Cervical Cancer Elimination: Is it a global hope?

Sitting in a beautiful boardroom at UNAIDS in Geneva waiting to interview Deputy Executive Director, Dr Shannon Hader gave me time to think. A bowl filled with hundreds of red ribbons sits on the table, a plaque to honour Dr Jonathan Max Mann, a pioneer in the international campaign against AIDS and a founder of a movement to link health issues with those of human rights, hangs on the wall. A sombre reminder of a great loss to the world.

I’m here to learn more about the link between cervical cancer and HIV/AIDS.

Mountains have been moved to save HIV positive women through antiretroviral treatment only to now have them die from what has recently become a preventable cancer- cervical cancer. Women who are HIV positive are 5 times more likely to develop cervical cancer.

The inequity in health care that the vast majority of women on this planet face is hard to comprehend.

Here’s me, getting a bit antsy at my GP’s before I left for Geneva because I’ll be 3 weeks overdue to get my biannual pap smear. My chances of developing cervical cancer due to regular screenings is low due so it’s really not a big deal to be a month late.

The vast majority of women across the globe, mainly in low to middle income countries are lucky to have access to screening once, maybe twice, if ever in their lives. Their reality is to present to a clinic when they develop intense pain and/or bleeding. This indicates advanced disease. Most likely untreatable due to the late stage diagnosis, a lack of access to treatment facilities, financial constraints or proximity to a hospital.

They will die in pain, often very young, often leaving behind children and loved ones.

My interest in this is because of the groundbreaking work that has resulted in a vaccine that prevents Human Papilloma Viruses (HPV) infection. HPV is now known to cause cervical cancer as well as some head and neck cancers. Vaccination programs are already underway and Australia has lead the charge and is now on track to eliminate cervical cancer in Australia by 2030. This in and of itself is extraordinary.

Cancer has perplexed physicians since the earliest documentation has been found referencing it as a disease. This documentation dates back to ancient Egypt. In recent history, cancer was considered incurable. Even the early 20th century there were no known cures, only surgery to remove a cancer, survival depended on whether or not the cancer was found before it had metastasised. With the invention of radiotherapy, chemotherapy and other medial innovations, many cancers are now curable.

But to have a solution that can prevent a certain type of cancer, the 4th largest killer of women worldwide- cervical cancer, is a first in the history of humankind. It’s not a cure, not a treatment, but a prevention. It has the potential to take this disease and put it in the history books, just as we’ve done with polio. It’s remarkable.

Now, all we have to do is administer the vaccine to every child on the planet by the ages of 9 – 14 years old. Yep, now you see the bigger problem. Perhaps a problem bigger than this cancer itself.

Can it be done?

How do you get every government, in every country to take up the challenge? They need to make the vaccine available which has enormous cost implications, let alone production and supply issues. They need to strengthen their health system to make delivery possible. They need to educate their people about what and why they should vaccinate their children. And they need to overcome the anti-vaccier’s who seem to be a growing and powerful influence. Don’t get me started on this…

For a country to succeed three things are required. An ongoing vaccine program, a screening program for the detection of pre-cancer lesions and cancer in women who were too old to receive the vaccine. Early detection of pre-cancer and cancerous lesions is extremely important in making effective treatment possible. And of course, you also need accessible treatment resources and facilities to treat any found pre-cancer or cervical cancer.

So here we have a unique opportunity to eliminate cervical cancer globally. But how will we as a global population come together and make this happen?

I’m on the journey to find out and I’ll report back as I learn more.

Drop me an email if you have any questions.