Scaling up cervical cancer prevention in Côte d’Ivoire, Burkina Faso, Guatemala and the Philippines

Cote d'Ivoire
On 21 December 2019, Unitaid and Expertise France signed a financing agreement in Abidjan for the implementation of the SUCCESS programme (Scale Up Cervical Cancer Elimination with Secondary Prevention Strategy). The project focuses on cervical cancer prevention and aims to improve screening and secondary prevention, i.e. prevent the development of cancer in women with a human papillomavirus (HPV) infection and precancerous lesions.

While cervical cancer is one of the easiest to prevent and treat, it is the fourth most common cancer in women worldwide: according to the World Health Organization (WHO), there were 570,000 new cases and 311,000 deaths from it in 2018. Furthermore, nine out of ten women who die from cervical cancer live in low or middle-income countries. This is due to the fact that these women have limited access to information and prevention for cervical cancer. The new WHO strategy for 2020-2030 for the elimination of cervical cancer therefore emphasises the crucial role of screening and treatment.

Ensuring the feasibility of screening and early treatment as close as possible to populations

Cervical cancer is mainly caused by the human papillomavirus (HPV), some of whose genotypes lead to the formation of precancerous lesions. It is preventable if these lesions are identified at an early stage. SUCCESS will consequently implement a prevention approach based on:

• Increased and simplified screening,

• Secondary cancer prevention with an HPV detection test and a thermal ablation of precancerous lesions,

• A greater dissemination of information about this cancer among the populations concerned.

The SUCCESS project targets women who are most at risk and will be implemented in Côte d’Ivoire, Burkina Faso, the Philippines and Guatemala. These four low or middle-income countries are representative of regions with limited resources where over 85% of women who currently die from this disease are to be found. SUCCESS will thereby allow the targeted countries, and beyond, through regional outreach, to scale up service provision for 70% of the population of women concerned.

Special attention for women living with HIV

SUCCESS will include at least 185,000 women over the next three years, 75,600 of whom (40%) are living with HIV. Indeed, immunocompromised people with HPV infection are more likely to develop pre-cancer and cancer more rapidly. Cervical cancer is particularly deadly among women living with HIV, especially for those who are not receiving antiretroviral treatment or who started their treatment at a late stage.

Experienced actors working to eliminate cervical cancer by 2030

The agreement signed last December between Unitaid and Expertise France provides for EUR 22m of Unitaid financing for three years, with EUR 600,000 of additional cofinancing from the French Government. For Unitaid, this investment is part of a more comprehensive strategy for cervical cancer prevention for a total amount of EUR 54m and follows WHO’s call for action to eliminate cervical cancer by 2030.

The programme will be implemented by Expertise France, in partnership with a consortium that already has experience and expertise in cervical cancer prevention and control, Jhpiego and the Union for International Cancer Control (UICC). The programme will also be supported by technical assistance from national cancer institutes: the French National Cancer Institute (INCa), the National Cancer Institute (NCI) – USA, the National Cancer Center (NCC) – Japan and the National Cancer Institute (INCA) – Brazil.

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