Soma, an eleven-year-old girl from the quiet rural community of Ozalla in Enugu State, Nigeria, sits in her mother’s modest kiosk on this warm, languid Saturday afternoon. As I join her to sit on the wooden bench inside the small store, we watch customers amble leisurely along the dirt road as they come up to the open shop window to purchase items.
Soma handles the transactions, her hands darting from item to item with the kind of rushed familiarity that comes from having done it a thousand times. The air is still, but her actions add a subtle tension to the otherwise slow-paced day in this rural corner of the Earth.
Soma lives with her two brothers, her pregnant mother, and her father in Ozalla. Ozalla is a close-knit community comprising six villages in the Nkanu West Local Government Area of Enugu State, Nigeria. It spans over 200 kilometres wide and hosts a majority youthful population, predominantly in the trades of farming and butchering.
Ozalla shares its southern border with Ituku, a sister village known for the famous University of Nigeria Teaching Hospital. Soma, with wide-eyed ambition, aspires to become a doctor and one-day work at this institution. She speaks with certainty about her future, as if her path to becoming a doctor and one day working at the prestigious hospital were already written.
But for Soma and countless young girls in rural parts of the continent, there remains a quiet, devastating threat that has been cutting short lives filled with potential and promise—cervical cancer.
Every year in rural Africa, thousands of women die from cervical cancer—a preventable disease. The gravity of the situation is underscored by data from the Word Health Organization, which reveals that 19 out of the top 20 countries with the highest burden of cervical cancer are in Subsaharan Africa. This can largely be attributed to low cervical cancer screening.
Groundbreaking results from an observational study in Scotland conducted by the PHS in collaboration with the University of Strathclyde and Edinburgh show great promise in the fight to eradicate cervical cancer and change the prevailing narrative on the African continent. The question is, will we seize this opportunity?
The findings from the HPV study sparked renewed hope in the fight against cervical cancer for young women and girls in rural Africa. For Soma and many others, this could radically change the trajectory of their futures and offer them the chance at a life free from the burden of this preventable disease.
The research study published in the Journal of the National Cancer Institute involved over 400,000 women who were eligible to be screened for cervical cancer. In what many consider an incredible breakthrough, the study revealed zero cases of cervical cancer in all women sampled, ie women who were born between 1988 – 1996 and who were fully vaccinated against HPV at the ages 12 – 13 years of age. These findings offer countries like those in Subsaharan Africa a clear roadmap to drastically reduce cervical cancer rates by improving access to this vaccine. We have the means to ensure cervical cancer becomes a rare disease.
Cervical cancer is the most common gynaecological cancer among women in Sub-Saharan Africa and the second most common cancer in Nigeria. It is an aggressive cancer, with the majority of patients presenting at advanced stages of disease. Cervical cancer is caused by oncogenic or cancer-causing strains of the Human Papilloma Virus. Prophylactic vaccination against HPV screening and treatment of pre-cancerous lesions have been proven to reduce the rate of cervical cancer death drastically.
Soma’s mother is aware of cervical cancer and the HPV vaccine but has been unable to get vaccinated due to financial constraints. When I ask her if Soma has been vaccinated, she answers in the negative, showing great scepticism about the threat of cervical cancer and the efficacy of the vaccine.
In Nigeria, the National Primary Healthcare Development Agency introduced the HPV vaccine into the routine immunisation schedule for girls aged 9 – 14 years of age. In Africa, 28 out of 54 countries have introduced the HPV vaccine to national immunisation programs. These are commendable efforts, but there is still much work to be done at the grassroots in dispelling specific myths, misconceptions and conspiracies regarding the human papillomavirus and vaccinating more of our young girls.
The success of Scotland’s HPV vaccination program offers valuable lessons for African countries. Scotland dramatically reduced cervical cancer incidence through a systematic approach that includes public health education, government-backed vaccination programs, and easy access to healthcare services. This model demonstrates that a coordinated effort combining education, infrastructure, and funding is the key to tackling this preventable disease in Africa.
As Soma continues her journey through junior secondary school, her bright future reminds us of what is at stake. With the right investments in healthcare and education, Sub-Saharan Africa can follow in Scotland’s footsteps and dramatically reduce cervical cancer rates. The question is not whether it is possible but whether we will make it happen.
Dr. Amarachi Ike is a licensed general practitioner, and emerging medical journalist living in Nigeria. She is passionate about boosting medical literacy and patient comprehension of disease through the use of media. Connect with her on LinkedIn (Dr Amarachi Ike) for more healthcare news and information.