supply problems that slowed progress in the past.
However, we cannot rely solely on vaccines. The benefit of the rapid expansion of vaccination of girls will not be appreciated for several decades, when they reach the adulthood at which this cancer usually appears. To save lives now, we must accompany increased vaccination with parallel increases in screening and treatment. That is why, secondly, we ask G20 leaders to support access to screening in all countries.
Decades ago, the performance of vaginal cytology made it possible to rapidly reduce mortality from cervical cancer in developed countries. Today we have even better evidence. More than 60 countries use high-throughput human papillomavirus detection tests in their screening programs. These tests allow women to collect their own samples, removing barriers to accessing life-saving services. In Australia, which is on track to become one of the first to achieve elimination, more than a quarter of screening tests are done this way.
We ask leaders to go beyond one-off and opportunistic testing and invest in organized screening programs so that coverage is high for the entire population. This is essential to achieve the 70% goal. However, high test prices and the margins retained by merchants remain an obstacle.
We ask leaders to go beyond one-off and opportunistic testing and invest in organized screening programs so that coverage is high for the entire population.
On the other hand, several countries are studying the use of artificial intelligence to improve the accuracy of screening in low-resource settings. When precancerous lesions are detected, many women are provided with treatments using portable, battery-powered devices that can be used in remote areas.
Third, we call on G20 leaders to support expanding access to treatment in all countries. Women with advanced cancer must be referred for surgery, radiotherapy and palliative care, but many sufferers die because the treatments used in high-income countries are not available where they live. In other countries, radiotherapy equipment is out of service and patients wait in vain while their tumors grow. No woman should have to travel abroad for treatment or die waiting in her own country when it has the equipment to treat her.
The Covid-19 pandemic demonstrated the extraordinary life-saving power of vaccines, tests and treatments, but it also exposed inequalities in access that lead to preventable deaths. Therefore, we urge all leaders, sectors and communities to join us to end this disease once and for all.
