DABUJA: For instance, Yunusa Bawa often talks about the vaccine for the human papillomavirus which is responsible for almost all cases of cervical cancer. However, in rural Nigeria where he works, it is only two or three parents that usually allow their daughters to be vaccinate most days.
The challenge at Sabo community on the outskirts of Abuja. However, lies in the false rumor that the HPV vaccine will hinder young girls from giving birth.
“The rumor is too much,” said Bawa, 42.
As more African countries try to increase their numbers of HPV vaccines. dealing with challenges such as misinformation among others hinders progress. The World Health Organization’s (WHO) Africa office approximates that still approximately one quarter of people are reluctant to use it — indicative of concerns witnessed elsewhere during early phases of vaccination campaigns against this disease in some parts of the global South.
Human Papilloma Virus (HPV) refers to a common sexually transmitted infection linked to certain types of cancer such as cervix and genital warts. In most cases, the virus doesn’t cause any problems, but some infections persist and eventually lead to cancer.
In 2020 alone, an average 190 women died daily from cervical cancer across Africa constituting 23% out of all deaths globally and putting the WHO African Region’s women on top regarding these fatalities as well. Eighteen out of twenty countries with highest rates of cervical cancer worldwide are located within Africa. Yet there has been slow take up for HPV vaccines in this region.
Amongst these immunization programs were 28 out 54 states across Africa. While only five have reached above 90% coverage which is what they are targeting by year 2030. In total just 33% young females have received a dose against HPv virus throughout this continent.
However, this stands in stark contrast with Europe where both boys and girls were vaccinate against HPv virus.
Emily Kobayashi, who heads the HPV Program at vaccine alliance Gavi, said limited access to women’s screening centres is one of the reasons why Africa has a high burden of cervical cancer.
“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.
However, Charles Shey Wiysonge, Head of Vaccine Preventable Diseases Program WHO Africa Region argues that “It’s one thing introducing the vaccine but if it remains in the fridge. It does not prevent cervical cancer.” He added that essential information should be given by people ”who are trusted, people who are close to the communities.”
According to another study published in Nature science journal in May this year there has been historical mistrust in vaccines in many African countries which sometimes arises from lack of trust on governments and therefore room for conspiracy theories and misinformation courtesy of social media influencers as well as religious leaders.
For example, in Zimbabwe which has the highest incidence rates of cervical cancer among women some Village Health Workers- mostly women- have bee sensitized about cervical cancer and Hpv vaccine awareness campaigns. However they grapple with high levels of hesitancy among religious sects which discourage followers from using modern medicines instead ask them to pray while drinking “anointed water” or rubbing themselves with “anointed” stones.
Zanele Ndlovu, a health worker around Bulawayo city outskirts said that the women who eventually agree to be screene for cervical cancer do so in secret.
Ndlovu argues that in Zimbabwe. Where people are very religious, “the spiritual leaders have so much influence that a lot of our time is take trying to educate people about the safety of vaccines or that they are not ungodly.”
Additionally, there have been other instances in Africa where there has been up to 90% vaccination success. For example Ethiopia also depends mostly on religious leaders, teachers and hotline workers.
Hesitancy is less of an issue because vigorous awareness work through school-based campaigns and community outreach programs has reduced it,’ notes Dr. Theoneste Maniragaba, director of the Rwanda Biomedical Center’s cancer program.’ Rwandan population was first vaccinated against HPV in 2011 making it the first African country.’
In Mozambique, school-based programs, door-to-door approach and mobile outreach among girls in hard-to-reach areas has helped it achieve an 80% coverage rate with the initial of two doses. In Tanzania since 2018 this vaccine has existed making authorities begin another campaign aimed at over five million girls which will further increase coverage but only reaches 79% of those who receive their first dose.
Nigeria which recently launched one of Africa’s biggest HPV vaccination drives targeting girls has purchased nearly 15 million shots with help from UN agency for children. It is intended for girls aged between nine and fourteen years old, with each receiving single doses recommended by WHO’s African Immunization Advisory Group as being equally effective as two regular ones.
According to Dr Aisha Mustapha – a gynecologist from northern Kaduna state: “One challenge is explaining the HPV vaccination to girls before they start having sex especially if they come from conservative societies.”
Mustapha herself successfully received treatment for cervical cancer; according to her. This is something that she specifically uses as a talking point when lecturing religious leaders or during outreach programs targeting communities in Kaduna. Where she is the head of the Medical Women Association of Nigeria.
She added that they try to make girls feel comfortable and understand why the vaccine is important. ’Sometimes using comic books would be need so much; sometimes it takes lots of singing.’
“The (cervical) cancer … is no respecter of any identity,” she said. “The vaccine is available, it’s free, it’s safe and effective.”
