Concerted actions of multi-sectoral stakeholderskey toward HPV-free and cervical cancer-free future

Cervical cancer is a grave threat to women’s health and lives, and globally, one woman dies of cervical cancer every two minutes. This suffering is unacceptable, particularly as cervical cancer is largely preventable.

The highest mortality rate for the disease is also recorded in developing countries, and in the Philippines, where cervical cancer ranks second as the leading prevalent type of cancer among women, the disease is almost exclusively attributable to the human papillomavirus (HPV) infection.

In recognizing the rising burden of the disease and acknowledging HPV as the major cause of cervical cancer, the fourth and culminating session of the 9th HPV Summit pushes for stronger initiatives for vaccination, screening, and treatment to save girls and women from cervical cancer deaths and prevent 74 million cases within the next 100 years.

The Summit, led by Cervical Cancer Prevention Network of the Philippines (CECAP) in partnership with the Asia & Oceania Federation of Obstetrics and Gynaecology (AOFOG), Philippine Obstetrical and Gynecological Society (POGS), and the Department of Health (DOH), is aligned with the World Health Organization’s (WHO) global strategy towards eliminating cervical cancer by 2030.

To achieve elimination, acceleration of implementation of cost-effective intervention for prevention and control should be prioritized in a comprehensive approach to include vaccination against HPV, screening and treatment of pre-cancerous lesions, early diagnosis and timely treatment of invasive cancer and palliative care.

“The goal for 2030 is to reduce cervical cancer mortality by 30 percent,” said CECAP chair Dr. Cecilia Llave during the culminating session of the HPV Summit. “In order to meet this goal, 90 percent of our girls should be fully vaccinated with HPV vaccine by age 15; 70 percent of our women will need to be screened with high-performance tests by age 35 and again by age 45; and to have 90 percent of those who are positive to receive treatment for precancerous lesion or invasive care.”

HPV vaccine co-inventor and University of Queensland professor Ian Frazer also joined the discussion and talked about the role of HPV vaccination in reducing the risk of developing HPV-associated cancers. Frazer noted that cervical cancer grows slowly, so there’s usually time to find and treat it before it causes serious problems. “We recognize HPV as a common infection and the progression to cancer takes time. That’s why prevention of the infection that causes cervical cancer would be a much-more sensible approach to controlling cervical cancer on a global basis,” he said.

Frazer explained that like other vaccinations that guard against viral infections, HPV vaccines stimulate the body to produce antibodies that, in future encounters with HPV, bind to the virus and prevent it from infecting cells.

Meanwhile, Dr. Maria Wilda Silva, DOH National Immunization Program Manager noted that the COVID-19 pandemic should not derail critical preventive care against HPV. DOH for its part is ensuring immunization services, which include HPV vaccination for adolescents, are maintained in order to protect more people against vaccine-preventable diseases.

“Despite this, regional health offices are advised to continue to provide HPV vaccines among young children,” said Dr. Maria Wilda Silva, DOH National Immunization Program Manager.

Dr. Silva added, “The DOH also released interim guidelines in the implementation of HPV vaccination amid the pandemic. In 2021 to 2023, we will expand our HPV vaccination program and we will incorporate it into the National Integrated Cancer Control Program.”

Dr. Silva added that a reduction in mortality could also be achieved more rapidly if cost-effective cervical cancer screening programs for adult women were implemented along with vaccination of young adolescent girls.

“Moving forward, the DOH will enhance community preparation and social mobilization in terms of HPV preparedness and to work hand-in-hand with key stakeholders on the importance of HPV vaccination. We will continue to conduct capacity-building [initiatives] to our vaccinators, LGUs, and partners in health centers,” said Dr. Silva.

In terms of legislation, Dr. Silva said it is good news that the 18th Congress has already passed in its 3rd reading the Expanded Mandatory Immunization Law, wherein HPV vaccination is included in the mandatory vaccinations. “Once passed into law, we will be assured of funding for the HPV vaccine procurement and operational funds will be allotted to the DOH National Immunization Program for operationalization of this Act.”

Lastly, Dr. Pherdes Galbo, vice president of the POGS – Cebu Chapter shared best practices in helping build HPV-free communities. Dr. Galbo cited multi-stakeholder collaboration as enabler for POGS Cebu to intensify its awareness and screening campaigns, and capacity building programs for doctors, nurses, and midwives. One of their advocacy initiatives held annually is the “Scarlet May” campaign which is a month-long event promoting cervical cancer awareness, prevention, and control. 

“POGS has one vision with regard to HPV-related diseases especially cervical cancer: that is education through awareness and screening. We thought of hitting the vision by spreading awareness through media mileage and educating mothers about the disease as they wait for their turn for cervical cancer screening,” Dr. Galbo said.

Complementary to DOH’s HPV vaccination program for adolescents, Dr. Galbo said POGS Cebu also thought of making teachers as movers by educating them about the disease and the vaccines available. “Last year, together with the DOH and Department of Education, we started providing seminars among teachers. This helped us in educating the children and the mothers about vaccines.” Dr. Galbo noted that the journey of building HPV-free communities has just begun, and it is still a long way to go. But if all stakeholders will take an active role in answering the call to accelerate the elimination of cervical cancer, this dream is not impossible.

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