Nigeria’s Action to Eliminate Cervical Cancer

On October 24, under the leadership of the National Primary Health Care Development Agency (NPHCDA), Nigeria began the first phase of its plan to introduce the human papilloma virus (HPV) vaccine into its routine immunization system. The launch in the capital city of Abuja was attended by top government officials from the Ministries of Health, Education, and Budget & Planning, as well as the first lady of Nigeria; and religious leaders including the sultan of Sokoto and the president of Christian Association of Nigeria.

This was a special event for the Nigeria Governors Spouses’ Forum and civil society organizations that have been advocating for the introduction of the HPV vaccine in Nigeria for years 10 years. On November 17, 2020, for example, the Cancer Society of Nigeria and the Nigeria Governors Spouses’ Forum co-sponsored the launch of the World Health Organization (WHO)’s Global Strategy to Accelerate the Elimination of Cervical Cancer by 2030. This strategy set ambitious targets: fully vaccinate 90 percent of girls by the age of 15; screen 70 percent of women by age 35 and again at 45; and treat 90 percent of women who have been diagnosed with cervical disease.

In Nigeria, cervical cancer is the third-most common cancer and the second-most cause of cancer deaths among women ages 15–44 (UNSDG 2023). Nigeria is protecting its next generation of girls from cervical cancer by implementing WHO’s recently updated recommended HPV vaccination schedule, with a single-dose schedule focused on girls 9–14 years of age. “The loss of about 8,000 Nigerian women yearly from a disease that is preventable is completely unacceptable,” said professor Muhammad Ali Pate, Nigeria’s coordinating minister of health & social welfare. He also noted that the Federal Government of Nigeria has prioritized HPV vaccination as part of its pledge to achieve health equity.

The Path to Success

In line with several national strategies on immunization and cancer control and prevention, the National Immunization Technical Advisory Group in 2019 recommended that Nigeria introduce the HPV vaccine in a phased approach. However, due to the global shortage of the HPV vaccines and the COVID-19 pandemic, HPV vaccine introduction was delayed until 2023.

The NPHCDA is leading introduction through the National Emergency Routine Immunization Coordination Centre. The Bill & Melinda Gates Foundation-funded and JSI-led HPV Vaccine Acceleration Program Partners Initiative (HAPPI) Consortium provided technical support on the development of a readiness dashboard to monitor vaccine introduction progress at national and subnational levels. HPV vaccine leadership convened partners from the health and non-health sector to plan and coordinate efforts with school health services to routinize HPV vaccination.

Where We are and the Way Forward

The first phase of introduction has rolled out in 13 states; three more will soon begin.[1] As part of Phase 1, adolescent girls were vaccinated during a five-day campaign held at health facilities, schools, community outreaches, and special sessions in the marketplace and farming areas to reach those who are out of school. As of ninth of November, 3,392,941 girls ages 9–14 years in 13 states had been vaccinated. Overall, HPV vaccination acceptance was good.

Moving forward, efforts will focus on organizing catch-up campaigns, integrating HPV vaccine into routine immunization, and informing caregivers and parents of eligible girls on vaccine safety and efficacy. Phase 2 HPV introduction planning and preparation is underway and will focus on the next 21 states.

Nigeria is an example of steadfast advocacy and government commitment to cervical cancer elimination goals—an example worth commending on this International Day of Cervical Cancer Elimination Action.

By Paul Bassi Amos, Dessie Mekonnen and Khadijah A. Ibrahim Nuhu.
Photos by Khadijah A. Ibrahim Nuhu

1.  Abia, Adamawa, Akwa-Ibom, Bauchi, Bayelsa, Benue, Enugu, FCT, Jigawa, Kano, Kebbi, Lagos, Nasarawa, Ogun, Osun, Taraba.