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We spoke to Prebo Barango, Claire Kimilu, Emily Suzuki, Mary-Anne Land, and Paul Bloem from the WHO about the burden of cervical cancer in Africa and the need for improved delivery of existing prevention, screening, and treatment methods
Africa carries the highest global burden of cervical cancer. What does WHO identify as the main drivers behind this disproportionate impact, and how are these trends evolving?
Africa’s disproportionate burden of cervical cancer is not inevitable. The science to prevent the disease exists: effective HPV vaccines, high-performance screening technologies, and proven treatments for precancer that can prevent progression to cancer when delivered in time. The challenge is no longer discovery; it is delivery. Proven interventions exist, yet systems to implement them remain insufficient.
The burden reflects long-standing structural and investment gaps that have limited health systems’ ability to deliver prevention, screening, and treatment at scale. Cervical cancer services are often fragmented and under-integrated within primary healthcare, while workforce shortages, limited laboratory capacity, and fragile supply chains constrain access.
In parts of sub-Saharan Africa, high HIV prevalence adds urgency: women living with HIV are up to six times more likely to develop cervical cancer, (1,2) making integration of HIV and cervical cancer services essential. Gender inequality, stigma, and low health literacy compound these structural barriers. The result is clear: more than half of girls are not yet vaccinated, while too many women are never screened, and too many are diagnosed only when the disease is advanced.
A shift is underway. Most countries have introduced vaccination (around 75%), (3) and more are adopting single-visit ‘screen-and-treat’ approaches. Political leadership is becoming more visible. Partners such as the African Union (AU), the Organization of African First Ladies for Development (OAFLAD), and governments are elevating cervical cancer elimination on national and regional agendas. Regional collaboration is strengthening delivery systems and sharing lessons across borders.
Progress remains uneven, and coverage is still too low – but momentum is building. With sustained leadership and long-term investment, countries across the region can move decisively toward elimination, a goal already in reach in countries with strong health systems.
Access to HPV vaccines remains uneven across the region. How can vaccine availability and uptake be improved?
The global expansion of HPV vaccination has accelerated in recent years, yet access and uptake remain uneven. (4) The shift to a single-dose schedule has simplified delivery, lowered costs, and allowed limited supply to reach more girls — removing a major operational barrier to scale.
Sustaining high coverage depends on how vaccination is embedded within national health systems. Integrating HPV vaccination into routine immunization and school-based programmes – with sustained financing to support delivery – expands access by meeting girls where they are. For those out of school, community outreach and mobile services are essential to avoid leaving the most vulnerable behind.
Reliable supply systems are equally critical at country level. Strong forecasting, procurement, and distribution prevent stockouts and ensure vaccines reach even remote communities. Global support remains critical. Partners such as Gavi, the Vaccine Alliance, are helping countries secure sustainable supply and strengthen national delivery systems, enabling equitable scale-up.
Acceptance also depends on public confidence. Trained health workers providing clear messages – alongside trusted community leaders and educators – play a decisive role in countering misinformation and reinforcing vaccine safety.
When global solidarity, national leadership, community engagement, and strong delivery systems align, HPV vaccination can move from reaching half of girls to protecting an entire generation.
How is the WHO supporting the scale-up of screening programmes and ensuring timely treatment?
In many settings, traditional multi-visit screening models have led to high loss to follow-up between testing and treatment. The shift toward HPV testing and single-visit ‘screen-and-treat’ approaches offers an opportunity for women to be tested and, if necessary, treated in the same appointment to reduce missed care. Self-sampling is expanding access further, particularly where stigma deters women from seeking care.
Yet innovation alone does not guarantee impact. In many low-resource settings, visual inspection with acetic acid (VIA), which is less accurate and harder to scale with consistent quality, remains the primary screening method. The gap between what is technically possible and what is routinely available remains significant.
Closing that gap requires more than new tools; it requires systems transformation. WHO supports countries through evidence-based guidelines as well as through technical assistance and capacity strengthening to expand trained workforces, improve quality assurance, and strengthen laboratory networks and referral pathways. WHO is also encouraging responsible innovation, including the use of artificial intelligence to strengthen data systems, support clinical decision-making, and extend the reach of screening and treatment services, particularly in low-resource and remote settings.
WHO’s global strategy aims to eliminate cervical cancer as a public health problem. What progress has been made, and what obstacles are most urgent to address?
In recent years, rapid innovation has transformed the landscape. HPV vaccination has shifted to a single dose recommendation, (5) simplifying delivery, lowering costs and making limited supply go further. Screening has moved beyond traditional pap smear toward more accurate HPV testing. Even self-sampling is expanding access, allowing women to collect their own samples safely and privately, helping overcome barriers linked to stigma.
The question now is whether these gains can be translated into sustained national coverage. The most urgent obstacles lie in how health systems are designed and financed, from integrating services and countering misinformation to strengthening workforce capacity. What will determine success is whether countries can translate these best practices into routine, institutionalized services – supported by sustainable financing, reliable supply systems, and primary health care platforms capable of delivering them consistently. These are governance and system design choices as much as technical ones.
Elimination will ultimately be defined by whether vaccination, screening, and treatment reach every woman at risk. Cervical cancer is the first cancer the world has committed to eliminate. The tools exist. Sustained leadership – political, community, and global – will determine whether elimination is achieved.
References
https://www.who.int/news-room/fact-sheets/detail/cervical-cancer
Stelze, Dominik et al. Estimates of the global burden of cervical cancer associated with HIV. The Lancet. 2020. https://doi.org/10.1016/S2214-109X(20)30459-9
World Health Organization HPV Dashboard, https://www.who.int/teams/immunization-vaccines-and-biologicals/diseases/human-papillomavirus-vaccines-(HPV)/hpv-clearing-house/hpv-dashboard; accessed on 16 February 2026
Adidja A, Paul B et al. Scaling HPV vaccination in Africa to eliminate cervical cancer by 2030,
The Lancet Global Health,13(12) 2025.e2006-e2008.https://doi.org/10.1016/S2214-109X(25)00349-3.