By Karen Nakawala, Founder of the Teal Sisters Foundation, Zambia
Last week, at the 73rd session of the World Health Organization (WHO) Regional Committee for Africa in Gaborone, Botswana, I stood with health leaders from across the African continent to call on countries to reaffirm their commitments to eliminate cervical cancer and act quickly to bolster essential health services. As a cervical cancer survivor myself, I know the urgency in which we must act: 19 of the 20 countries with the highest burden of the disease are in the WHO African region.
I left the meeting with two key takeaways. First, survivors’ voices are critical to overcoming the stigma and misinformation that surrounds cervical cancer. And second, the support of national, regional, and global leaders is vital to our progress towards cervical cancer elimination.
When I was diagnosed with cervical cancer in 2019, I was reluctant to tell people about my own diagnosis and treatment, wanting to avoid the attention and pity. Now, I recognize how dangerous silence is. If no one talks about human papillomavirus (HPV) vaccines—which can prevent nearly all cases of cervical cancer—and the importance of cervical cancer screenings, then they’re not seen as a normal part of girls’ and women’s lives. I didn’t know about the HPV vaccine until after I was treated for cervical cancer and I’m not alone. More than 340,000 women globally still die of cervical cancer every year—90% of these deaths occur in low- and middle-income countries.
I started the Teal Sisters Foundation in 2020, a Facebook group where cervical cancer survivors could support each other, encourage women to get screened, and advocate for better access to HPV vaccines for girls, to combat this silence. We became 100,000 strong within a month. The silence around HPV and cervical cancer was broken here. We could talk openly about our experiences, and we could trust that others understood.
I was reminded of the power of survivors’ voices at a cervical cancer survivors’ meeting held before the WHO AFRO Regional Committee meeting. At the event, I spoke about the need for equitable access to HPV vaccines, screening, and treatment and challenged the media to report regularly on cervical cancer to help change people’s attitudes towards the disease. Survivors have a wealth of knowledge and passion to share. Giving us a platform can improve awareness and acceptance.
Definitive progress towards eliminating cervical cancer is also contingent on the support of leaders who make cervical cancer elimination a priority. While HPV vaccines are increasingly available in many countries, immunization programs still don’t reach all girls. As of 2022, only 31% of girls by the age of 15 have received a dose of the HPV vaccine in the WHO African region. My daughter, who knows all too well the importance of the vaccine, is too young to be vaccinated in Zambia. Due to budget constraints, HPV vaccines are only available in school-based programs for girls aged 14-15 even though WHO recommends the vaccine for girls 9-14 years old. Girls who leave school early may miss the opportunity to be vaccinated, putting them at risk of developing cervical cancer later in life.
I’m hopeful that access to this life-saving vaccine will soon increase. Recent guidance from WHO says that one dose of the HPV vaccine is just as effective two doses. Zambia has announced that they will move to a single dose schedule, which will lower costs and simplify delivery. This development has enormous potential for protecting more girls from HPV and presents an opportunity for advocates to call for policy changes that follow this guidance in their own countries.
Access to screening and treatment also needs to be improved. Even with early diagnosis, the cost and difficulty of treatment is overwhelming. Access to a hospital with the resources to treat cervical cancer is not a given. We need champions of all kinds in this fight: women who talk about screening, healthcare providers who educate patients, men who support the women in their lives, and political leaders who commit to making treatment accessible and affordable.
Along with the African leaders who called for urgent action to eliminate cervical cancer last week, there is growing global momentum. A Global Declaration to Eliminate Cervical Cancer was launched at the World Health Assembly in May in support of WHO’s Global Strategy to Accelerate the Elimination of Cervical Cancer as a Public Health Problem. Alongside more than 2,300 others from 135 countries, I signed to call on country leaders, healthcare providers, vaccine manufacturers, and more to improve access to prevention, screening, and treatment. Moments like this illustrate that the women who joined the Teal Sisters are not alone in this fight.
We should not be losing a woman to cervical cancer every other minute. Together, we can eliminate cervical cancer and save thousands of women a year from a preventable disease.