Jhpiego Corporation

The Chance To Make History: Eliminating Cervical Cancer in Zambia

Cancers

Putting Zambia on the path to eliminating cervical cancer by dramatically expanding equitable access, coverage, and coordination of cervical cancer prevention and treatment services.

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To learn more about – or provide significant funding to – this project, please contact Lever for Change.

Project Summary

For the first time ever, we have the power to eliminate cancer, cervical cancer. Over 550,000 women are diagnosed with cervical cancer annually, 300,000 of whom lose their lives[1], disproportionately affecting sub-Saharan Africa. But, armed with innovative approaches, technologies, and solutions, we’re prepared to defeat cervical cancer. Beginning in Zambia, currently facing the second highest cervical cancer burden globally, we’ll deploy deep technical expertise and innovation, field experience, and global oncological networks to accelerate introduction and scale-up of prevention and treatment solutions, most notably the highly effective vaccine for Human Papilloma Virus (HPV), known to cause 90% of cervical cancers[1]. We’ll engage stakeholders in a multi-sector effort to increase access, availability, and demand for prevention and treatment services. We’re primed with a bold, achievable plan and a coalition with ample knowledge and experience, ready to achieve a cervical cancer-free Zambia, a goal that will model the way to global elimination.

Problem Statement

Cervical cancer is a crisis that we can, and must, solve. More than 85% of the 300,000 women who died from this disease in 2018 lived in low-income countries, most in sub-Saharan African countries with high HIV rates[1]. Zambia has the 2nd highest incidence of cervical cancer in the world at 58 cases per 100,000 women[3]. One major challenge impeding elimination is the lack of strategies for addressing high HPV-HIV co-infection rates; HIV-positive women are 4-5 times more likely to develop cervical cancer[4]. Myths, misconceptions, lack of awareness, early sexual debut and marriage, and high teen pregnancy rates pose significant challenges to effective prevention, increasing the risk of cervical cancer for Zambian women and girls, especially for those with low socioeconomic status. Zambia’s health system, primarily the public sector, is under-resourced and overburdened, lacking capacity at provincial and district levels to manage treatment, and global HPV vaccine shortages currently pose significant challenges for widespread prevention. However, using our coalition’s knowledge and experience with implementing innovative cervical cancer solutions, we’ll scale up Zambia’s current prevention efforts and enhance coordination capacity with the government for a multi-sector approach. With strong political commitment to high quality healthcare for all Zambians and support from the Ministry of Health and PEPFAR, we can leverage our technical expertise in generating public awareness and demand for prevention and treatment services, capitalize on new vaccine manufacturers that are poised to expand supply, and engage with health systems and civil society networks to realize the elimination of cervical cancer.

Solution Overview

Our solution is multi-pronged, building on Zambia’s National Cancer Control Strategic plan[7] to further leverage technological advances, increase engagement with key stakeholders, enhance community-driven demand for HPV vaccination and self-sampling for screening, strengthen government coordination and capacity, and strengthen capacity for treatment, in order to achieve WHO 90-70-90 targets[5] by 2030 and set Zambia on the path to cervical cancer elimination.1) We’ll increase HPV vaccination coverage for girls ages 9-14 years old by strengthening vaccine delivery systems, securing sufficient supply through partnerships with manufacturers and the Global Vaccine Alliance (GAVI), and generating public demand through communications campaigns that use targeted messaging. We’ll emphasize multi-age vaccination in schools and health facilities, and use local mobilization of community volunteers to myth-bust and educate communities. 2) We’ll expand equitable screening for women ages 35-59 years old using the latest HPV testing, enabling self-sample collection, taking the screening to women’s doorsteps, and facilitating decentralization of treatment to local communities, helping to expand access for all. We’ll also utilize community volunteers to help provide referral pathways and follow-up for services.3) We’ll broaden accessibility of treatment and care for women diagnosed with cervical cancer. Through government coordination, implementation of the Single Visit Approach (SVA), and utilization of our global and local oncological networks, we’ll strengthen health system capacity to adequately and appropriately treat women. Leveraging global efforts for bringing prices of key medicines down, we’ll also work to secure additional resources to expand treatment access.

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