Unitaid and global health partners reach 90 percent treatment target for women screened with cervical cancer in multi-country pilots

• Unitaid-funded implementation programs in Burkina Faso, Côte d’Ivoire, Malawi, Nigeria, Philippines, Rwanda, and Senegal are reaching 90 percent treatment targets for women identified with pre-cancerous lesions just two years after the launch of the WHO cervical cancer elimination strategy – seven years ahead of schedule.
• Cervical cancer is highly preventable, yet poorly adapted tools and ineffective screening have left women in low- and middle-income countries – where nine out of 10 deaths occur – without access to life-saving prevention.
• Implemented by the Clinton Health Access Initiative (CHAI) or the SUCCESS consortium (Expertise France, Jhpiego and the Union for International Cancer Control), programs in seven countries are advancing an effective model of care ready for broad and urgent scale-up.
• The pilots in the seven countries have also reached more than 50 percent of eligible women with HPV tests, progressing towards a second WHO target to reach 70 percent of women with high-performance screening.
• Pricing agreements secured through Unitaid investments have reduced costs for pre-cancer treatment devices by nearly 45 percent and HPV tests by nearly 40 percent and are widely available for global uptake.

November 17, 2022 – Global health agency Unitaid and its partners have developed and implemented a highly effective package of tools and strategies for cervical cancer prevention. Project sites in seven countries are already exceeding the WHO target to treat 90 percent of all women identified with pre-cancerous lesions by 2030, just two years after the launch of the WHO Cervical Cancer Elimination Strategy (November 17, 2020).

Funded by Unitaid and implemented in partnership with the Clinton Health Access Initiative (CHAI) and the SUCCESS consortium (Expertise France, Jhpiego and the Union for International Cancer Control), the programs in Burkina Faso, Côte d’Ivoire, Malawi, Nigeria, Philippines, Rwanda, and Senegal are demonstrating a life-saving cervical cancer prevention model poised for broader and urgent scale-up.

These models integrate a package of preventive care using high-performance HPV screening and portable devices for treating pre-cancerous lesions into existing health structures to increase coverage and awareness. Implemented widely, the models can achieve the WHO target for pre-cancer treatment and contribute to averting nearly 65 million deaths from cervical cancer over the next century.

The programs are also progressing towards a second WHO target to reach 70 percent of women with high-performing screening by age 35 and again by 45, with more than 50 percent of women having received an HPV test. In addition, three in four women receiving HPV tests are opting for self-sampling, which circumvents pelvic examinations that can be a deterrent to screening, confirming this method’s promise to extend access to even more women.

HPV testing replaces a far less accurate, subjective screening method based on visual inspection of the cervix in countries that already have solid diagnostic network capacity. Hand-held, battery powered thermal ablation devices replace heavy cryotherapy containers that require compressed gas. These devices allow for treatment of pre-cancerous lesions in primary health centers and reduce treatment time to one to two minutes, compared to 15.

To facilitate uptake, pricing agreements secured by Unitaid and CHAI have reduced the cost of thermal ablation devices by nearly 45 percent and HPV tests by nearly 40 percent. However, field data from countries show that the overall cost of thermal ablation is nearly ten times less than cryotherapy per woman treated.

Cervical cancer is highly preventable when women have access to early detection and treatment. However, in low- and middle-income countries where nine out of 10 cervical cancer deaths occur, progress has been held back by a lack of awareness and financing, as well as high costs, ineffective screening methods, and poorly adapted treatment devices.

“Unitaid and partners have delivered the models and technologies to make cervical cancer elimination a reality,” said Dr Philippe Duneton, Executive Director of Unitaid. “Now it comes down to access for all women. We must see concerted urgent action from governments and partners to scale up these models and bring an end to cervical cancer for generations to come.”

“On this second anniversary of WHO’s cervical cancer elimination strategy, we applaud all those who are helping to make innovative technologies accessible, so that women everywhere can enjoy the fundamental right to healthcare that we all deserve,” said Dr Princess Nothemba (Nono) Simelela, WHO Assistant Director-General for Strategic Priorities and Special Advisor to the Director-General. “Unitaid and its partners are making a very important contribution to our collective mission – I hope even more supporters will take inspiration from the early progress and join us in the effort to scale up services.”

Unitaid is the largest funder of innovative tools to find and treat precancerous lesions in women living in low-resource settings with nearly US$70 million invested. Projects in 14 countries are developing models for cervical cancer prevention adapted to low- and middle-income countries’ needs.

Additional quotes

“As the world marks the anniversary of WHO’s Cervical Cancer Elimination Strategy Launch, CHAI celebrates the incredible milestones achieved over the past three and a half years thanks to Unitaid funding. We are committed to working with governments to expand equitable access to lifesaving health services for women and provide affordable and effective tools to reach those most in need. This is crucial to accelerate our progress toward eliminating cervical cancer as a public health issue. We hope our success so far will inspire more countries and partners to implement programs to help protect the health of women and provide better access to crucial treatments.” – Joshua Chu, Executive Vice President, Vaccines and Non-Communicable Diseases, CHAI

“The fight against cervical cancer is a fight against inequalities. Cervical cancer disproportionally affects women in limited-resources countries as well as women with disadvantaged social-economic status in high-income countries. Women living with HIV have a six-fold increased risk of developing cervical cancer compared to women without HIV. Despite being identified as an AIDS-defining disease in 1993, little has been done to address the need for cervical cancer prevention for women living with HIV. With Unitaid’s support, the SUCCESS project works on supporting governments and civil societies in lower- and middle-income countries to join forces of cancer and HIV national programs and communities. We focus on exploring people-centered and integrated interventions suitable for local contexts. Expertise France, through L’Initiative, is also contributing to this synergy by financing technical assistance, implementation, and operational research projects addressing HIV and HPV coinfections.” – Dr Lisa Huang, SUCCESS Project Director, Expertise France

“We are seeing incredible progress on introduction and adoption of new secondary prevention approaches since the launch of the WHO Elimination strategy. This innovations journey underscores that healthcare system thinking is critical to see increased gains towards the elimination targets, and see cervical cancer prevention integrated and financed into routine women’s health and HIV services, and ensure the necessary communications, training, supply chain, and laboratory systems to scale and sustain this progress. Jhpiego continues to support government partners, providers, and communities to increase women’s access to prevention and treatment, and is thrilled over the progress with self-sampling for HPV.” – Tracey Shissler, Implementation Director, SUCCESS, Jhpiego

 “The progress towards eliminating cervical cancer highlights what can be achieved in all income settings through effective financing, political will and on-the-ground expertise. In order to ensure that the gains made are secured for the long term, UICC will continue to work with and support its global network of member organisations and civil society more generally to fulfil their vital role in advocacy and hold governments to account.” – Dr Kirstie Graham, Director, Capacity Building, UICC

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Notes for editors

Cervical cancer statistics:

• A woman dies every two minutes from cervical cancer
• Nine out of ten cervical cancer deaths worldwide occur in low- and middle-income countries
• Women living with HIV are six times as likely to develop cervical cancer
• For every 1 million women screened and treated, 200 to 300 cases of cervical cancer will be averted; for every 1 million women living with HIV screened and treated, several thousand cases of cervical cancer will be averted
• Achieving the WHO cervical cancer elimination targets by 2030 would result in over 62 million cervical cancer deaths averted by 2120

WHO targets:

To eliminate cervical cancer as a public health problem, all countries must reach and maintain an incidence rate of below four per 100,000 women. Achieving that goal rests on three key pillars and their corresponding targets:

• Vaccination: 90 percent of girls fully vaccinated with the HPV vaccine by the age of 15
• Screening: 70 percent of women screened using a high-performance test by the age of 35 and again by 45
• Treatment: 90 percent of women with pre-cancer treated and 90 percent of women with invasive cancer managed

About Unitaid’s cervical cancer programs

Unitaid has invested nearly US$70 million to advance an effective package of tools and delivery models to support secondary prevention of cervical cancer in low- and middle-income countries. The projects are currently working in partnership with the governments of 14 countries – through CHAI in India, Kenya, Malawi, Nigeria, Rwanda, Senegal, South Africa, Uganda, Zambia, and Zimbabwe, and through the SUCCESS project in Côte d’Ivoire, Burkina Faso, Guatemala, and the Philippines. The SUCCESS project is implemented by Expertise France, Jhpiego, and the Union for International Cancer Control (UICC).

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Media contacts

Hervé Verhoosel, Spokesperson Unitaid, mobile/whatsapp +33 6 22 59 73 54, [email protected]

Corina Milic, Acting Director of Communications, CHAI, [email protected]

About partners

About Unitaid

Unitaid is a global health agency engaged in finding innovative solutions to prevent, diagnose, and treat diseases more quickly, cheaply, and effectively, in low- and middle-income countries. Its work includes funding initiatives to address major diseases such as HIV, malaria, and tuberculosis, as well as HIV co-infections and co-morbidities including advanced HIV disease, cervical cancer, and hepatitis C, and cross-cutting areas, such as fever management. Unitaid is now applying its expertise to address challenges in advancing new therapies and diagnostics for the COVID-19 pandemic, serving as a key member of the Access to COVID-19 Tools (ACT) Accelerator, co-leading the Therapeutics Pillar with Wellcome and the Global Fund to Fight AIDS, Tuberculosis and Malaria and participating in the Diagnostics Pillar. Unitaid is hosted by the World Health Organization.

About CHAI

The Clinton Health Access Initiative, Inc. (CHAI) is a global health organization committed to saving lives and reducing the burden of disease in low- and middle-income countries. We work with our partners to help strengthen the capabilities of governments and the private sector to create and sustain high-quality health systems. For more information, please visit www.clintonhealthaccess.org.

About Expertise France

Expertise France is a public agency and the interministerial actor in international technical cooperation, subsidiary of the Agence française de développement Group (AFD Group). As the second largest agency in Europe, it designs and implements projects that sustainably strengthen public policies in developing and emerging countries. Governance, security, climate, health, education… It operates in key areas of development and contributes alongside its partners to the implementation of the Sustainable Development Goals (SDGs). For a world in common.

For more information: www.expertisefrance.fr

About Jhpiego

Jhpiego, a global health non-profit and Johns Hopkins University affiliate, creates and delivers transformative health care solutions that save lives. For 50 years, Jhpiego has worked in partnership with 155 countries to build a strong health workforce and develop systems that improve health and transform the futures of women and their families. For the past three decades, Jhpiego has worked to eliminate cervical cancer in low and middle-income countries. Jhpiego’s approach mirrors the WHO Elimination Strategy goals, and begins with prevention through HPV vaccination, detection with HPV-DNA screening with a priority on primary and community settings, and early treatment for precancerous lesions. Through SUCCESS and in partnership with Expertise France and UICC, we have introduced this accessible, affordable, and achievable approach in the four project countries, Burkina Faso, Côte d’Ivoire, Guatemala, and the Philippines.

About UICC

The Union for International Cancer Control (UICC) is the largest and oldest international cancer-fighting organisation. Founded in Geneva in 1933, UICC has over 1,200 member organisations in 172 countries. It enjoys consultative status with the United Nations Economic and Social Council (ECOSOC) and has official relations with the World Health Organization (WHO), the International Agency for Research on Cancer (IARC), the International Atomic Energy Agency (IAEA) and the United Nations Office on Drugs and Crime (UNODC). UICC has over 50 partners, including associations, companies and foundations committed to the fight against cancer. UICC is a founding member of the NCD Alliance, the McCabe Centre for Law & Cancer and the International Cancer Control Partnership (ICCP). UICC established the City Cancer Challenge Foundation in January 2019 and the Access to Oncology Medicines (ATOM) Coalition in 2022.

UICC’s mission is to both unite and support the cancer community in its efforts to reduce the global cancer burden, promote greater equity and ensure that cancer control remains a priority on the global health and development agenda. It pursues these goals by bringing together global leaders through innovative and far-reaching cancer-control events and initiatives, building capacities to meet regional needs and developing awareness campaigns.