Today is International Human Papilloma Virus (HPV) Awareness Day. More than 80 per cent of us are likely to be infected by HPV in our lifetime. There are more than 200 different kinds of HPV that are circulating among humans. Most are harmless. But there are several HPVs which cause cancer. More than 90 per cent of cervical cancers are caused by only a handful of HPVs. The main ones that cause cervical cancer are HPV16 and HPV18, both of which are prevalent in Guyana.
Guyana is part of a global effort to eliminate cervical cancer, one of the most prevalent forms of cancers in women. The UK, Western Europe and North America are on track to eliminate cervical cancer between 2040 and 2050. The President Irfaan Ali-led PPP Government is positioning Guyana to eliminate cervical cancer by 2050. Minister Frank Anthony and the MOH are working hard to ensure Guyana achieves this milestone.
Cervical cancer is the second most common cancer among women in Guyana, with approximately 121 new cases and 63 deaths reported annually. The disease disproportionately affects women, ranking second for both incidence and mortality among women aged 15–44. High-risk HPV (16/18) is a major factor, with high prevalence rates noted, particularly among indigenous populations. With an incidence rate of more than 20/100,000 women, Guyana’s cervical cancer rate is very high.
On March 13th, Guyana’s Permanent Mission in Geneva will join Permanent Missions from different countries around the world to push for global elimination by 2080. Guyana’s Permanent Representative in Geneva has been a lead proponent for a global push to eliminate cervical cancer by 2080. The elimination of cervical cancer before or by 2080 will mark only the second time that the world would have achieved the end of a disease. It will also mark the first time we would have eradicated a cancer.
While the WHO global strategy envisages global elimination of cervical cancer by 2120, a growing number of public health experts have joined Guyana’s Permanent Representative in Geneva to urge acceleration to end cervical cancer by 2080, 40 years before the WHO’s global elimination deadline. With the robust strategy in Guyana, our country can play a leading role by trying to achieve national elimination by 2050.
The latest available global data reveal approximately 600,000 new cases of cervical cancer and 338,800 deaths annually, constituting 6.5 per cent and 7.7 per cent of total new cancer cases and deaths in women, respectively. Low-Human Development Index (HDI) countries have the highest incidence and mortality rates of cervical cancer, with incidence rates three times higher than those in countries with high-HDI and mortality rates six times higher.
With vaccines on hand and remarkable scientific and technological advancements, the world can duplicate the lessons of smallpox eradication to eliminate cervical cancer. Several Ambassadors in Geneva, led by Guyana’s ambassador, have issued a call to action. These ambassadors argue that just as the world, working together, eradicated smallpox, we can together, today, eliminate cervical cancer. These ambassadors urge nations to strive as ONE WORLD to end cervical cancer before May 8, 2080, when we celebrate the 100th anniversary of the eradication of smallpox.
Over thousands of years, from as early as 1350 BC, smallpox, a highly infectious, deadly disease, killed hundreds of millions around the world. But today, it remains the only human infectious disease to have been eradicated. The beginning of the end was when the World Health Assembly in 1958 issued a call for the eradication of smallpox, a global call to action. In 1959, the WHO launched the Smallpox Eradication Program, with mass vaccination as the foundation of the eradication strategy. In the height of the Cold War, British, Canadian, Cuban, French, Russian, and US vaccines were given freely to the WHO and distributed onwards, sometimes with the strategic financial support of Sweden. The result was that the WHO declared zero cases of smallpox in the world as of October 26, 1979; a Global Commission of Scientists certified the eradication of smallpox on December 9, 1979; and on May 8, 1980, the WHO at WHA33 declared smallpox officially eradicated.
National, regional and global investments in the fight against HPV and cervical cancer are a “best buy”, an option we ignore at great peril for people, particularly for women in resource-poor settings. Remarkable advancements in science and technology, an armoury of tools, provide countries with the real possibility for ending cervical cancer before 2050 in many countries and before 2080 in all countries. Guyana can be a leading light by ending cervical cancer by 2050.
Ending a cancer for the first time will be monumental. The progress we have made in the fight against cervical cancer in the past two decades must motivate us to reach the finish line in eliminating cervical cancer. The question must not be “if” we can; it must be “when”.
On November 17th, 2020, Member States of the WHO adopted the Global Strategy for Cervical Cancer Elimination. An important outcome of the strategy is for countries to achieve an incidence rate of below four per 100,000 women. As a first step towards reaching this goal, countries must achieve the “90-70-90” targets by 2030. The 90-70-90 targets are 90 per cent of girls vaccinated with the HPV vaccine before the age of 15; 70 per cent of women screened using a high-performance test by the age of 35 years and again by the age of 45; and 90 per cent of women with pre-cancer treated and 90 per cent of women with invasive cancer managed.
Although daunting, the global ambition to eliminate cervical cancer before the 100th anniversary of the eradication of smallpox is possible. We, the world, must not abdicate this responsibility. It will be reckless and immoral for us not to grab the opportunity for a public health milestone that is staring at us.