Eliminating cervical cancer in the Philippines

Globally, cervical cancer remains one of the most common cancers affecting women. In the Philippines, it ranks as the second most frequent cancer among women and the second most frequent cancer among women between 15 and 44 years of age. Every year, around 7,900 Filipino women are diagnosed with cervical cancer and around half — more than 4,000 — of them die from the disease, according to the recent data released by the International Agency for Research on Cancer.

The sad part is that most of these women who have been victimized by the dreaded disease were at an age when they were supposed to be at the prime of their lives. This is an age when they are considered significant contributors to the workforce and economy, and, at the same time, fulfilling their duties to provide and care for their families.

The premature deaths and suffering could be averted if there are evidence-based tools and innovations in place in the health system. This will also be true if current knowledge and lessons are applied to prevent, screen, and treat cervical cancer. Cervical cancer is no longer a death sentence; it is actually one of the most preventable and treatable forms of cancer — if detected early and managed effectively.

Indeed, the elimination of cervical cancer as a public health problem is feasible. It is a matter of putting ample resources in the right strategies and providing them at the right time.

In November 2020, at the height of the COVID-19 pandemic response, the World Health Organization (WHO) released a landmark resolution — The Global Strategy to Accelerate the Elimination of Cervical Cancer as a Public Health Problem. The strategy contains three main pillars: 1.) increasing coverage of human papillomavirus (HPV) vaccination of all girls ages nine to 14 years to 90%, 2.) increasing coverage of cervical cancer screening of women twice, at age 35 and age 45, to 70%, and, 3.) increasing coverage of treatment for all women identified with precancerous lesions and invasive cervical cancer to 90% — all by 2030.

As early as 2016, the Asia-Pacific Economic Cooperation (APEC) introduced a multi-year cervical cancer elimination roadmap. This would encourage member economies to scale up efforts to build technical capacity and support policies that improve primary and secondary prevention, treatment, and palliative care. August 2021, APEC released an updated Roadmap to Promote Sustainable Economic Advancement for Women through Cervical Cancer Prevention and Control through 2025, which is currently aligned with the WHO Global Strategy.

According to the WHO, putting investments in interventions to meet the 90-70-90 targets can offer significant returns in both the economy and society. For every $1 invested through 2050, an estimated $26 is gained in societal and economic benefits. In addition, the WHO also recommends proper coordination between partners in the public and private sectors so that the integrated delivery of these interventions will be successful.

As a step towards the elimination of cervical cancer, the Stratbase ADR Institute organized a hybrid event on May 25 to officially launch the Philippine Cervical Cancer Elimination Movement. This is in collaboration and partnership with Jhpiego Philippines, the Philippine Obstetrical and Gynecological Society (POGS), the Philippine Society for Cervical Pathology and Colposcopy, the Cancer Coalition of the Philippines, and UHC Watch.

During this event, Prof. Dindo Manhit, President of the Stratbase ADR Institute, said that the “effective advocacy and communication strategies can overcome the many challenges that impede access to and use of cervical cancer prevention and care services. Such strategies should reflect national policy and be integrated into all levels of the health system.”

Dr. Jan Aura Laurelle Llevado, Division Chief of the Cancer Control Division, Department of Health, said that “having a benefit package is important. However, only few are included in the Z-Benefit Package of PhilHealth.” She also said that “one of the things that we should really communicate with our legislators, that if you give us a budget, give us also the budget for the entire continuum of care,” referring to the lack of budget provided for cervical cancer screening.

Dr. Ingrid Magnata, Country Program Manager of Jhpiego Philippines, said that “if this country wants to move towards cervical cancer elimination, we have to have good data.” She also mentioned that “achieving a nation free of cervical cancer is doable… but we need to organize ourselves, we need to systematize our efforts, and for us to reach elimination level, we have to scale up and, most especially, we need to empathize.”

Dr. Efren Domingo of the POGS, Dr. Fatima Gimenez of the Pediatric Infectious Disease Society of the Philippines, and Dr. Rui De Jesus of the WHO Philippines also shared their insights during the event.

As a signatory and member of the United Nations and APEC, the Philippines must adhere to the recommendations and targets of both international bodies. The country’s legislators, national and local governments, private organizations, civil society organizations, and other stakeholders should work together and ensure that the recommended strategies are promoted and supported in schools, academic institutions, workplaces, and communities.

Let us all take a giant leap towards the elimination of cervical cancer in the country by joining this movement. If we work together, we could fulfill the set targets or, even better, beat them prior to 2030.

Alvin Manalansan is the health and nutrition fellow at Stratbase ADR Institute and co-convenor of Universal Healthcare (UHC) Watch.