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Do more to fight and eliminate cervical cancer

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Cervical cancer is the second most prevalent cancer among women between 15 and 44 years old in the Philippines. Worse, most cases are only diagnosed in the advanced stage. Global Cancer Statistics reported in 2020 that 4,052 women died out of the 7,897 diagnosed with cervical cancer. In the same year, the Philippine Statistics Authority said approximately 38 million women aged 15 years and older were at risk of developing the disease.

What is being done about this?

In 2020, the World Health Organization (WHO) released the Global Strategy to Accelerate the Elimination of Cervical Cancer as a public health problem. The aim is that by 2030, 90% of girls should be fully vaccinated with HPV (Human papillomavirus) vaccine by the age of 15; that 70% of women are screened with a high-performance test by the age of 35 and again by 45; and that 90% of women identified as having cervical disease receive treatment (90% of women with pre-cancer treated, and 90% of women with invasive cancer managed).

Here at home, the government and other stakeholders have spearheaded efforts to reduce and eventually eliminate cervical cancer. We have the Universal Health Care law and the National Integrated Cancer Control Act. However, due to the pandemic and several challenges in the health sector, there is still a need for the country to revitalize and further scale up the implementation of evidence-based and cost-effective interventions.

Thus, despite these efforts, cervical cancer programs in the Philippines have remained inadequate. The main challenge is how to come up with improved financial strategies for cervical cancer programs in the Philippines, as timely diagnosis and treatment, as well as other out-of-pocket expenses, come at a high price for patients and their families.

In an attempt to occasion multisectoral discussion and fresh solutions, the Asia-Pacific (APAC) Women’s Cancer Coalition, in partnership with the Cancer Coalition Philippines (CCPh) and Jhpiego, organized a hybrid town hall discussion entitled “Addressing the Gaps to Cervical Cancer Elimination in the Philippines.” Held on May 17, the forum gathered key stakeholders to discuss evidence-based and cost-effective interventions, as well as get inputs and commitments that will scale up the elimination of cervical cancer in the Philippines and the timely and successful implementation of the global recommendations.

Giving the keynote address was Senator Joseph Victor “JV” Ejercito, the former chair of the Senate Committee on Health and Demography. There is much work to be done, he said, because despite the availability of vaccination against HPV many women continue to suffer and die from this preventable disease.

Department of Health (DoH) Undersecretary Glenn Mathew Baggao committed to explore sustainable funding mechanisms for their programs. “The elimination of cervical cancer is not merely a medical goal; it is a testament to our commitment to the well-being of our Filipinas and the generations to come,” he said.

The first panel discussed the need for a National Elimination Plan for Cervical Cancer. Professor Deborah Bateson, Professor of Practice and Co-Lead of the Cervical Cancer and HPV Stream of The Daffodil Center, told the audience about what is happening in Australia in terms of primary and secondary prevention of the disease. The country has a national HPV vaccination program and a national cervical screening program, as well as a national cancer screening register. Australia is on track to be one of the first countries in the world to eliminate cervical cancer by 2035.

The Cancer Control Division Chief of the DoH, Dr. Jan Aura Laurelle Llevado, stressed the need for the department to decide on strategies. There are many practical questions that must be resolved, she said: should all nine-to-14-year-olds be vaccinated, and does the government have the money and capacity? Do we have the right demand generation and social mobilization? When do we shift to the actual implementation of HPV DNA testing?

Roche Diagnostics’ country manager, Marco Valencia Sanchez, who is also the president of the Health Technology Association of the Philippines, highlighted multiple problems in our geographies. “The private-public partnerships together can tackle it right and it goes from the National Government through LGUs.”

Panel 2 tackled improving financing strategies. PhilHealth’s Senior Vice-President, Renato Limsiaco, Jr., said sharing of information is an important component for them. The target for the year 2028 is 27% contribution from the total healthcare expenditures. In 2022, the figure was only at 13.6%. Dr. Maria Julieta Germar of the Health Technology Assessment Council said they ensure that the appraisal process responds to the priority healthcare needs of the country. The Department of Budget and Management’s Undersecretary, Wilford Will Wong, said that to be able to allocate resources for a program, they rely on the submissions of the primary agency concerned.

What was clear during the forum was that mechanisms are already in place for the country to help Filipinas suffering from cervical cancer. The strategies and programs have been identified. However, for all these to materialize and for the objectives to be met, there need to be sustainable sources of funding that would complement allocations made by the government, which also has a lot of other responsibilities and priorities.

It has been an established fact that cervical cancer is preventable and curable. This is the time to make use of collaboration with various firms and organizations that are driven by these collective goals — to improve the quality of life of those living with cervical cancer, to boost the capacity for early detection and treatment, and to eventually eliminate cervical cancer.

Victor Andres “Dindo” C. Manhit is the president of the Stratbase ADR Institute.

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