The HPV Vaccine and Women’s Health

By Treezer Michelle Atieno

Cervical cancer is a significant public health challenge in Africa, with the continent bearing a disproportionate share of the global burden. Human papillomavirus (HPV) is responsible for nearly all cases of cervical cancer, making vaccination and screening critical tools in the fight against this disease.?

The Burden of Cervical Cancer in Africa

In 2020, 18 of the 20 countries with the highest cervical cancer cases globally were in Africa.?

Currently, about 190 women die daily from cervical cancer across Africa. This staggering statistic underscores the urgent need for comprehensive cervical cancer prevention strategies, including HPV vaccination and screening.

The financial and social implications of cervical cancer are severe. A study in Ethiopia revealed that among women suffering from the disease, 46% of them lost income, 71% faced financial distress, and 67% encountered employment challenges due to the disease.?

Additionally, cervical cancer places a heavy burden on health systems, diverting resources that could be better invested in preventive measures. This cycle of poverty and vulnerability is perpetuated by limited access to healthcare services, particularly in rural and underserved areas.

Importance of HPV Vaccination

HPV vaccination is a crucial preventive measure against cervical cancer. The World Health Organization (WHO) and partners have been working to accelerate the introduction of the HPV vaccine in African countries.?

As of 2023, 27 African countries had incorporated the HPV vaccine into their national immunisation programs, and 34 had initiated cervical cancer screening programs.?

These efforts are crucial, as the HPV vaccine can prevent most cases of cervical cancer if administered before the onset of sexual activity.

The WHO has endorsed a single-dose HPV vaccine schedule, which has been shown to provide protection comparable to the traditional two-dose regimen. This simplified schedule is expected to increase vaccine uptake and coverage, particularly in resource-limited settings.?

However, despite these advances, only five African countries have achieved the desired 90% coverage among girls aged 9-14, reflecting the ongoing challenges in vaccine delivery and acceptance.

One of the significant obstacles to HPV vaccination in Africa is vaccine hesitancy, fueled by misinformation and distrust in government and healthcare systems. About 25% of the population in the region still has doubts about the vaccine.

Overcoming these barriers requires robust community engagement and advocacy, particularly in deeply religious and conservative societies where traditional beliefs may discourage vaccination.

The Role of Cervical Cancer Screening

While vaccination is a powerful tool in preventing cervical cancer, it must be complemented by regular screening to detect and treat precancerous lesions before they develop into full-blown cancer.?

In Africa, 34 countries have initiated cervical cancer screening programs, with 14 using human papillomavirus deoxyribonucleic acid (HPV DNA) testing. This method is more effective in detecting and preventing cervical cancer than other commonly used screening methods.

Screening is especially critical for women who were not vaccinated before becoming sexually active, as they remain at risk of contracting HPV. However, access to screening services is limited in many African countries, particularly in rural areas.?

Efforts to integrate cervical cancer screening into primary healthcare services and make it more accessible and affordable are essential in reducing the disease burden.

Other HPV-Related Cancers

In episode 143 of the Root of the Science Podcast, Dr. Cornelia Ndifon explains that depending on how one engages in sexual activities, HPV can also cause several other types of cancers, including anal, vulvar, vaginal, penile, and oropharyngeal cancers. While cervical cancer is the most common and well-known of these, the other HPV-related cancers also pose significant health risks.?

The same strains of HPV that cause cervical cancer are responsible for these cancers, highlighting the importance of HPV vaccination for both girls and boys.

Including boys in HPV vaccination programs, as advocated by the Director-General of the Africa Centres for Disease Control and Prevention, is a critical step in a comprehensive strategy to combat HPV. This approach protects boys from HPV-related cancers and contributes to herd immunity, reducing the overall prevalence of the virus in the population.

To eliminate cervical cancer in Africa, it is crucial to strengthen vaccination and screening programs, address vaccine hesitancy, and ensure equitable access to these life-saving interventions. By doing so, we can protect future generations from the devastating impact of cervical cancer and other HPV-related diseases.