Cervical cancer: MSD seeks push beyond HPV vaccination

…18m girls vaccinated, but elimination fight far from over
…Stakeholders seek stronger private-sector role in cancer care

By Joseph Erunke, Abuja

Nigeria must move beyond its gains in Human Papillomavirus, HPV, vaccination and urgently strengthen cervical cancer screening, early diagnosis and treatment, the External Affairs Director for sub-Saharan Africa at MSD, Vuyo Mjekula, has said.

Mjekula said while the country had laid a strong foundation for cervical cancer elimination through its national HPV vaccination programme, the next phase required broader collaboration to ensure women at risk were screened and those diagnosed received timely treatment.

She spoke at a high-level policy roundtable organised by MSD in partnership with Africa Health Business, AHB, in Abuja, with the theme, “Accelerating Cervical Cancer Elimination in Nigeria: Uniting Public and Private Sectors for Equitable Access.”

According to her, Nigeria’s progress in HPV vaccination provided an opportunity to expand the country’s focus across the entire cervical cancer prevention and care continuum.

“What we were trying to explore together is, how do we build on the firm foundation that has already been built within Nigeria and work towards accelerating cervical cancer elimination in Nigeria?” Mjekula said.

She said the national HPV programme had recorded substantial progress since its introduction in 2023, but argued that greater private-sector involvement was needed to complement government efforts and extend access to prevention and care.

“The main thing was, how do we build upon that foundation and even the work of these various task groups? And one of the areas which we believe was a gap or is a gap is we see that there’s a great opportunity for the increased involvement of the private sector,” she said.

Mjekula also called for a shift towards integrated women’s healthcare, saying opportunities to screen women for cervical cancer and other diseases should not be missed when they present at health facilities for other services.

“We don’t look at women in a siloed way. Look at women perhaps just in the context of maternal health, look at women just in the context perhaps of HIV/AIDS, or just in the context of broader sexual reproductive health,” she said.

She advocated a system where women could receive multiple preventive interventions during routine healthcare visits, including screening for cardiovascular diseases and HPV-related risks where appropriate.

Mjekula further called for private-sector representatives to have seats on national cervical cancer task forces, partnerships and technical working groups, arguing that greater participation could help reduce fragmentation and improve the use of available resources.

“The different sectors of society and stakeholders are not competing with each other. There’s a huge opportunity to break down fragmentation, galvanise and integrate resources so that the resources can be deployed to the most impactful areas and build efficiencies in general,” she said.

Her call comes as Nigeria reports more than 18 million adolescent girls vaccinated against HPV since the launch of the national programme.

The Director, Disease Control and Immunisation, National Primary Health Care Development Agency, NPHCDA, Dr Rufai Ahmed Garba, said the figure represented about 76 per cent of the country’s target population.

Garba said the scale of the vaccination campaign was significant, but stressed that eliminating cervical cancer required more than preventing HPV infection.

“Today, we are around 76 per cent coverage of our target, but in terms of numbers, we have crossed 18 million adolescent girls, which is equivalent to three countries in Africa,” he said.

He said the government was now focused on strengthening screening, early diagnosis, treatment and follow-up of women with cervical cancer.

“If it is not diagnosed early, if it is not treated early, it leads to death. So, that’s what all of this is about, not just the vaccination, which NPHCDA does, but also how we are able to get women to screen them, to catch them early, treat them and follow them up till they actually get better,” Garba said.

According to him, Nigeria records about 12,000 new cervical cancer cases and nearly 8,000 deaths annually, underscoring the need to close gaps between prevention and access to treatment.

Nigeria introduced HPV vaccination into its national immunisation programme in October 2023, with the vaccine subsequently incorporated into routine immunisation and offered free to nine-year-old girls at public health facilities.

Garba said HPV vaccines were also available at private health facilities for people outside the routine target age who wished to receive them.

He explained that the routine vaccination age was selected to provide protection before possible exposure to HPV.

“The best time to actually give the vaccine is before the person becomes sexually active. The reason being that 98 per cent of the time the infection is from sexual intercourse,” he said.

The NPHCDA official said school-based vaccination and outreach programmes were being used to improve access, while adolescent-friendly health services could provide safe spaces for young people to obtain information and preventive care without stigma.

Mjekula said MSD had also supported catch-up HPV vaccination for girls up to age 20 who were not covered when Nigeria introduced the national programme.

She disclosed that MSD was working with Gavi and UNICEF on access to higher-valency HPV vaccines in Africa.

On broader health interventions, Mjekula said MSD had invested more than $44 million in Nigeria over the past decade through its MSD for Mothers initiative to support civil society organisations working in maternal healthcare.

She added that the company was working with City Cancer Challenge in Abuja to identify gaps and co-create solutions for improving oncology services.

Mjekula said the changing global health financing environment had made domestic resource mobilisation and stronger partnerships increasingly important.

She said sustained progress towards cervical cancer elimination would depend on coordinated action involving government, healthcare providers, private-sector organisations, civil society and patient advocates.

Nigeria has placed cervical cancer elimination on its national health agenda, with the disease having a dedicated strategic elimination plan and being among the cancers covered by the Cancer Health Fund.