Eradicating cervical cancer in low and middle income countries through HPV vaccination: Collaboration resulted in a synergy that is very productive

Abstract

Background: Human papilloma virus (HPV) is the main cause of cervical cancer (CC) which poses a threat to the Low and Middle Income countries (LMICs) It is the second most diagnosed and deathly cancer in sub-Saharan Africa. According to International Agency for Research on Cancer's (IARC) GLOBOCAN project, the pace will increase if nothing is done. It is estimated that 317000 women will die in 2030 due to CC in LMICs whereas it'll continue to be 17000 in developed countries. Fortunately, unlike other cancers CC can be vaccinated and is treatable when early detected. This research explored the possibility of HPV vaccination in LIMCs to reduce the mortality rate. We have taken Rwanda which is the first African country to implement the program as the case study. Methods: A Literature review from various published journals and both national reports from Ministry of Health of Rwanda on CC and IARC reports on cancers was done to collect data. Results: East Africa accounted 8.66% of the total world new CC cases in 2012 and CC was the leading cause of death due to cancer and the most diagnosed in women aged 15-44 years. In Rwanda, 1366 new CC cases were diagnosed. The government of Rwanda in collaboration with Merck and Qiagen has opted tackling this challenge by initiating a three-year strategic plan aiming at providing HPV vaccines and treatments. This started in 2011 and 93.2% of 98 792 targeted girls were vaccinated. In 2012 with the aim of vaccinating all girls younger than 15 years old, the government has targeted 139 968 and 96.6% were vaccinated. Discussion and conclusion: The incidence of CC in LMICs can be stopped by political will and good strategic plans. However, the program encountered various hindrances including few medical doctors and misconceptions of people who thought it would make them sterile. Thus, the government had decided to train community health workers and nurses which speeded up the program. Local leaders and school authorities also played a remarkable role in sensitization. Basing on the success of the program, Global Alliance for Vaccines and Immunization promised to support Rwanda's national HPV vaccination program which will make it sustainable. LMICS should take an example from Rwanda to curb this problem.