REGIONAL PERSPECTIVES
49 CANCER CONTROL 2021
Confronting inequitable access
to health commodities for the
acceleration of cervical cancer
elimination goals within the
Commonwealth
Dr Janneth Mghamba, Health Advisor, Commonwealth Secretariat; Emily Gilmour, Health Research Officer,
Commonwealth Secretariat; Yunus Mohammed, Executive Director, SAPAM; Victoria Rutter, Executive Director,
Commonwealth Pharmacists Association and Layne Robinson, Head of Social Policy Development,
Commonwealth Secretariat
The Commonwealth is disproportionately affected by
cervical cancer. Whilst the Commonwealth represents
30% of the world's population, it carries a 36% share
of the global cancer incidence burden, and 39% of the global
mortality burden (1). This sizable burden can be in part
attributed to a greater proportion of being low- and middleincome countries
(LMICs) in the Commonwealth, with many
countries being further impacted due to a lower survival rate
for cervical cancer in LMICs (2).
The Commonwealth carries a significant cervical cancer
burden, particularly in LMICs. Whilst the causes of high
incidence and mortality rates are multifaceted, a considerable
challenge that member states face relates to equitable access
to health commodities. Although 94% of cases are seen as
preventable, LMICs continue to face inequities with regards
to cancer prevention and control measures (3). Public health
measures such as the establishment of cancer prevention and
early detection programmes through increased cervical cancer
screening, public health education programmes promoting
safe sex to reduce risks of sexually transmitted infections such as HPV and HIV, and the introduction of affordable HPV
tests, medicines and vaccinations are critical in reducing global
cervical cancer disparities, particularly among women in LMIC
developing countries.
This article provides an overview of the cervical cancer
landscape in the Commonwealth and explores the key
challenges to equitable access to cervical cancer medicines and
vaccines In the following discussion potential strategies for
address the issue, in alignment with the WHO's 2020 Global
Strategy to Accelerate the Elimination of Cervical Cancer are
considered
Burden of cervical cancer in the Commonwealth
The 2018 Globocan Estimates on Cancer Incidence and
Mortality Report indicates that Commonwealth's incidence of
cervical cancer will rise by 38% by 2030 in line with population
growth, in addition to the deaths increasing by 42% (4). It is
important to note that these figures incorporate the varying
scales of health systems across the Commonwealth.
The five Commonwealth member states with the highest
As part of the Commonwealth efforts to eliminate cervical cancer, and
in alignment with the WHO's 2020 Global Strategy to Accelerate the
Elimination of Cervical Cancer, the Commonwealth Secretariat has
developed a new database that will provide member states with access to
information and pricing of quality essential medicines. With greater access
to fair and transparent pricing, governments will be able to make more
informed procurement decisions and in turn, a reduction in inequities and
disparities for low- and middle- income countries. Whilst the COVID-19
pandemic has threatened major global health goals, it is critical that
governments take collection action to increase equitable access to health
commodities to ensure that no country is left behind.
YUNUS MOHAMMED
JANNETH MGHAMBA EMILY GILMOUR
VICTORIA RUTTER LAYNE ROBINSON