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Several other countries reported vaccinating at a pilot scale. In Cameroon, vaccine was donated for over
6,000 girls in five regions. In Tanzania, a pilot study of HPV vaccination is being implemented for 5,200
primary school girls in one district and a memorandum of understanding has been signed for a donation
of vaccine for a five-year program. Another pilot vaccination program was implemented in Lesotho: this
began in 2008 with vaccine donated to vaccinate 40,000 girls in two districts, and another donation was
received to continue in 2011 in the same districts. In Ghana and Rwanda, proposals for vaccination
programs are under review and may be implemented soon. On the other hand, Kenya, Malawi, and
Zambia have no organized HPV vaccination programs to date.
In reporting on secondary prevention, most countries noted that screening coverage was very low, for
example, less than 5 percent in Ghana and Malawi, less than 1 percent in Kenya, and no organized
program in Rwanda. A number of countries have limited cytology services available in urban areas, but
many are starting to implement the more feasible method of VIA. In Zambia, a new program has had
success in using digital cervicography in performing VIA.
In Uganda, the Strategic Plan for Cervical Cancer Prevention and Control was recently published,
although no funds have yet been allocated to implement recommendations. The Ministry of Health
expects to enlist the support of several partners, and a technical advisory committee will guide the
overall approach to cervical cancer prevention. Training sessions in selected areas in VIA and
cryotherapy were conducted in 2009 and 2010.
In order to assess the potential of HPV DNA testing as a primary screening method appropriate for
developing countries, PATH and partners are evaluating the careHPV Test, a new, low-cost method.
Uganda is one of the countries where testing is under way to demonstrate how to organize and monitor
HPV DNA testing programs using the careHPV Test.
The second day of the conference included workshops at which participants set priorities and planned
activities. Some of the short-term goals set by countries included preparing national strategic cervical
cancer prevention plans, training health workers for cervical cancer screening, raising awareness and
advocating for prevention, establishing HPV vaccine pilot projects, and sensitizing policymakers. Longterm
goals included introducing HPV vaccines, strengthening and scaling up screening programs,
integrating full-scale screening and vaccination into routine health services, improving monitoring and
evaluation at all levels, and introducing or improving palliative care facilities.
Dr. Jean-Marie Dangou summed up some of the important steps that conferees indicated should be
taken after the conference:
• Set up national cervical cancer coordination committees.
• Advocate and mobilize for comprehensive cervical cancer prevention programs.
• Share the Uganda HPV vaccines project report with all African countries.
• Scale up HPV vaccine demonstration and pilot projects.
• Develop plans for HPV vaccine introduction before donations arrive.
• Provide skilled personnel and equipment for screening at all levels.
• Lobby together to obtain the lowest price for HPV vaccines.
Report of an African Regional Meeting on Cervical Cancer: September 2010 8