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Thembi’s Plea: How a Vaccine Helps Ensure African Girls Have an Opportunity to Succeed

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Learn more about Crystal Cazier.
Crystal Cazier
Former Deputy Director, Global Health
George W. Bush Institute

We join Thembi, a bold ten-year-old school girl in Botswana, in reaffirming the importance of the HPV vaccine to protect girls from cervical cancer while they are still young.

In a primary school in Gaborone, Botswana, Thembi, a bold ten-year-old school girl stood up and proclaimed to President and Mrs. Bush in a room full of dignitaries, “This injection is very important to us.”  She was talking about the vaccination against the human papillomavirus (HPV).  Thembi knows that because she has received the full regime of vaccine doses, her chances of getting cervical cancer as a woman have been nearly eliminated. 

On International Day of the Girl Child, we join Thembi in reaffirming the importance of the HPV vaccine to protect girls from cervical cancer while they are still young. 

Over the past four years, Pink Ribbon Red Ribbon has worked to expand access to the HPV vaccine and has supported the vaccination of more than 141,000 girls.  Pink Ribbon Red Ribbon partners with countries in sub-Saharan Africa to raise awareness about the benefits of the HPV vaccine and create demand for it, introduce the HPV vaccine – often first on a demonstration scale, and strategize with governments to include the vaccine in their national cancer control plans.  Several questions have guided Pink Ribbon Red Ribbon’s work and approach.

Why for young girls?

Because HPV is sexually transmitted, inoculating girls before sexual debut increases the effectiveness of the vaccine.  The World Health Organization (WHO) recommends the primary target group for vaccination between the ages of 9 to 14, but the U.S. vaccinates up to age 26. There is also scientific evidence of effectiveness for women into their 40s.

Why girls in sub-Saharan Africa?

Cervical cancer is the leading cancer and most common cause of cancer death among women in sub-Saharan Africa.  Nearly all cases of cervical cancer are caused by HPV.  Furthermore, the high burden of HIV in sub-Saharan Africa is well-documented.  Women living with HIV are five times more likely to develop cervical cancer because their compromised immune systems leave them susceptible to opportunistic diseases, like HPV.  

Why are schools a common distribution location?

We know that when girls have access to education, a host of benefits follow.  One of those benefits is better access to healthcare services, like the HPV vaccine.  Pink Ribbon Red Ribbon has found that offering the vaccine to girls while they are in school increases coverage rates by providing easy-access to the target population.  In Botswana, for example, healthcare workers visit schools to provide the vaccine on a routine schedule to all the girls in the school on the same day.  Because the HPV vaccine is a multi-dose series, vaccinating all girls in one school makes tracking the doses easier, as well.

What about out-of-school-girls?

Pink Ribbon Red Ribbon believes that all girls should have access to the HPV vaccine, and recognizes that while it might be easier to provide services to girls attending school, no girl should be left behind. 

Do HPV vaccination campaigns have other benefits?  

Thembi’s mom said through her daughter’s knowledge of the vaccine and the risks of cervical cancer, her daughter encouraged her to be tested for HIV and cervical cancer. Thembi’s mom recalled, “Now I know what my status is, for which I am very grateful.”

Mom and daughter are now both living without fear of cervical cancer, and young Thembi has a full life ahead of her.  In the words of Botswana’s Permanent Secretary for the Ministry of Health and Wellness, “Cervical cancer is a major public health problem… Prevention should always be our focus…  We can’t afford not to vaccinate our women, our girl child.  So, these are not options or choices that we can make, no. It’s absolutely necessary.”