The lives of 3,700 South African women could be saved each year if the Department of Health makes the HPV vaccine available to the public sector – a move this department is seriously considering, according to the minister of health’s talk at the recent Stop Cervical Cancer in Africa Conference, held in Cape Town.
Two vaccines against the human papillomavirus (HPV) – the virus which causes over 80% of cases of cervical cancer – were registered in South Africa last year and are currently available in the private sector.
However, cervical cancer is often associated with poverty – as it is the women who cannot afford to go for regular Pap smears who are most burdened by the disease. Priced at around R1,350 and R2,100 respectively for the three doses required, the vaccine is out of reach for those who need it the most – the poor.
Introducing the HPV vaccine as part of the vaccine bouquet provided by the state will save thousands of lives a year and reduce morbidity in tens of thousands more.
“The Department of Health is seriously considering introducing two vaccines in the public sector to prevent new cases of cervical cancer,” reads a DoH statement. “It [the department] has to find the resources needed for the introduction of these vaccines.”
“In South Africa our constitution guarantees everyone the right to access to health, including reproductive health services,” said Dr Aaron Motsoaledi, South Africa’s minister of health, but also acknowledged the financial and human resource challenges facing the country’s healthcare system.
First lady Tobeka Madiba Zuma added her voice to this campaign: “I have learnt that in South Africa the vast majority of patients that are diagnosed with cervical cancer are presented at an advanced stage of the disease.
“Some of the obstacles include missed screening opportunities, lack of knowledge about screening, lack of transport, inadequate medical infrastructure, low socioeconomic background, misconceptions about cancer. This is especially true for women from the rural areas where the delivery of health care services is still a major challenge in Africa,” she said.
SA’s screening policy
Compared to other developing countries, South Africa has a progressive policy on cervical cancer screening that offers three Pap smears for all women in the public health sector at the ages of 30, 40 and 50. This however, does not translate into a successful reproductive health service as the uptake is very low, and only around 22% of South African women make use of these Pap smear services.
In 2004, South Africa set itself a target of screening 70% of women 30 year and older within a period of 10 years – this translates to nearly 6 million women. But by June 2009 – almost midway to the envisioned target for 2014 – the National Health Laboratory Services (NHLS) has handled just over 2 million screenings.
According to Motsoaledi, the reason for this low coverage includes increasing financial and personnel constraints, and a lack of awareness by women for the need for screening.
“We acknowledge that we have to strengthen our cervical cancer screening programme,” Motsoaledi admitted.
The DoH is also planning to review the National Cancer Control Programme before the end of the year. This review will provide the department with a clear direction on improvements that are needed to achieve optimal quality.
The Department also needs an effective National Cancer Registry. Regulations to strengthen reporting are being finalised. This is a useful tool for planning and budgeting for activities that are aimed at the prevention and treatment of cancers. – (Wilma Stassen, Health24, August 2009)
Cervical cancer centre
Cervical cancer vaccine