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Global Forum on Cervical Cancer Prevention in Kuala Lumpur, Malaysia

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Global Forum on Cervical Cancer Prevention in Kuala Lumpur, Malaysia Meeting Report 27 May 2013 Kuala Lumpur, Malaysia MEETING PARTNERS TABLE OF CONTENTS American Cancer Society (www.cancer.org) African Organisation for Research & Training in Cancer (www.aortic-africa.org) Asia Oceania Research Organisation on Genital Infections and Neoplasia (www.aogin.com) Bill & Melinda Gates Foundation (www.gatesfoundation.org) Cervical Cancer Action (www.cervicalcanceraction.org) Cervical Cancer-Free Coalition (www.cervicalcancerfreecoalition.org) Forum of African First Ladies Against Breast & Cervical Cancer GAVI Alliance (www.gavialliance.org) George W. Bush Institute (www.bushcenter.org/george-w-bush-institute) Global Health Strategies (www.ghstrat.com) Global Task Force on Expanded Access to Cancer Care and Control in Developing Countries (www.gtfccc.harvard.edu) Grounds for Health (www.groundsforhealth.org) Harvard Global Equity Initiative (www.globalhealth.harvard.edu/org/harvard-global-equity-initiative) International Federation of Gynecology and Obstetrics (www.figo.org) International Gynecologic Cancer Society (www.igcs.org) Jhpiego (www.jhpiego.org) Malaysian Council for Child Welfare (www.mkkm.org.my) Management Sciences for Health (www.msh.org) Marie Stopes International (www.mariestopes.org) Ministry of Health of Malaysia (www.moh.gov.my) Background 2 Ministry of Women Family and Community Development of Malaysia (www.kpwkm.gov.my) National Population and Family Development Board of Malaysia (www.lppkn.gov.my) PATH (www.path.org) Key Themes 3 Perdana University Graduate School of Medicine (www.perdanauniversity.edu.my/pugsom) Pink Ribbon Red Ribbon (www.pinkribbonredribbon.org) Key Outcomes 8 Population Services International (www.psi.org) Princess Nikky Breast and Cervical Cancer Foundation Meeting Agenda 12 Union for International Cancer Control (www.uicc.org) Women Deliver (www.womendeliver.org) YouWeCan (www.youwecan.com) Advisory Committee Members 14 BACKGROUND 2 On 27 May 2013, a group of 30 international partners convened the Global Forum on Cervical Cancer Prevention in Kuala Lumpur, Malaysia. The meeting aimed to accelerate “I believe that the prevention of the disease worldwide by strengthening advocacy efforts, sharing every country best practices and increasing positive media coverage. Drawing nearly 300 participants owes its women from more than 50 countries, the forum was one of the largest cervical cancer advocacy a healthy life. meetings to date. and the time The forum grew out of the However, despite unprecedented recognition that we are at a critical financial and political commitments, moment in the fight against cervical hundreds of thousands of girls and cancer. Over the past few years, women – largely in low- and middle- the field has witnessed significant income countries – still do not have has come to join progress. The GAVI Alliance opened access to life-saving prevention a funding window for HPV vaccines and treatment tools. Approximately and negotiated a price reduction 275,000 women die from the to US$4.50/dose. The World Health disease each year, and this number Organization (WHO) committed is projected to nearly double by hands to prevent to introduce the vaccine in 50 per 2030, with 98 per cent of deaths cent of the 75 focus countdown occurring in low- and middle-income countries by 2015 and has released countries. Additionally, despite the comprehensive guidelines for the evidence-base behind cervical cancer cervical cancer.” prevention and control of cervical prevention technologies, uptake in cancer. In addition, a number of low- many countries is slow and a number and middle-income countries, such of media articles have questioned the — Datuk Dr. Maimunah Abdul Hamid as Malaysia, Mexico and Rwanda, safety of HPV vaccines and the need have rolled out vaccine, screening to make them widely available. Ministry of Health, Malaysia and treatment programs. KEY THEMES 4 its own pricing agreement directly up hinder uptake of services. A diverse organizations collaborate. One Against this backdrop, partners launched a with Merck, conducted national number of organizations and service example of successful collaboration global call for universal access to cervical cancer awareness campaigns to sensitize the providers have overcome these is the GAVI Alliance, which recently public and administered the vaccine delivery obstacles by implementing opened a funding window for HPV prevention. The call emphasized that all girls through a school-based strategy in alternative screening methods. Visual vaccines. In association with public have a right to HPV vaccines and all women to collaboration with the Ministry of inspection with acetic acid (VIA), and private sector partners, GAVI’s Education. Similarly, Lesotho was used by organizations like PATH and price reduction announcement of screening and treatment options. It underscored successful in its transition from pilot to Jhpiego and in Vietnam, Bangladesh, the HPV vaccine to US$4.50/dose that now is the time to act on this promise and national program because it secured Peru, Uganda and other countries, represented a major step forward in political commitments, developed is an affordable, effective screening dramatically decreasing the burden invest in cervical cancer. Before and during concrete transition plans, educated option designed for low-resource of the disease in GAVI-eligible the meeting, more than 400 individuals and the community and administered settings. The “screen and treat countries. Pink Ribbon Red Ribbon the vaccine through its compulsory approach” provides an on-the-spot is another public-private partnership organizations signed the call and pledged to education system. The strategies treatment option for women who test that leverages investments from work toward achieving universal access. The deployed by Rwanda and Lesotho positive for precancerous cervical partners and works with governments are replicable and can be adopted in cells and limits necessary follow-up. to provide women with access to full text of the call is included on page 8. other low-income countries. Another approach to screening that comprehensive screening and care is becoming more prominent is self- for breast and cervical cancer. Various Participants spent a significant portion of the Middle-income countries face a sampling. This option reduces barriers partners are responsible for unique unique challenge in financing HPV and stigma by enabling women to facets of the program – from vaccine HE Dr. Christine Kaseba-Sata meeting discussing how to make the call to vaccines because they often do not screen themselves in the privacy of delivery to screening and education. First Lady of Zambia action a reality. From discussions that took place have access to donor support, yet the their own home. Additionally, HPV full price of HPV vaccines is not always DNA testing is a highly effective Through regional collaboration, during two plenaries and nine breakout sessions, affordable. However, several countries screening option that is increasingly countries are able to share information five key themes emerged: have introduced the vaccine by being used in countries around the and lessons-learned. In Latin America, negotiating pricing agreements with world. A low-cost, low-resource the Network of National Cancer setting HPV test is anticipated to be Institutes (RINC – Red de Institutos 1. Utilize proven models to build new cervical vaccine manufacturers and by building political support. For example, in on the market soon. Nacionales de Cáncer) provides a cancer programs Latin America, the Pan-American forum for national cancer institutes in the region to exchange information, 2. Strengthen existing partnerships and build Health Organization (PAHO) Revolving Strengthen Existing new ones Fund used collective bargaining 2 share best practices, identify common to negotiate an HPV vaccine price Partnerships and Build interests and priorities and build 3. Innovate in delivery systems reduction for all countries in the New Ones regional capacity to prevent and 4. Increase advocacy region. In another example, Malaysia control cancer. In the Caribbean, was able to mobilize political support, Over the last few years, a number the Healthy Caribbean Coalition, a 5. Promote accurate information sharing broker its own pricing agreements and of organizations have begun to civil society alliance, works to build provide HPV vaccines to all girls aged work together to advance cervical communication channels and mobilize 13 through a school-based program. cancer prevention efforts. Several resources to combat chronic diseases, Utilize Proven Models to Build New Cervical 1 In May 2013, South Africa announced partnership models exist, including including cervical cancer. In Africa, the Cancer Programs its plans to negotiate a price reduction public-private partnerships and Forum of African First Ladies Against for HPV vaccines – a monumental step regional collaboration networks Breast and Cervical Cancer hosts the There is a growing body of Early adopters in low-income forward for a country with high rates – and together, the organizations high-profile, annual “Stop Cervical programmatic experience to guide countries have demonstrated that of HIV/HPV co-infection. and countries involved are building Cancer in Africa” meeting to raise current and future implementation. nationwide roll-out of HPV vaccines is effective programs to increase access awareness, increase dialogue, build Best practice models include HPV possible. Rwanda became the world’s On screening,
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