Sierra Leone moves against cervical cancer with HPV vaccine

In a move to protect adolescent girls from cervical cancer, the Government of Sierra Leone has introduced the Human Papilloma Virus (HPV) vaccine to the routine immunisation schedule and launched the start of a campaign to reach 153,991 girls with the vaccine. The introduction of HPV vaccine is one of the key strategies that the Government is implementing toward cervical cancer elimination in the country.

The Ministry of Health and Sanitation (MoHS) – with support from Gavi, the Vaccine Alliance (Gavi), the United Nations Children’s Fund (UNICEF) and World Health Organization (WHO) – will administer HPV vaccines nationwide through schools, targeting 153,991 10-year-old girls, who will each receive two doses over a six-month period.  

Despite the HPV vaccine providing a proven and safe tool to protect women and girls against HPV and the risk of cervical cancer, global coverage rates among 15-year-old girls remain low at 15 percent with two doses on average. Latest global immunisation coverage data shows that just 12% of girls globally are receiving the crucial vaccine with immunisation campaigns particularly disrupted by lockdowns and school closures.

“The Government of Sierra Leone wholeheartedly welcomes the introduction of the HPV vaccination drive and urges all to support girls ten years of age to be vaccinated and thus preventing them from cervical cancer and its consequences during the course of their entire lives”, said Dr Austin Demby, Minister of Health and Sanitation.

Globally, cervical cancer is the fourth most common cancer among women with an estimated 266,000 deaths and 528,000 new cases each year. Around 85 percent of the global burden of cervical cancer occurs in lower income countries. According to the Sierra Leone Cancer registry, cervical cancer is the second most common, and number one killer, of all cancers among women aged between 14 and 44 years old - and in 2021, approximately 504 new cases of this deadly cancer were diagnosed.

“Today’s launch should be celebrated as a first step towards protecting girls in Sierra Leone from cervical cancer and providing them with a better chance of living longer, healthier lives and reaching their full potential,” said Thabani Maphosa, the Managing Director of Country Programmes at Gavi, the Vaccine Alliance. “Historically, HPV coverage worldwide, but especially in lower-income countries where the cancer burden is highest, was already too low. The pandemic and school closures have taken a further toll. Supporting countries to catch up and improve HPV coverage is a critical priority Gavi moving forward and will require action on the demand- and supply-side. We look forward to working with our partners towards this goal.”

The introduction of the HPV vaccine in Sierra Leone comes after several months of thorough planning led by the Ministry of Health and Sanitation’s National Immunisation Programme. In 2014, a Gavi-supported HPV vaccine pilot project was undertaken in Bo District.

This pilot demonstrated the country’s ability and readiness to implement a school-based vaccination programme nationwide. However, due to the Ebola Virus Disease and COVID-19 outbreaks, the MoHS had to postpone the introduction of the nationwide vaccine.

“The introduction of the HPV vaccine is a welcome demonstration of the collaborative efforts in Sierra Leone to support the good health of every child. Good health is a basic human right, which every child in Sierra Leone should enjoy, regardless of where they are in the country,” said UNICEF Representative, Dr. Suleiman Braimoh.

More than 55 percent of the 194 WHO Member States have introduced HPV vaccination, however in West and Central Africa the HPV vaccine has been introduced in only eight countries. With the launch, Sierra Leone joins the group of regional pacesetters introducing the HPV vaccine into routine immunisation programs as a key strategy to prevent mortality and morbidity due to cervical cancer.

“We are in the era where no one should suffer or die from diseases that are preventable with the use of vaccines. And, as we make these lifesaving services accessible to safeguard the health of women and girls, we are also contributing to empowering the individual, the community, as well as enhancing sustainable social and economic development of the nation”, says Dr Steven Velabo Shongwe, WHO Representative in Sierra Leone. “We urge authorities and parents to ensure that their girls are protected against the distress of cervical cancer by protecting them against HPV at an early age”.

“Cervical cancer is the second most frequent cancer among women in Sierra Leone. The introduction of the HPV vaccine is a momentous milestone in protecting the health of girls and reducing their risk of future illness. This campaign also provides an important opportunity to expand education and outreach to promote uptake of cervical cancer screening and treatment services by older women. Alongside HPV vaccine rollout, these services are essential to eliminating one of the most preventable cancers,” said Nadia Rasheed, UNFPA Representative.

To ensure the effective introduction of the vaccine, Gavi is supporting the procurement and installation of 463 sets of solar refrigerators to help strengthen cold chain systems and ensure that vaccines stay at optimal temperatures during shipping, storage, and delivery to vaccination points. In addition, 1,500 healthcare workers have been trained to administer this lifesaving vaccine.

Gavi, The Vaccine Alliance has worked with the MoHS and the government of Sierra Leone since 2001 to extend equitable access to immunisation services to every child.  This support, amounting to US$101 million to date, has included the procurement of vaccine doses and cold chain equipment, including for COVID-19, as well as investments in health systems and technical assistance to support routine immunisation, new vaccine introductions and supplementary campaigns.

Through the leadership of the MoHS, intensive sensitization is ongoing at a community level to help raise public awareness about the HPV vaccine and uptake – focusing on the targeted age group of girls, community members and leaders, so they are empowered and informed about the tools available to prevent cervical cancer. With support from partners, a wide range of materials have also been developed to inform and respond to the questions which girls, parents, and caregivers might have about this new vaccine.