Scaling up an effective model of care to prevent and treat cervical cancer in Rwanda
Cervical cancer is both preventable and highly treatable if caught early. Yet globally, a woman dies from cervical cancer every two minutes, with the African continent accounting for the majority of these deaths. Indeed, according to the World Health Organization, 19 of the 20 most burdened countries are located in Sub Saharan Africa. In Rwanda, it is the most common cancer affecting women.
It is a tragedy that thousands of women are still dying from cervical cancer. We know how to prevent it, and if women participate in regular screening and pre-cancerous cells are caught early enough, it is straightforward to treat. Women don’t need to be losing their lives and families don’t need to be left motherless.
Rwanda has made significant progress over the last few years to increase access to screening and treatment in rural areas, strengthen national programs, and build effective delivery systems that enable rapid expansion of cervical cancer services at the health center level. Critically, this includes scaling up the use of HPV testing, integrating cervical cancer screening with other health services, implementing patient tracking systems to ensure continuity of women’s care, and generating demand for screening through district-wide awareness campaigns.
Thanks to this program funded by Unitaid, nearly 95,000 have been screened for pre-cancerous lesions in Rwanda, and 91% of those testing positive have received treatment, directly saving lives while proving out an effective package of tools that is ready to scale. The country had already been running a successful HPV vaccination program which reached 93% of 12-year-old girls within just two years, and has since implemented a comprehensive training program to increase the provision of screening and treatment services.
By the end of 2022 fifteen districts in Rwanda were offering cervical cancer screening and treatment with thermal ablation, including five districts and 101 health facilities supported by CHAI. We also supported integrated cervical cancer screening with HIV testing and treatment services to reach more women living with HIV, who are at greater risk of developing cervical cancer. We trained more than 260 HIV peer educators to disseminate cervical cancer screening and prevention messages and 95 nurses in cervical cancer screening and treatment, doubling the number of women screened. Today, Rwanda is firmly on the path towards elimination.
Of course, more work is needed to achieve the goal of reaching 70% of eligible Rwandan women – but the groundwork to scale up these services has now been laid. The country has launched an ambitious five-year national strategy that aims to triple the number of hospitals with colposcopy machines, and reach 1.5 million women through the introduction of HPV testing by 2024. Meanwhile, CHAI is dedicated to continuing our work across countries to embrace new innovations and drive multi-sectoral collaboration to reach even more women with lifesaving care.
Now is the time for countries and partners to make a concrete commitment to the World Health Organization’s Cervical Cancer Elimination Initiative and progress towards reaching the vaccination, screening and treatment goals it sets out, by 2030.
We must all come together to prioritize saving women’s lives, reduce the gender inequalities created by this disease, and ultimately make progress towards eliminating deaths from cervical cancer altogether – creating a generation free from cervical cancer for our children.