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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

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