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"The next enemy to combat is cervical cancer"
A 19-year-old HIV-positive mother of a young child came to the cervical cancer screening clinic in Zambia. The health worker carried out visual inspection with acetic acid and discovered she had invasive cancer of the cervix. Within a short period, she succumbed to the disease and died leaving the young child orphaned. Such aggressive cervical cancer in a teen would be considered rare in most developing countries. However, doctors in countries with a high prevalence of HIV are seeing it more frequently. During a recent visit to the African nations of Botswana and Zambia by our Pink Ribbon Red Ribbon (PRRR) team, we saw the evidence: HIV-positive women have a higher incidence of cervical cancer than those who are HIV-negative, and are presenting with more advanced disease. PRRR’s goal for this visit was to work with the two countries to plan how to rapidly accelerate their services to address women’s cancers. The President’s Emergency Plan for AIDS Relief (PEPFAR), a PRRR partner, has an established network of HIV/AIDS clinics that are being used as the catalyst for the acceleration plan. We met with senior officials from the two nations’ Ministries of Health to assess the resources they have available to help combat women’s cancers. We also investigated ways our team’s expertise and resources could extend the Ministries’ reach. One senior health official from Botswana said at a meeting: “If you had been here 10 years ago, perhaps this room would be only half filled because some of the people would not be there. And those who were there [alive] would be away burying relatives due to HIV/AIDS…Today, we have made significant progress in fighting HIV/AIDS and giving hope and life to people – thanks to PEPFAR. Now, we know that the next enemy to combat is cervical cancer.” The picture she drew stuck with me as we continued on our trip. We saw clear evidence of how HIV/AIDS was promoting the spread of cervical cancer. Health workers in Botswana and Zambia are seeing and reporting an unusually high number of young women ages 20-35 years old with invasive cervical cancer, many of whom are HIV-positive. The women over the age of 40 who have this late stage cancer are more likely to be HIV-negative. During the week of our visit to a facility in southern Zambia, 480 women were screened for cervical cancer – 11 percent were positive for cervical pre-cancer, and another 4 percent were sent for advanced diagnosis and treatment. A 32-bed female surgical ward in Botswana was 100 percent occupied, and 85 percent were cervical cancer patients, many of whom were HIV-positive. The time to act is now. This post was written by Doyin Oluwole, Founding Executive Director of Pink Ribbon Red Ribbon based at the George W. Bush Institute