Zimbabwe to implement new cancer strategies

Rumbidzayi Zinyuke Senior Health Reporter

INNOVATIVE strategies for screening and preventing cervical cancer are set to be implemented by Government to promote early detection and reduction of mortality rates.

Zimbabwe continues to be heavily burdened by cervical cancer and has the highest burden of the disease in Africa and the world.

Cervical cancer is caused by the Human papillomavirus (HPV), the most common sexually transmitted infection, which can trigger six cancers.

However, cervical cancer is the only HPV-related cancer that can be prevented through vaccination and early detection.

Zimbabwe is presently screening for cervical cancer using the Visual Inspection with Acetic Acid and Camera (VIAC) and has started rolling out the HPV DNA testing method, among others.

Health and Child Care Minister, Dr Douglas Mombeshora, said screening was a key part of case identification adding that HPV DNA testing was more effective.

“We would like to roll out a comprehensive programme for elimination of cervical cancer and part of the programme will involve testing.

“DNA testing is a better method but we are using other methods currently. So for us to be able to do the most effective testing which is the DNA, we need to invest more money in that.

“The other issue that will affect us also is availability of trained personnel to be able to interpret those results. So we are continuing with the processes that we are doing at the moment, but as we get more resources, we will then want to shift to DNA testing,” he said.

The World Health Organisation in 2021 recommended the use of DNA-based testing for HPV after it was established to be more effective than most of the commonly used screening methods.

The test, which has a self-sampling component, allows community health workers to take the kits to the women where they can collect samples on their own and only have to visit the health facility if they test HPV positive.

Dr Mombeshora said the country had rolled out a pilot programme in 60 facilities and would start integrating the new screening method into the rest of the health facilities across the country once resources were available.

“We don’t have enough kits to go around the whole country but we are getting more centres to have the kits. We also need to train more village health workers. But ideally we would want that done because it cuts short the time of communicating with the villagers and also lessens the burden for our trained nurses since the patients, or the would-be patients, will be able to collect specimens which will then go to the laboratories,” he added.

The cross-cutting lead for non-communicable diseases and special initiatives in the WHO headquarters NCD department, Dr Prebo Barango, said screening of women using the HPV test was cost-effective.

He said undergoing a physical examination at a health facility was a disincentive for most women to get screened.

“There is a lot of work that the country is doing through the village health worker arrangement and we were able to see at the rural facility the self-sampling option where the village health worker takes the samples to the women.

“The women collect the sample so they don’t have to travel long distances. That is actually something that other countries can learn from and it’s something that I think is a great example that Zimbabwe can show to the world.

“If we can put this to scale, it’s actually going to be a game changer,” he said.

Dr Barango said HPV vaccination for girls was also the best method in the prevention of cervical cancer.

“There are vaccines that are cost-effective, the HPV vaccine. Giving girls between 9 and 15 years old one shot of the HPV vaccine will protect them from getting cervical cancer later on in life,” he said.

Zimbabwe began rolling out the HPV vaccine in 2018 and since then, over two million girls have been vaccinated.

Government is presently developing an HPV vaccination revitalisation plan, which is expected to ensure that all girls that were missed during the Covid-19 pandemic were vaccinated.