What The US Can Learn from Rwanda on Dealing with Cervical Cancer

What The US Can Learn from Rwanda on Dealing with Cervical Cancer Image

It’s hard to believe that there is something a small nation like Rwanda can teach the US (a first world country).  But surprisingly there is- Rwanda made history by becoming the first African nation to launch a countrywide cervical cancer prevention program.

In 2010 that country entered an agreement with Merck pharmaceuticals to vaccinate Rwanda girls against Human Papilloma Virus(HPV).  In 2013, the country started immunizing girls aged 11 to 12 against HPV, the primary cause of cervical cancer.  

So, it’s no surprise that today they have a 93%  vaccination rate among adolescent girls. The approach that Rwanda took to reduce the rate of cervical cancer in the country proves that we can eliminate cancer across the world if we achieve high vaccination coverage.

So how did a country that was once ranked the poorest in the word eliminate cervical cancer, when high-income like the US and France couldn’t achieve high vaccine coverage?

The truth is it wasn’t easy! There were lots of cultural barriers against the vaccine program, and talking about sex was taboo in the country.  Also, there were rumors that the vaccine could make Rwanda women infertile, so some parents were hesitant to allow their daughters to be part of the program.

However, Rwanda enlisted the help of an army of educators- teachers, community health workers, church leaders and nurses to educate its people on the importance of the vaccination. Now even the US cannot compete with Rwanda in HPV vaccination coverage.

Over 8 million American teens are currently suffering from some kind of HPV virus. The country reports over 4,000 women die of cervical cancer and over 13,000 are diagnosed with it every year.  But still, its only 49% of the adolescent teen between the age of 13 to 17 who have received HPV vaccines.

The low rates of immunization against HPV in the US are contributed by the myth that the vaccine increases promiscuity and its dangerous.  These kinds of bogus claims hinder the efforts of the Government and Big Pharmaceuticals in combating cervical cancer prevalence in the County.

Luckily, there is still hope. In May 2019,  the VACCINES Act was introduced to the House. If the bill passes, it will allow funding for the CDC to carry out research on the vaccine averseness and increase public awareness on the benefits of the HPV immunization.

States are also taking action- Virginia, District of Columbia, and Rhode Island require students to get vaccinated for HPV before they join secondary school. Other states have passed laws to permit minors to undergo HPV vaccination even when the parent is against it.

The cost of Cervical cancer is high, and it involves a painful surgery, therefore prevention is the best solution. Australia and Scotland have already made plans to follow in the footsteps of Rwanda. 

It’s therefore prime time for the US to participate by increasing immunization rates through HPV vaccination for both boys and girls and the house passing the VACCINES Act.

References

http://www.moh.gov.rw/index.php

https://thehill.com/opinion/healthcare/456933-the-us-can-learn-from-rwanda-on-stamping-out-cervical-cancer

https://www.who.int/bulletin/volumes/91/9/12-116087/en/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4662515/

https://dash.harvard.edu/bitstream/handle/1/27662069/4877733.pdf?sequence=1&isAllowed=y

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3790215/

HIV And Cancer – What Patients Need To Know

HIV cancer

Each year, the HIV virus infects more than one million people around the world, with an estimated 1.7 million individuals infected in the year 2018. Africa accounts for quite a large percentage of adults and children that are infected with this virus. In the Eastern and Southern regions of Africa, an estimated 57% of adults have been infected with HIV.

A large number of those individuals who have been infected with this particular virus have not yet been tested – and do not realize the risks that they are facing with their general well-being. One particular risk that needs to be addressed is the fact that there is an increased risk of cancer among individuals who suffer an HIV infection.

The Increased Risk Of Cancer Caused By HIV

A common question asked by those infected with the HIV virus is whether or not they are truly at a higher risk of cancer. The short answer is yes – there is actually a significant increase observed in the risk of cancer among HIV sufferers. It is, however, important to note that the risk is only increased for a specific number of cancerous diseases.

When a patient develops cancer after they have been infected with HIV, the condition will usually be referred to as HIV-associated cancer.

The most important types of HIV-associated cancers that patients do need to be wary of include:

  • Cervical cancer (only applies to female patients who are infected)
  • Kaposi sarcoma (a type of B-cell non-Hodgkin lymphoma that is considered aggressive and dangerous)
  • Acquired immunodeficiency syndrome defining cancers, also called AIDs-defining cancers

The increased risk of these cancers among individuals with HIV is defined as follow:

  • An HIV positive individual is 500 times more likely to develop Kaposi sarcoma than those who are not infected.
  • There is a 12x increased risk of non-Hodgkin lymphoma among individuals with HIV.
  • Women diagnosed with HIV are also three times as likely to develop cervical cancer compared to those female patients who are not infected with the virus.

In addition to considering these HIV-associated cancers, there also seems to be an increased risk of other cancers among these patients:

  • Liver cancer
  • Anal cancer
  • Oral cavity cancer
  • Pharynx cancer
  • Lung cancer

In addition to considering these factors, it is important to note that when the HIV virus is accompanied by certain conditions or complications, there is a further increase in the patient’s risk of developing certain cancers.

One example is Kaposi sarcoma-associated herpesvirus. This disease is also called human herpesvirus 8. The presence of Epstein-Barr virus, along with HIV, also puts a person at a higher risk of both Hodgkin and non-Hodgkin lymphoma.

Patients with HIV and infection with either hepatitis B or C are also at an increased risk of developing cancer in their liver.

Using testing kits, such as those provided by Ghana Medicals, can help a person detect the presence of HIV at an early stage – which might assist in reducing the risk of cancer when appropriate treatment is initiated.

Weak immune system

People who are infected with the virus that causes HIV to have a weak immune system and have also been found to be at a significantly higher risk of developing certain types of cancer. Those individuals who are affected by certain complications associated with HIV are at an even higher risk of developing these cancers.

References

https://www.hiv.gov/hiv-basics/overview/data-and-trends/global-statistics
https://www.cancer.gov/about-cancer/causes-prevention/risk/infectious-agents/hiv-fact-sheet#r2

Rwanda Being the First Country to Possibly Wipe Out Cervical Cancer

Rwanda and sexually transmitted infections

With cervical cancer being one of the most common causes of death all around the world, especially in high burden countries such as Rwanda, the people in Rwanda have made a great step forward, focusing on wiping out cervical cancer altogether. With the techniques and methods that they have developed over the years, the rates of cervical cancer have declined, offering their residents an opportunity to live a healthier, longer life.

Rwanda and the possibility to completely wipe out cervical cancer

Cervical cancer has represented a potentially life-threatening health issue for the longest time now, accounting for more than 68 000 new cancer cases in Africa. Every 23 out of 100 000 women is estimated to die from cervical cancer, with every 34 out of 100 000 women being affected by it. These are some frightening numbers.

Most cases of cervical cancer are caused by HPV (Human Papillomavirus), with HPV-16 and HPV-18 being the two most common types of HPV out of the 100 different ones that are most frequently leading to cervical cancer.

Read more: 1 in 9 men has oral HPV

Being the most common type of cancer in their country, the people of Rwanda, Africa have decided to put a stop to it. It was 2010 when Rwanda first decided to make wiping out cervical cancer a health priority, agreeing on a partnership with the pharmaceutical company called Merck that was supposed to deliver the much-needed HPV vaccines and with that, contribute to the preventing HPV in the first place.

It wasn’t easy to raise awareness

It took the authorities in Rwanda a long time to raise the much-needed awareness and convince the parents to agree on getting their children vaccinated. There are different reasons as to why that was the case. While some deny to talk about reproductive health and think of it as a taboo, others believe that by vaccinating their children, they ought to become promiscuous in the near future, engaging in frequent sexual activity with multiple sexual partners, thus exposing themselves to the other common STDs.

But since then, the authorities in Rwanda have succeeded at changing more and more people’s opinions, helping to protect younger lives, thus becoming potentially the first country to wipe cervical cancer.  A lot of things have changed since Rwanda first decided to focus on eliminating cervical cancer. Nowadays, they are offering the newest vaccine called Gardasil 9, which works by preventing nine different types of HPV.

But it is not only their prevention method that has improved over the years. Today, Rwanda also focuses on proper screening and managing the cases of cervical cancer, offering support along the way. They are now offering proper immunization for other dangerous diseases such as rubella, polio, and measles, helping the lifespan of the people of Rwanda to double between 1995 and 2011.

Effective prevention was key

Since 2010, which is when the authorities in Rwanda first decided to make a great change in the lives of their female residents, the rates of cervical cancer and HPV infections have successfully declined. It was all about effective prevention through immunization that has been made available and offered to everyone, in addition to offering proper management and treatment that has helped increase the life expectancy of the people of Rwanda.

References

https://www.afro.who.int/news/cervical-cancer-common-amongst-african-women

https://travelnoire.com/rwanda-could-be-the-first-country-to-eliminate-cervical-cancer

https://edition.cnn.com/2019/05/30/health/rwanda-first-eliminate-cervical-cancer-africa-partner/index.html