Jhpiego

Early Detection and Prevention Saves Lives

Jhpiego believes in a world in which an integrated and coordinated response to women’s cancer detects disease early and ends preventable deaths of breast and cervical cancers, often the top cancer killers with a particularly high burden of mortality in low- and middle-income countries.

Since the early 1990s, when we pioneered early clinical trials on visual inspection with acetic acid (VIA) for identification of cervical precancer, Jhpiego has expanded to increase access to newer screening and treatment methods in primary and secondary cervical cancer prevention, resulting in more lives saved. From this we are enhancing early detection, diagnostics and linkages to complete treatment for both breast and cervical cancer.

Breast Health
Breast cancer is the most commonly diagnosed cancer in women, with more than 2.3 million newly diagnosed in 2022. It is the leading cause of cancer deaths in women, with more than 670,000 deaths annually. In low- and middle-income countries, breast cancer is often diagnosed very late, which increases mortality rates.

Cervical Health
Cervical cancer is preventable and treatable if diagnosed early, but it remains one of the most common cancers in women worldwide. Close to 9 of every 10 cases occur in low- and middle-income countries. Most cervical cancers are caused by the human papillomavirus (HPV), a common sexually transmitted infection that can be prevented with the HPV vaccine. In the last 5 years, nearly half a million women worldwide benefited from Jhpiego’s cervical cancer prevention services, which include low-cost, effective screening and treatment.

Jhpiego partners with governments, global technical bodies, the private sector, civil society, and community-based organizations to bring a coordinated and resourced response to prevention, detection and treatment. Our work is grounded in five guiding principles:
• Lead with programming that addresses systemic barriers and equal access to health care services
• Build robust data governance that generates evidence to show level of impact and inform iterative design
• Innovate and design programs grounded on a woman-centered approach to ensure respectful and responsive services based on needs and values
• Build sustainably from the beginning, partnering with local and national stakeholders to build foundations that will be scalable
• Pave the pathway for more efficient channels for investment and innovation, balancing exploration and scalability.

OUR APPROACHES

Expanding Access to HPV Vaccines

We work at a global and country-level to expand HPV vaccinations, which protects girls from cervical cancer and improves adolescent health. In partnership with Gavi, the Vaccine Alliance, we helped the governments introduce the HPV vaccine into public-sector health programs. We have supported and are supporting the introduction of HPV vaccines in Côte d’Ivoire, India, Guinea, Liberia, Pakistan, the Philippines, and Zambia.

HPV Self-Sampling

To increase the number of women who are screened for HPV, Jhpiego supports countries with the introduction of HPV self-sampling around the world including India, the Philippines, Guatemala, Burkina Faso, Cote d’Ivoire, and Mozambique. In Botswana, cervical cancer is the leading cause of cancer and cancer-related deaths among women. A 2015 HPV self-screening study in Botswana found that overtime women found it easier and more acceptable to use the HPV self-sampling, leading to an increase of treatment for women who tested positive for HPV.

Expanding HPV Screening Models and Methods

Through Unitaid’s investment in the global Scale Up Cervical Cancer Elimination with Secondary Prevention Strategy (SUCCESS) project Jhpiego has supported ministries of health in Burkina Faso, Côte d’Ivoire, Guatemala, and the Philippines since 2020 in expanding integrated HPV testing approaches and the use of thermal ablation in reproductive health and HIV service delivery settings. Jhpiego prioritizes increasing screening and treatment access in the primary health care space, we piloted centralized and decentralized laboratory models to demonstrate options in a variety of contexts, and assess the use of different clinical algorithms and application of cancer genotyping for risk management.

Treatment of cervical pre cancer

Jhpiego prioritizes cervical cancer prevention treatment to ensure that women who are diagnosed with precancer can effectively reach treatment where they seek services, and not in a faraway city. Jhpiego supports partner countries with training, procurement, and planning for thermal ablation as a precancer treatment option, an easy-to-use device, ideal for trained nurses in the health setting.

Single Visit Approaches in Cervical and Breast Health

We work with ministries of health and other stakeholders to implement national screening, diagnostic-and-treatment programs that efficiently employ the latest technologies in a timely fashion. This includes all diagnostics services in a single visit for cervical cancer assessment, HPV positive test treatment, breast cancer detection, and diagnosis. Along with our partners, we pioneered the single visit approach (SVA) for VIA, a clinically safe, acceptable and effective approach to cervical cancer prevention for low-resource settings, this is our foundation for making women-centered care our lens for cancer services.

Integrating Services for Women With HIV

Because of advances in HIV treatment, women are now living with HIV but are at risk of dying of cervical cancer due to the lack of screening and treatment. Women infected with HIV are six times more likely than the general population to be diagnosed with cervical cancer. Building on our experience establishing and scaling up cervical cancer screening and treatment programs, we work to integrate cervical cancer prevention programs with HIV care and treatment services and family planning programs to increase access to these services.

Early Breast Cancer Detection

We introduce and expand programs that promote early detection and enhanced diagnostics linkages in Botswana, Mozambique, Ethiopia, Tanzania and India. This includes increasing access to clinical breast examinations at the primary health care level integrated into other services and promoting breast health awareness among communities and providers.

Strengthening Diagnostics and Treatment Systems

Diagnosis is a long journey. Jhpiego is prioritizing support to countries to downstage cancer with faster detection and earlier access to treatment. We focus on saturating primary health care for early detection, integrating breast health awareness into social platforms, strengthening diagnostics at a district level, and facilitating access to multiple forms of treatment. Our aim in support of global WHO goals is for 60% of invasive cancers to be caught at stage I or II, to complete all diagnostics in 60 days, and for 80% of women to complete treatment. Through the BEAT Breast Cancer project in Ghana and Tanzania, we are working to decentralize diagnosis and treatment, improving access to key health services for women who need it most.

Program Experts

Dr. Parag Bahmare

Associate Director and Technical Lead for Women's Cancers

Countries

The Pfizer Foundation Provides $15 Million Investment to Improve Breast Cancer Care in Sub-Saharan Africa

The Pfizer Foundation progressed a three-year $15 million initiative to help improve the lives of women with breast cancer in Rwanda, Ghana, and Tanzania.