Cervical Cancer - Global Strategies and India's Indigenous Solution

As the world observes International Women’s Day, India’s interim Union Budget 2024-25 has emerged as a beacon of hope, particularly in the realm of women’s health as the current government’s support in encouraging the vaccination of girls (from nine to 14 years) against cervical cancer stands out as a pivotal move towards safeguarding women’s well-being.

The ‘90-70-90’ targets, global programmes

Despite advances in health care, cervical cancer remains the second most common cancer among women in India, with 1.27 lakh cases and around 80,000 deaths being reported annually.
Human papillomavirus (HPV) is a primary culprit in the development of cervical cancer.
In response to this pressing public health challenge, HPV vaccination emerged as a cornerstone of a comprehensive strategy for disease prevention and health promotion.
The World Health Organization has outlined the ‘90-70-90’ targets by 2030 — for 90% of girls to be fully vaccinated with the HPV vaccine by age 15, for 70% of women to undergo cervical cancer screening tests by the age of 35 and 45, and for 90% of women with cervical cancer to be treated.
Across the world, over 100 countries have implemented HPV vaccination programmes, resulting in a notable decline in the incidence of cervical cancer.
The successful HPV vaccination campaign in Rwanda, Africa, has significantly reduced the prevalence of vaccine-targeted HPV types.

The Sikkim model

The key to the success of any vaccination campaign is a robust communication strategy that educates and empowers communities.
Within India, Sikkim’s exemplary approach to HPV vaccination is an example of an effective public health strategy.
Through targeted efforts to educate teachers, parents, girls, health-care workers, and the media about the benefits of the HPV vaccine, Sikkim achieved vaccination coverage of 97% during its campaign rollout in 2018.
It provides a compelling example of effective communication and outreach.
This rigorous effort has not only dispelled myths and misconceptions but has also fostered trust and confidence in the vaccination process.

Ceravac

India’s recent milestone in developing its indigenous quadrivalent vaccine, Cervavac, marks a significant stride towards ensuring accessibility and affordability.
Developed by the Serum Institute of India in collaboration with the Department of Biotechnology, and priced at 2,000 a dose, Cervavac is cheaper than available vaccines, and holds promise in the fight against HPV infections and cervical cancer.

Meet the challenges

However, challenges persist, particularly in addressing vaccine hesitancy and ensuring equitable access to HPV vaccination.
The interim Budget also announced the rollout of U-WIN throughout the country.
U-WIN, like Co-WIN that was designed to track the COVID-19 vaccination campaign, is a portal that will maintain an electronic registry of all immunisations across the country and enable vaccination programmes to be responsive in real time.
Cultural and societal norms are also a factor, highlighting the importance of tailoring messages to resonate with diverse communities.
Utilising diverse channels such as social media and community workshops can amplify reach. Including HPV information in health education in schools can be a step to generate demand among adolescents.
Collaborations between government agencies, community partners, health-care providers, and civil society organisations will be instrumental in building trust and ensuring the success of HPV vaccination programmes.
Public-private partnerships are instrumental in ensuring equitable access to vaccination services, thereby advancing the collective goal of safeguarding women’s health against cervical cancer.

Conclusion

India’s track record in vaccination campaigns, exemplified by the widespread acceptance and coverage of the COVID-19 vaccine, instils confidence in the feasibility of scaling up HPV vaccination efforts.

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