Quote this article as:
F Assad & AK Chandio (May 2024). Cervical cancer prevention and HPV vaccine introduction in Pakistan. www.HPVWorld.com, 247

Jhpiego, a Johns Hopkins University affiliate, is working globally to support cervical cancer elimination through primary prevention of HPV, including vaccination of adolescent girls and an integrated services approach to screening, care, and treatment. Jhpiego’s expertise in women’s health and immunization is based on its 50 years of experience developing the health workforce and improving health service delivery. Our international partnerships with the World Health Organization (WHO), Gavi, the Vaccine Alliance, UNICEF, and others and contributions to global policy are firmly anchored in the experiences of our staff in some 40 countries across Africa, Asia, and the Americas.

With Gavi funding, Jhpiego has supported HPV vaccine introduction in seven countries. In Liberia, Côte d’Ivoire, and Zambia, Jhpiego trained vaccinators, supported quality supervision, and helped monitor progress. In these countries as well as in India, Ethiopia, and Tanzania, Jhpiego helped build local consensus with leaders and community groups, and used human-centered approaches to identify how to reach all eligible girls. In India and Tanzania, Jhpiego is supporting better integration of youth health and adolescent vaccination. In Tanzania, sites where Jhpiego supports integrated care reported particularly high HPV vaccine coverage.

In Pakistan, Jhpiego received support from Gavi and internal sources to collaborate with the Federal Directorate of Immunization, Ministry of Health, and provincial stakeholders to develop a roadmap for prevention of cervical cancer and future introduction of HPV vaccination, after thorough deliberations with subject specialists, professional bodies, stakeholders, and policymakers. This roadmap presents tangible measures for prevention of cervical cancer and vital steps for HPV vaccination rollout in Pakistan. It identifies gaps and impediments and presents a detailed cost analysis of HPV vaccine introduction in Pakistan.



The Government of Pakistan remains committed to working alongside Gavi, WHO, UNICEF, Jhpiego, and other partners to implement the proposed roadmap and reaffirms our support to the country’s health leadership in taking on this noble endeavor. Key recommendations include:

• Support development of a comprehensive national policy on cervical cancer elimination.
• Incorporate the HPV vaccine into future national immunization plans.
• Integrate HPV vaccination into broader women’s cancer prevention and control programs and improve cervical cancer screening and treatment facilities.
• Perform rapid formative research on issues related to operations and community acceptance.
• Mobilize greater resources for immunization programs in general.
• Estimate disease burden and localized costing.
• Advocate for and raise awareness of HPV vaccination with all stakeholders.
• Strengthen capacity of health professionals at all levels.

Through the Bill & Melinda Gates Foundation-funded Coalition to Strengthen the HPV Immunization Community project, Jhpiego has been advocating with key stakeholders to implement the roadmap for stronger cervical cancer prevention that will ultimately include HPV vaccine introduction. The Government of Sindh, under the leadership of the Minister for Health and Population Welfare, was the first to respond to the call and convened a taskforce whose mandate is to devise a strategy for cervical cancer prevention, formulate a cancer registry especially for women’s cancers (including cervical cancer), and revive school health programs with HPV introduction in the province.

Through the HPV Vaccine Acceleration Program Partners Initiative (HAPPI) Consortium (led by JSI and partners and funded by the Bill & Melinda Gates Foundation), Jhpiego is supporting the Federal Directorate of Immunization to prepare for future introduction of HPV vaccination country-wide for girls aged 9–14 years, through an immunization campaign followed by the introduction of the HPV vaccine in the routine immunization schedule. Jhpiego is committed to supporting the Federal Directorate of Immunization in future strengthening of HPV vaccination for girls through school- and community-based vaccination, along with implementation of school-based programs on adolescent health and cervical cancer screening programs through the healthcare system.

DISCLOSURE
The Authors are employed by Jhpiego and work on programs that receive funds from Gavi and the Bill & Melinda Gates Foundation.