HIV-positive women are living longer, but are now dying of cervical cancer. In Zimbabwe, cervical cancer is now the most common cancer among women, particularly those living with HIV. Activists are urging the government to step up efforts to prevent deaths related to the disease, accusing it of paying lip service to the problem.
According to the Zimbabwe National Cancer Registry, cervical cancer affects about 30 percent of women in the country. Cervical cancer is caused by the sexually transmitted human papilloma virus (HPV). Although condoms are said to lower the risk of getting HPV, they do not prevent the risk of acquiring this virus completely. About 1,900 women are diagnosed with the disease every year in Zimbabwe and 1,300 die, according to the UN World Health Organization.
Efforts poorly resourced
In October last year, the government registered a cervical cancer vaccine for the prevention of HPV and reported that by early this year the new vaccine would be available for women in the country. However, those plans have been scuppered by financial constraints.
A number of public health institutions in Zimbabwe, including Parirenyatwa Hospital, the country's largest referral hospital, were supported by the UN Population Fund (UNFPA) to run free cervical cancer tests known as visual inspection with ascetic acid and cervicography. While this method is faster and cheaper than the traditional pap smears, the machines at Parirenyatwa Hospital are not enough to service the large number of women coming from around the country for the service. Women have been forced to wait for up to a month to get screened.
In addition, some women who had been screened and found to have cervical cancer have been waiting for up to three months for treatment. One woman at the hospital, who asked not to be identified, told IRIN/PlusNews that after waiting for three months to begin her treatment, she was told the radio therapy machines had broken down and had to wait again until the machines were repaired.
AIDS activist Promise Mthembu noted that research indicated that more women in sub-Saharan Africa are dying of cervical cancer than of maternal mortality-related deaths. She urged the Zimbabwean government to do more to address this growing crisis.
“Before HIV/AIDS, cervical cancer was a disease of older women, affecting women beyond reproductive age, and it was marginalized because of this. But now it is affecting younger women,” said Mthembu.
“It is important that we have a comprehensive package for women that addresses cervical cancer. What we have seen in HIV/AIDS policy is that policy has been promoting pap smears or screening for cervical cancer. While a pap smear is a means to an end, why should the government screen cervical cancer if it doesn’t have means to treat cervical cancer?”
Oncologist and cancer-prevention activist Anna Nyakabau says it is unacceptable that a large number of women continue to die as a result of cervical cancer given the slow progression of cervical cancer in a person’s body.
According to Nyakabau, many women are dying in Zimbabwe because they present themselves to health facilities when it is too late to save their lives. She says the disease is evasive because symptoms only show when the disease is already at an advanced stage. She says it is important for the government and its partners to increase knowledge among the population about the dangers of cervical cancer and the importance of regular screening for the disease.
Minister of Health and Child Welfare Henry Madzorera admitted that lack of funds had stymied the roll-out a cervical cancer vaccine early this year, but said the government would be mobilizing funds from donors to launch the vaccine in 2014. Meanwhile, he said, the government would focus on other strategies to reduce cervical cancer deaths in the country, such as screening and testing and treatment for those infected.