WHO Director-General addresses conference on cervical cancer in Africa
Dr Margaret Chan
Director-General of the World Health Organization
Excellencies, honourable ministers, distinguished delegates, ladies and gentlemen,
I thank the government of Namibia for hosting this event and for bringing so much hope to the cancer situation in Africa.
The focus on cervical cancer is appropriate. The goal of providing universal access to preventive services is a noble one.
Doing so is entirely feasible, even in low-resource settings. The early detection and early treatment of cervical cancer do not require sophisticated facilities and equipment or highly specialized staff. Making progress in this area can inspire similar ambitions for other cancers.
Cancer has been the orphan on this continent’s health agenda. Africa’s capacity to detect, diagnose, and treat all forms of cancer has traditionally been weak, as health systems remained heavily focused on managing infectious diseases.
Cancer was on the agenda of the WHO Regional Committee for Africa in 2008. At that time, the situation was extremely bleak.
Cancer incidence, at nearly 600,000 cases, was expected to double by 2020. Those figures were largely guesswork, as so few African countries had cancer registries.
Most cancer patients in Africa had no access to screening, early diagnosis, treatment, or even palliative care, including pain relief. Cervical cancer was the most common cancer in Africa, accounting for around 12% of all new cases.
Throughout most of the region, national programmes for cancer prevention and control were weak or, in several cases, non-existent. Few specialized facilities for cancer diagnosis and treatment were available, and all were concentrated in urban settings. Fifteen countries did not have even a single radiotherapy machine.
Early detection was rare. Most patients sought health care at an advanced stage of disease, when treatment prospects are greatly diminished. Five-year survival rates were the lowest in the world. Too many people died from cancers that could be easily treated elsewhere.
The lucky patients were the ones with enough money to seek care abroad.
Ladies and gentlemen,
Fortunately, this situation has changed. These orphan diseases have found a home in the series of conferences you have held on cervical, breast, and prostate cancer in Africa and in the health strategies of the African Union.
Thanks to WHO support, the region now has 20 countries with a population-based cancer registry in operation.
Your focus on cervical cancer aligns well with the top priority I give to the health of women and the health of the African people.
The approaches set out in your agenda are sound and entirely feasible. WHO’s International Agency for Research on Cancer has demonstrated the efficacy of visual inspection, using acetic acid, a component of vinegar, to detect precancerous lesions in the cervix.
These lesions can then be removed by cryotherapy, which destroys the abnormal tissue by freezing.
These simple procedures are effective, carry a low risk for patients, and can be quickly performed in a clinic by non-specialized staff, with no need for a hospital stay. In addition, a vaccine is now available to prevent human papillomavirus infection, and its price keeps going down.
Working with the media is on your agenda. The media can help raise public awareness of the importance of screening and early detection. The media can also raise hope: early detection increases the prospects of successful treatment.
No African woman needs to die from this disease.
First Ladies can enforce these messages using their personal voices, stories, and persuasive power. Committed and respected role models can do a world of good.
You are also making wise use of what already exists, that is, by integrating the prevention and control of cervical cancer into existing services for HIV/AIDS and for reproductive health.
Even countries with very limited human and financial resources can expand services in this value-added way. Above all, by pushing forward on the cervical cancer agenda, you give Africa hope that other cancers can be prevented or detected early and effectively treated.
It is my sincere wish that, from this solid starting point, initiatives for cancer prevention and control will flourish throughout Africa.
Rest assured of WHO support.
I have a final comment.
Historically, Africa has enjoyed a low prevalence of tobacco use, especially in women. Please do everything you can to keep it that way.
In the eyes of the tobacco industry, low tobacco use makes Africa the world’s most attractive market for future growth.
Don’t let an industry that kills grow roots in your countries.