ABUJA, Nigeria – Yunusa Bawa spends a lot of time talking about the human papillomavirus vaccine, which is responsible for almost all cases of cervical cancer. But on most days, only two or three people allow their daughters to be vaccinated in the rural part of Nigeria where he works.
The challenge in the Sabo community, on the outskirts of the capital Abuja, is the unfounded rumor that the HPV vaccine will prevent girls from later giving birth.
“The rumor is too much,” said Bawa, 42.
As more African countries strive to manage more HPV vaccines, Bawa and other health professionals face challenges that slow progress, especially misinformation about the vaccine. The World Health Organization’s African office estimates that around 25% of the population still has doubts about this — reflecting concerns seen in some other parts of the world in early vaccine campaigns.
A common sexually transmitted virus, HPV can cause cervical cancer, some other types of cancer, and genital warts. In most cases, the virus does not cause problems, but some infections persist and eventually lead to cancer.
Across Africa, an average of 190 women died daily from cervical cancer in 2020, representing 23% of deaths globally and making it the leading cause of cancer death among women in the WHO African region, comprised of by 47 countries. Eighteen of the 20 countries with the highest rate of cervical cancer cases in the world are in Africa. However, the HPV vaccination rate in the region has been low.
More than half of the 54 African countries – 28 – have introduced the vaccine into their immunization programs, but only five have achieved the 90% coverage that the continent hopes to achieve by 2030. Across the region, 33% of girls have been vaccinated with HPV.
It’s a stark contrast to most European countries, where both girls and boys have received HPV vaccines.
Part of the reason Africa has a high burden of cervical cancer is due to limited access to screening for women, said Emily Kobayashi, head of the HPV Program at the Gavi vaccine alliance.
“The elimination strategy is a long game… but we know that vaccination is the strongest pillar and one of the easiest to implement,” Kobayashi said.
But “it’s one thing to introduce the vaccine, but if the vaccine remains in the refrigerator, it doesn’t prevent cervical cancer,” said Charles Shey Wiysonge, head of the vaccine-preventable diseases program in the WHO’s African region. He said information must be provided by people “of trust, people close to the communities”.
There is a long history of vaccine hesitancy in many African countries, which is sometimes linked to a lack of trust in the government, as a study published in the scientific journal Nature in May found, giving rise to conspiracy theories and misinformation from social media influencers. social and religious. leaders.
In Zimbabwe, where cervical cancer is the most common cancer among women, a group made up of mostly women, known as Community Health Workers, was formed to raise awareness about cervical cancer and the vaccine against it. HPV in rural areas. But they combat a high level of hesitancy among religious sects that discourage followers of modern medicines, asking them to rely on prayers and “anointed” water and stones.
Women who eventually agree to be screened for cervical cancer do so in secret, said Zanele Ndlovu, one of the health workers on the outskirts of Bulawayo city.
For a deeply religious country like Zimbabwe, “spiritual leaders have so much influence that we spend a lot of our time trying to educate people about the safety of vaccines, or that they are not godless,” Ndlovu said.
There are also success stories in Africa, where authorities have achieved a vaccination rate of up to 90%. One example is Ethiopia, which relies heavily on religious leaders, teachers and hotline workers.
In Rwanda, the first African country to implement a national HPV vaccination program in 2011, the coverage rate reached 90%. Hesitation is less of a problem due to vigorous awareness work that relies on school campaigns and community outreach programs, said Dr. Theoneste Maniragaba, director of the Rwanda Biomedical Center’s cancer program.
Mozambique implemented school-based programs, a door-to-door approach and mobile outreach for girls in hard-to-reach areas that helped it achieve an 80% coverage rate with the first of two doses. In Tanzania, where the HPV vaccine has been used since at least 2018, authorities launched a campaign in April aimed at reaching more than 5 million girls and further increasing coverage, which reached 79% of girls with the first dose .
One of the largest HPV vaccination initiatives in Africa, aimed at girls, recently began in Nigeria, which acquired almost 15 million doses with the help of the United Nations children’s agency. It will target girls aged 9 to 14 with single doses that the WHO’s African immunization advisory group said is as effective as the normal two doses.
One challenge is explaining HPV vaccination to girls before they begin sexual activity, especially in conservative societies, said Dr. Aisha Mustapha, a gynecologist in northern Kaduna state.
Mustapha was successfully treated for cervical cancer. She said the experience helps in her meetings with religious leaders and in community outreach programs in Kaduna, where she leads the Women Doctors Association of Nigeria.
They try to make girls feel comfortable and understand why the vaccine is important, she said. This sometimes requires comic strips and a lot of singing.
“(Cervical) cancer… doesn’t respect any identity,” she said. “The vaccine is available, it is free, it is safe and effective.”
___
Associated Press writers Farai Mutsaka in Harare, Zimbabwe, and Ignatius Ssuuna in Kigali, Rwanda, contributed to this report.
___
The Associated Press receives financial support for global health and development coverage in Africa from the bill & Melinda Gates Trust Foundation. AP is solely responsible for all content. Find APs standards for working with philanthropies, a list of supporters and areas of coverage funded in AP.org.
This story originally appeared on ABCNews.go.com read the full story
