SALC and its Partners Chart a Roadmap to Increase Availability of and Access to Cervical Cancer Services in Southern Africa
April 24, 2012
From 25 – 26 April 2012, SALC will host a meeting to discuss an advocacy strategy aimed at increasing access to and availability of cervical cancer prevention and treatment services as part of sexual and reproductive health services for women in southern Africa.
SALC recently undertook research on the status of policies related to cervical cancer, as well as the availability of and access to prevention and treatment services in southern African countries using Namibia and Zambia as case studies. The meeting brings together stakeholders with experience working on cancer, sexual and reproductive health, HIV and women’s rights more broadly in southern Africa to discuss the findings of the research and possible advocacy strategies in Namibia and Zambia specifically, as well as at the regional level.
Cervical cancer is a disease of female reproductive system. It begins in the cervix which is the lower portion of the uterus that connects the upper vagina to the uterus. The primary risk factor for developing cervical cancer is being infected with the human papillomavirus (HPV). HPV is a common virus that is transmitted through sexual contact.
A woman dies every two minutes from cervical cancer in the world, while about 86% of cervical cancer cases occur in developing countries. Cervical cancer is the leading cause of cancer death among women in southern Africa.
The negative impact of cervical cancer is exacerbated in southern Africa given the high prevalence of HIV among women. Many studies worldwide have shown a higher prevalence of potentially cancer causing lesions called cervical intraepithelial neoplasia (CIN) among HIV-positive women. The relationship between cervical cancer and a sexually transmitted disease has already resulted in stigmatization of this disease. The additional link with HIV paired with the existing stigma around women’s sexual and reproductive health may further entrench discrimination and stigma against women, particularly women living with HIV.
In all the 10 countries in which SALC operates, cervical cancer is the primary or second cause of cancer deaths; while it is the tenth most common cause of cancer death among women in high-income regions and countries like the United States, Canada, and Japan. Deaths from cervical cancer in resource rich countries are significantly lower primarily due to prevention, early detection and treatment; however, access to cervical cancer screening services in the southern Africa region remains minimal.
The research conducted by SALC found that cervical cancer management in southern Africa remains under-recognised and under prioritized. Consequently, a significant number of patients are diagnosed with advanced-stage disease, which carries a high morbidity and mortality rate. Based on the current medical science, cervical cancer is easily preventable and treatable. There are currently enough medical and scientific tools available to reduce the incidence and mortality caused by cervical cancer in any resource setting. Yet despite the ability to reduce mortality, southern African countries continue to lose thousands of lives to cervical cancer each year.
There are many reasons for the higher cervical cancer incidence and mortality in southern Africa. These include: lack of awareness of cervical cancer among the population, health care providers and policy-makers; lack of epidemiological data; lack of resources including health infrastructure, human and financial resources; non-existent service policies and a lack of political will to provide for sexual and reproductive health needs of women in Africa.
Given the secondary status of women in southern Africa, it is unsurprising that issues specifically affecting women are not prioritised by government officials. This is particularly true with respect to sexual and reproductive rights. In most countries in southern Africa, legal restrictions on women’s sexual and reproductive rights continue. Furthermore, as seen in the reports of coerced sterilization in Namibia and South Africa, women’s reproductive rights are significantly impugned with little response from government, particularly when the violations are aimed at women living with HIV. Globally more than 13 million women are infected with both HIV and HPV yet services for these women are extremely limited, both in terms of finances and in terms of the science available. As one activist once put it
“Women are not dying because of diseases we cannot treat … they are dying because societies have yet to make the decision that their lives are worth saving.”
(Mahmoud Fathalla, past president of the International Federation of Obstetricians and Gynecologist (FIGO) – 21 November 2009)
Controlling cancer not only preserves life and prevents disability but also creates improvement in the health and well-being of families. Many of the deaths caused by cervical cancer are preventable, as is the physical pain, discomfort and social stigma associated with advanced disease. Failure by southern African governments to adequately provide medical and other cervical cancer related services may result in violations of: the right to life; the right to health; the right to equality and freedom from all forms of discrimination; the right to dignity and freedom from cruel inhuman and degrading treatment; rights relating to bodily integrity and autonomy; and the right to information.
During our research it became evident that there is a dearth of information on the accessibility to and availability of cervical cancer related services provided by governments and other stakeholders. Moreover, there is little awareness of the burden of cervical cancer in general or the link between cervical cancer and HIV among stakeholders and civil society.
To continue the discussion on access to and availability of cervical cancer services in southern Africa we are hosting a forum on the AfricanLII website. You can get more information on our cervical cancer advocacy forum and how to join in here.
Also please watch out for the release of the detailed research report due to be published on the SALC website at the end of June 2012.
For more information on cervical cancer visit:
Cervical Cancer Action: A Global Coalition to Stop Cervical Cancer:
Alliance for Cervical Cancer Prevention
RHO Cervical Cancer
World Health Organisation International Agency for Research on Cancer