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Malawi
Zambia
• Involve policymakers (parliamentarians).
• Financial resources for new technologies (i.e., HPV DNA testing at point of care, vaccine).
• Training and education.
• Screening—VIA/cytology/DNA/colposcopy (pilot studies and full-scale rollout).
• Screening and management of treatment, including palliative care.
• Strengthen the referral system.
• HPV vaccination.
• Country-wide campaigns promoting cervical cancer prevention.
• National expansion of screening; integrate HPV DNA testing into screening programs.
• Establish HPV vaccination program.
Group 3: Cameroon, Ghana, and Rwanda
Common challenges across countries in this group included:
• The cervical cancer burden is not accurately known.
• Current cervical cancer prevention policies are not comprehensive.
• Low possibility of government financing for strengthening screening services or for HPV
vaccination.
• Cancer control is generally neglected as part of the non-communicable disease agenda.
• Lack of awareness of cervical cancer among clinicians and patients.
• Lack of equipment for screening and treatment.
• Women have a fear of being screened.
• Sustainability of the cervical cancer prevention program.
• Low capacity for screening and treatment of precancerous lesions and palliative care.
As with the other groups, coordination of activities for cervical cancer prevention across reproductive
health, cancer, and immunization was a central concern. Here, the teams suggested the creation of a
national technical committee to coordinate activities across service providers. The committee would
decide which group would do vaccination, screening, and other activities. At the outset, it seems logical
that EPI would be in charge of vaccinations, since this group has expertise in immunizations.
Another question was how to coordinate cervical cancer screening with HIV programs. Adding screening
to the HIV programs may stigmatize those getting cervical cancer screening, so it may work better to
have screening clinics that also offer other services, such as HIV testing, family planning, and nutritional
Report of an African Regional Meeting on Cervical Cancer: September 2010 53