NIGERIA — Nigeria, Africa’s most populous nation, has taken a significant step in the battle against cervical cancer by introducing the human papillomavirus (HPV) vaccine into its routine immunization system.
This groundbreaking move aims to reach 7.7 million girls, marking the largest-ever vaccination campaign against the virus responsible for nearly all cases of cervical cancer on the continent.
The World Health Organization (WHO) designated cervical cancer as a global public health concern in 2020, emphasizing the critical role of HPV vaccination in reducing cervical cancer cases worldwide.
The initiative aims to vaccinate 16.6 million girls aged 9 to 14 by the end of 2025. HPV is known to be responsible for some cases of cervical cancer.
Girls between the ages of 9 and 14 will receive a single dose of the vaccine, proven to be highly effective in preventing HPV types 16 and 18, which account for at least 70% of cervical cancer cases.
Africa grapples with one of the highest burdens of cervical cancer deaths, primarily due to the limited availability of prevention, screening, and treatment services.
In 2020, Nigeria recorded 12,000 new cervical cancer cases and 8,000 deaths, making it the third most common cancer and the second leading cause of cancer-related fatalities among women aged 15 to 44.
Muhammad Ali Pate, the Coordinating Minister of Health and Social Welfare, expressed his concern, stating, “The loss of about 8,000 Nigerian women yearly from a disease that is preventable is completely unacceptable.”
He highlighted the pivotal role of HPV vaccination in preventing cervical cancer and urged parents to protect their children with a single vaccine dose.
To kickstart the vaccination initiative, a five-day mass vaccination campaign will be conducted in schools and communities across 16 states and the Federal Capital Territory.
Subsequently, the vaccine will be integrated into routine immunization schedules within healthcare facilities. The second phase of vaccination introduction is scheduled to commence in May 2024 across 21 states.
In November 2020, the WHO launched the “90/70/90” global initiative to eliminate cervical cancer as a public health issue.
The strategy aims to achieve a 90% vaccination rate of girls against HPV by age 15, screen 70% of women by age 35, and treat at least 90% of identified precancerous lesions and invasive cancers.
However, a significant challenge persists as nearly half of low- and middle-income countries (LMICs) struggle to introduce HPV vaccinations due to the cost barrier.
The vaccine’s procurement price negotiated by global health agencies stands at US$4.50 per dose, making it unaffordable for many nations.
Rwanda took the lead as the first sub-Saharan African country to introduce HPV vaccination in 2011.
Despite initial progress, uptake has been slow, with only a handful of African countries incorporating the vaccine into their regular healthcare services.
In 2019, six new countries, including The Gambia, Liberia, Côte d’Ivoire, Kenya, Malawi, and Zambia, joined the effort.
Cervical cancer isn’t the sole HPV-related concern; other cancers, including anal, vulvar, oropharyngeal, vaginal, penile, oral, and laryngeal cancers, are also linked to HPV infection.
A recent report from Kenya highlighted that cervical cancer remains the leading HPV-related cancer in women. In Kenya, the Gardasil HPV vaccine is the only approved HPV vaccine for boys.
UNICEF is spearheading a significant initiative to bolster HPV immunization, supplying approximately 36 million vaccine doses to 52 low- and middle-income countries globally in 2023.
Several African countries have received support for HPV vaccinations, whether or not they have been fully integrated into routine immunization programs.
Meanwhile, a global study has advocated for the inclusion of men in HPV vaccination programs, based on an analysis of HPV infection prevalence in males aged 15 and older.
The study, published in The Lancet Global Health, revealed that one in three men worldwide is infected with at least one type of HPV, with one in five men carrying one or more high-risk or potentially carcinogenic HPV types.
The study underscores the importance of addressing HPV infection in sexually active men, regardless of age, to further combat HPV-related health issues.
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