• The only reassuring fact is that cervical cancer can actually be eliminated in Kenya. It can be prevented and in cases of early diagnosis, it can be cured.
• To achieve elimination, pre-cancer screening and treatment must be available and accessible
Image: COURTESY
In August, the world resolved to eliminate cervical cancer. During the World Health Assembly, 194 countries took a stand against cervical cancer and resolved to ensure its elimination.
A new global strategy was developed to ensure serial elimination of cervical cancer across the globe. The strategy laid down a roadmap through targets that should be achieved by 2030. These targets include, ensuring 90 per cent of girls fully vaccinated with the HPV vaccine by 15 years of age; 70 per cent of women screened twice in their lifetime using a high-performance test; ensuring that 90 per cent of women identified with cervical cancer disease receive treatment (90 per cent of women with pre-cancer treated, and 90 per cent of women with invasive cancer managed).
The scenario of cervical cancer in Kenya is heartbreaking. Cervical cancer is the most common cancer among our women aged 15 -44 years. Moreover, it is the leading cause of cancer related deaths among females in this country.
The only reassuring fact is that cervical cancer can actually be eliminated in Kenya. It can be prevented and in cases of early diagnosis, it can be cured.
To achieve elimination, pre-cancer screening and treatment must also be available and accessible
A recent study by International Agency of Research on Cancer study modelled the impact of scaling up screening and treatment services among women living with HIV (WLHIV) in Kenya. Model comparisons from 2020-40 estimated that scale-up of screening and treatment services in the country could avert 28,000 cases of cervical cancer and 7,700 deaths.
Although women in the developed world have access to high quality testing, those in Africa are often left to be tested with lower quality methods. In African countries, it is common to screen for cancer by applying household vinegar on the woman’s cervix. When done properly by the healthcare worker, this method can help.
But Kenyan women deserve better. High quality tests, known as “HPV tests,” are more reliable. They are important for improving the ability to detect the disease early. HPV testing has another benefit too: this type of test can allow a woman to collect the sample herself with a simple swab, so that she does not need to have a pelvic exam by the doctor in order to be screened.
These testing methods are already available in high income countries and are starting to become available in some parts of Kenya. Bringing these new methods to more parts of the country is important because women deserve to have more choices. The same instruments used to rapidly scale up Covid-19 tests can also be used for the HPV tests.
The Covid-19 response shows the speed and high coverage of testing that can be achieved when there is commitment to confront a public health problem with urgency.
INTERVENTIONS
For Kenya to be able to realise rapid elimination of cervical cancer all stakeholders in the country must play their part in the process. The Ministry of Health has to work on increasing access to treatment and palliative care for invasive cancer.
The work of the ministry in establishing 10 county chemotherapy centres and construction of radiotherapy bunkers in Mombasa, Nakuru, and Garissa regional cancer centres to improve access to treatment for invasive cancers is commendable.
Moreover, the noted efforts for capacity building for the provision of safe chemotherapy services by the Ministry of Health is a great plus to the improvement cancer services in the country. After such commendable work, it is time to increase reach to women who are eligible to these services since only 16.4 per cent of eligible women have been reached in these regions.
The call to elimination of cervical cancer is not just a choice but a mandatory venture considering the great benefits it will provide for women in Kenya. Committing to the elimination of cervical cancer will ensure women no longer suffer or die from a preventable and curable disease.
It’s a choice to restore women’s dignity, to de-stigmatise women’s healthcare, and to confront the injustices reflected in the unequal burden of disease that affects women in developing countries.
Besides elimination of cervical cancer, investing in prevention and treatment of cervical cancer will equally benefit the efforts of prevention and treatment of all other cancer. The benefits of these services are fully realised when they are embedded within the Universal Health Coverage and the cost is covered by health insurance schemes.
While this may seem like a long journey to many, we believe the time for action is now. We owe it to the next generation to leave a legacy in which they can live in a world free of cervical cancer.
With the world’s recent adoption of the resolution to eliminate cervical cancer, Kenya must urgently choose. If we act now, Kenya could be among the countries that will finally eliminate cervical cancer.
Maria Mbeneka is the chairperson, County First Ladies Association, while Dr Nono Simelela is the assistant director for Strategic Programmatic Priorities, World Health organization