Cervical cancer is the fourth common cancer among women and one of the leading causes of death in women worldwide, with nearly 85% of deaths occurring in low- and middle-income countries. Human papillomavirus (HPV) infection is the main cause of cervical cancer, but it is highly preventable through vaccination and screening. The World Health Organization (WHO) has endorsed a global strategy for cervical cancer elimination, but its implementation remains poor in many regions, including the Eastern Mediterranean. Vaccination, screening, and management are crucial to preventing cervical cancer deaths and achieving the Sustainable Development Goals target 3.4 which is Noncommunicable diseases and mental health.
To shed light on this topic, EMPHNET held a webinar titled “Combating the HPV, EMR Efforts to Prevent the Spread of the Virus” on Tuesday, March 21, 2023. The 90-minute session provided an opportunity to discuss HPV, its transmission, its consequences, and effective prevention.
The sessions were presented by three knowledgeable specialists, namely: the Executive Director, of the Australian Centre for the Prevention of Cervical Cancer, Professor Marion Saville, the Medical Officer at the WHO EMRO, Dr. Kamal Fahmy, and the Head of the Child Health Protection Service & EPI Manger at the Ministry of Health in Morocco, Dr. Mohammad Ben Azzouz, the session was moderated by Public Health Specialist at EMPHNET, Dr. Nada Ahmad.
In her presentation titled “HPV Global Burden, Preventative Approaches and Progress Towards Cervical Cancer Elimination” Prof. Marion Saville discussed the global burden of cervical cancer caused by HPV and progress towards elimination. She shed light on the significant number of deaths resulting from it, and. And how the lack of access to preventative strategies, such as vaccination and screening is causing the disease to occur inequitably, particularly in low and middle-income countries. She also spoke about how the strategies for elimination aim to reduce the worldwide incidence of cervical cancer to fewer than four cases per 100,000 women in every country in the world within the next 100 years.
Furthermore, Prof. Saville discussed the barriers to cervical screening in different countries, including cultural acceptability and lack of laboratory capability.
Moreover, Prof. Saville discussed the WHO guidelines for primary screening and how HPV DNA detection is now recommended as the primary screening test. She also discussed the importance of the negative predictive value of the HPV test in lengthening the interval between screenings, which can help reduce the cost of the program in the long run.
To conclude her session, she presented data on the use of self-collection for cervical cancer screening, showing that it is more effective in reaching under screened women in high-income countries, with high adherence rates to follow-up on among those who tested positive. Self-collection presents an exciting opportunity to overcome patient and health system barriers to screening and to improve equity within and between countries.
From his end, Dr. Kamal Fahmy delivered a presentation titled: “HPV Vaccination: EMR Regional Situation, Opportunities, and Challenges “in which he spoke about the cervical cancer elimination strategy. He focused on the global and regional situations of HPV vaccine introduction and the efforts being made to eliminate cervical cancer. He highlighted the three pillars of the elimination strategy and the need for collaboration and coordination between departments. Dr. Fahmy also discussed the challenges faced while introducing the HPV vaccine, including vaccine hesitancy, stigma, safety concerns, lack of knowledge, awareness, and cost. He emphasized the need to work towards the acceleration of HPV vaccine introduction to achieve the ambitious goals.
Furthermore, Dr. Fahmy emphasized the importance of community engagement, strong advocacy at decision-maker levels, and effective communication and planning for high coverage and successful delivery of the HPV vaccine. He mentioned that supply and cost of the vaccine are improving, with more products being pre-qualified, and that the Global Alliance for Vaccine and Immunization (GAVI) is supporting middle-income countries in the region with the cost of the vaccine and an introduction grant. Dr. Fahmy also discussed the role of the Expanded Program on Immunization (EPI) in providing regional advocacy, technical support, and stakeholder coordination to support the decision-making process for HPV vaccine introduction and their openness to supporting NGOs in any country to support decision-making regarding the introduction of the HPV vaccine.
Finally, In the third and last presentation for the evening, under the title: “Introduction of the HPV Vaccine in the NIP” Dr. Mohammed Ben Azzouz discussed the experiences of Morocco in HPV vaccination and the steps taken to eliminate cervical cancer. He mentioned that the country's government introduced HPV vaccination in 2010 for girls aged 9-13 years, which resulted in a significant decrease in HPV prevalence and cervical cancer cases. Dr. Azzouz emphasized the importance of advocacy and awareness campaigns to improve vaccine acceptance rates and reduce vaccine hesitancy. He also highlighted the need for close monitoring and evaluation of the HPV vaccination program to ensure its effectiveness.
Dr. Ben Azzouz also presented a study revealing four segments of people with different attitudes towards the HPV vaccine, and a national introduction plan with a two-dose vaccination schedule for 11-year-olds. While the study showed a lack of understanding and misconceptions about HPV and the vaccine, 54% were willing to vaccinate their daughters. He emphasized the need for better education, and documents were produced to support the campaign, with the Technical Committee reconsidering the vaccination schedule at an upcoming meeting.
Following the presentations, Dr. Nada Ahmad facilitated the Q&A session, where participants and panelists engaged in the discussion. She then concluded the session by thanking the speakers and the attendees for their participation.
To watch the webinar recording Click Here