Harnessing the Power of the Private Sector in the Fight Against Cervical Cancer

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The client is a multilateral global health agency that works to promote health and well-being, prevent disease and improve access to healthcare.  

The client sought to engage more private sector actors as partners in the addressing the access challenges associated with HPV nucleic acid amplification tests (NAATs) to promote cervical cancer elimination.

The Problem:

Cervical cancer is a preventable and treatable disease, but it remains a persistent and devastating public health problem worldwide. It is the fourth most frequent cancer in women. In 2020, there was an estimated 604,000 new cases and an estimated 342,000 deaths. In addition, nine of ten deaths occur in low-and-middle-income countries (LMICs) with the most vulnerable being women living with HIV.

In response, a global strategy has been initiated to help eliminate cervical cancer as a public health issue by setting the 90-70-90 targets by 2030.These three targets are:

• 90% of girls fully vaccinated with HPV vaccine by age 15;  

• 70% of women are screened with a high-performance test by 35, and again by 45 years of age; and  

• 90% of women identified with cervical disease receive treatment (90% of women with pre-cancer treated; 90% of women with invasive cancer managed).

However, the current cervical cancer screening methods (cytology and visual inspection) are less effective due to their high subjectivity and low reproducibility, high infrastructure and specialised equipment requirements. Consequently, there is a need to scale up access to highly sensitive and cost-effective HPV NAATs, particularly in LMICs. In the process of, access challenges to these tests have been reported.  

The Solution:

The client partnered with Market Access Africa to establish a basis and point of reference for a private sector dialogue on avenues for partnerships. To establish this reference and discussion facilitator, MAA conducted a comprehensive market analysis and craft a detailed discussion paper aimed at exploring the access challenges associated with HPV NAATs. This extensive project encompassed thorough desk research to map out the current landscape of cervical cancer screening, including an examination of the various HPV NAAT assays available in the commercial market. The analysis also focused on the specific limitations and barriers to access that hinder the widespread adoption and utilization of these assays. The key access challenges identified included:

• HPV NAAT reagents and consumables are expensive making it difficult for governments to switch from the less expensive screening modalities already in use.

• Accessibility of global access pricing for HPV NAATs dependent on high minimum volumes limiting ability of national buyers with low resources and local implementing partners.

• Inadequate funding for HPV screening limit national programs’ ability to scale up screening with HPV NAATs and implement national cancer control policies.

• High need but low uptake of HPV NAAT testing in public and private sectors

• Limited awareness of cervical cancer at primary healthcare level contributing to limited requests by women and recommendations by healthcare providers for HPV NAATs.

• Availability and quality concerns regarding self-collection devices and HPV NAATs.

Market Access Africa conducted more than 15 in-depth consultations with key stakeholders actively involved in cervical cancer elimination programs across a range of LMICs to ensure the accuracy and relevance of these findings. These stakeholders provided invaluable perspectives, which were instrumental in validating the research outcomes,shaping the recommendations presented in the discussion paper, and defining the approach to engaging private sector actors.

The Outcome:

MAA delivered a policy discussion paper that provided a thorough assessment of the market access challenges and possible solutions for cervical cancer screening with HPV NAATs. Additionally, a brief was provided on the current state of HPV vaccination and cervical cancer management. The client used the discussion paper and the brief as the main point of reference in successfully convening private sector actors, including HPV test manufacturers, and achieving a policy consensus facilitating access to HPV molecular tests in LMICs.  

Read more about the private sector dialogue for cervical cancer elimination here.