Gender Focus with EMELDA MWITWA
CERVICAL cancer affects over half a million women every year, and kills a quarter of a million in the same period.
In sub-Saharan Africa, where Zambia lies, 34 out of every 100,000 women are diagnosed with cervical cancer and 23 out of every 100,000 women die from the disease.
The picture is not so different in Zambia where 33 percent of all cancers are cervical. Zambia is actually said to have one of the world’s highest rates of invasive cervical cancer incidence at 58 per 100,000, whereas 36 per 100,000 women die of it per year, according to information from the Ministry of Health.
“Cervical cancer presents by far the biggest public health concern in Zambia than other non-communicable diseases,” Minister of Health Chitalu Chilufya said in an interview recently.
The cervical cancer prevalence is thus serious in the world, the reason why the disease was among the non-communicable diseases that were under consideration at the 73rd United Nations General Assembly (UNGA) in New York last week.
The issue attracted a high-level meeting dubbed “Elimination of cervical cancer”, which was attended by President Edgar Lungu, Dr Chilufya and World Health Organisation (WHO) Director General Dr Tedros Ghebreyesus.
Also in attendance was chief executive officer of Gavi, The Vaccine Alliance, ministers of Health from UN Member States, heads of UN agencies, civil society organisations and the private sector.
From what I got from the discussants, there are more women dying of cervical cancer in the world than those dying in childbirth.
This is not to say that maternal deaths are acceptable, but rather to emphasise the upsurge in cervical cancer deaths.
The purpose of the meeting was to discuss ways of curbing the killer disease, which is preventable and also needn’t kill so many people in the world because it can be successfully treated if detected early.
One of the preventable measures that was discussed in the global call of action to end cervical cancer was the vaccination of girls with the HPV vaccine.
It was felt that the vaccination of girls, and also boys (although this has not yet started), is one of the sure ways of preventing the occurrence of cervical cancer in women.
Apparently the challenge in the HPV vaccination drive has been the inadequate supply of vaccines the world over.
According to Gavi, the demand for HPV vaccines all over the world outstrips supply.
Gavi Chief Medical Officer Seth Berkley said manufacturers of drugs are aware of this and are working at increasing the supply of vaccines. With the supply of drugs permitting, they hope to vaccinate 40 million girls by 2020.
In future, they also hope to vaccinate boys, apparently to stop the transmission of the human papilloma virus, which causes cervical cancer, from men to women.
From that meeting, it seems there will be renewed vigour in the world towards the vaccination of girls, and this is the heart of my write-up today.
As you know, vaccination exercises are often met with mixed feelings in Zambia and some people shun them for no apparent reason.
Well, for your information, Zambia will be rolling out the HPV vaccination exercise in targeted areas sometime next year.
Of course Zambia’s response to the cervical cancer epidemic is in three ways – prevention, early screening and treatment. The vaccination of girls is one of the preventive measures.
Dr Chilufya shared with me in an interview during the UNGA that the Alliance for Cervical Cancer Prevention has approved Zambia’s request to roll out the HPV vaccination exercise.
The target age group are girls aged between 9 and 14 and parents will therefore be required to avail their daughters to take part in the vaccination exercise when it starts.
Actually some parents did well last year by giving consent for their daughters to be immunised against cervical cancer when the exercise was piloted in schools.
But I know for a fact that there were parents who withheld their daughters from taking part; either they doubted the safety of the vaccines, or they did not fully understand the benefits of the exercise.
The way the pilot project of the HPV vaccination exercise was done was such that parents had to give consent for their daughters to be inoculated. I remember that my husband and I had to write a letter of consent to our daughter’s school to let her take part in the vaccination exercise, which was done in two phases.
The first time, she was given a jab at school and the second time her father had to take her to Chilenje First Level One Hospital to get the vaccine.
Obviously, as a parent it was not easy for me to give consent and I had to do personal research on the HPV vaccine, particularly on how people around the world perceived it before allowing our 12-year-old girl to take part.
Like any other parent, I wanted to be sure that Africa was not just being used to test a new vaccine called HPV.
My husband wa s more courageous in consenting than I was, but finally we did it and I am sure it was for our daughter’s good, based on the literature that we came across.
From the information I got from my daughter, there were more girls in her school who shunned the HPV vaccine exercise than those who were actually inoculated.
And the reason is that there was ‘no response’ from some parents when the school authorities gave out letters requesting for parental consent for the girls to be vaccinated.
Vaccination is often a thorny issue in Zambia and some, for unknown reasons, are sceptical about allowing their infants to receive the usual vaccines given to under-five children.
The apprehension is worse when it comes to new vaccines like the HPV, and the Ministry of Health needs to do enough sensitisation to allay fears and myths that people have about vaccines.
But from what I know, the main reason why people are afraid of receiving vaccines border on the safety of the drugs and unfounded suspicion that the Western world, which supplies these drugs, is up to no good to the recipients in poor countries.
In the townships, there are a lot of rumours about vaccines as some believe they aren’t safe, while others think they could make their children sterile.
There is a common belief that the Western world wants to decimate our population by making ‘us’ infertile, while others believe that they want to use Africans as ‘guinea pigs’ for testing new drugs.
These are some of the issues the Ministry of Health needs to deal with before rolling out the HPV vaccination programme in Zambia.
For the exercise to be successful, they need to convince as many parents as possible about the safety and benefits of the HPV vaccine.
They also need to do outreach programmes in the communities to dispel rumours, otherwise the turnout of volunteers for vaccination may not be as good as desired.
From what I heard at the 73rd UNGA, there is global demand for the HPV vaccine to eliminate cervical cancer and stop the deaths of millions of women and girls.
To me this means that the vaccine is safe because it is actually recommended by WHO.
In the meeting I learnt that adolescent girls have also been diagnosed with cervical cancer, meaning every sexually active woman is at risk.
If the HPV vaccine could help us to eliminate cervical cancer and save millions of lives, why not let the girls go for it?
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Gender Focus with EMELDA MWITWA