Nigeria has vaccinated more than 18 million adolescent girls against Human Papillomavirus (HPV), achieving about 76 per cent coverage of its target population and prompting calls for stronger collaboration to accelerate the elimination of cervical cancer.
Health stakeholders said the vaccination milestone demonstrated what could be achieved when government institutions, the private sector and communities work together, but stressed that vaccination must be complemented by wider access to screening, early diagnosis, treatment and follow-up care.
They made the call at a policy roundtable convened by Merck Sharp & Dohme (MSD), in partnership with Africa Health Business (AHB), in Abuja.
The meeting, themed “Accelerating Cervical Cancer Elimination in Nigeria: Uniting Public and Private Sectors for Equitable Access,” focused on strategies for sustaining the gains made in HPV vaccination while addressing gaps across the cervical cancer care pathway.
Stakeholders Seek ‘All-of-Society’ Approach
Ms Vuyo Mjekula, Director of External Affairs, Policy and Market Access, MSD, South Africa and Sub-Saharan Africa, said the scale of Nigeria’s HPV vaccination programme demonstrated the potential of coordinated action involving government and communities.
The National Primary Health Care Development Agency (NPHCDA) introduced the national HPV vaccination programme in 2023, reaching approximately 12 million girls during its first year. Coverage has since increased to about 18 million girls.
“The national HPV programme targeted at girls between the ages of nine and 14 is going really well. However, there is always room for improvement,” Mjekula said.
She identified education, awareness and community mobilisation as areas requiring continued attention and called for an “all-of-society approach” to cervical cancer prevention.
According to her, faith-based organisations, traditional institutions, the media, employers, private healthcare providers and community groups all have important roles to play in ensuring that accurate information reaches families.
“You need faith-based organisations. You need the media, such as yourselves, to share balanced and accurate information. You need traditional authorities within the communities, and your broader community members that have influence, to all sing the same song and be aligned,” she said.
Mjekula also called for stronger integration of private healthcare providers into the national cervical cancer response.
“The private sector is already doing a really good job, but there is an opportunity for the Ministry of Health to guide and direct and bring the private sector and public together, so that we can do more together,” she said.
She advocated increased private-sector participation in the national cervical cancer task force, the Partnership for Cervical Cancer Elimination in Nigeria (PECAN) and relevant technical working groups.
“We are not competing with each other. There is a huge opportunity to break down fragmentation, galvanise and integrate resources, so that the resources can be deployed to the most impactful areas,” she said.
Vaccination Alone Not Enough
Mjekula stressed that HPV vaccination was only one component of cervical cancer prevention and that Nigeria would need to strengthen the links between vaccination, screening, diagnosis and treatment.
She also called for cervical cancer prevention to be integrated into existing women's health services, including family planning and maternal healthcare, allowing more women to access screening and other services through established healthcare platforms.
The World Health Organisation's cervical cancer elimination strategy sets targets of vaccinating 90 per cent of girls against HPV, screening 70 per cent of women with a high-performance HPV test and ensuring appropriate treatment for 90 per cent of women identified with cervical disease.
Mjekula said Nigeria's existing programme for girls aged nine to 14 remained appropriate but suggested that alternative financing arrangements involving insurers, employers and other partners could help extend vaccination to other eligible groups.
Government Expands Cancer Infrastructure
Director of Cancer Prevention and Control at the National Institute for Cancer Research and Treatment (NICRAT), Dr Mairami Waziri, said the government was expanding cancer treatment infrastructure while working to remove barriers that prevent patients from receiving timely care.
Waziri said the administration planned to establish six additional multidisciplinary cancer treatment centres before the end of its term, with the centre in Katsina already operational.
He also announced the National Initiative for Cancer Early Detection, Screening and Coordinated Access to Network of Care (NISCAN), which is designed to make cancer screening more routine and accessible to populations at risk.
The initiative is currently being piloted in the Federal Capital Territory using a hub-and-spoke model. Under the arrangement, primary healthcare facilities serve as entry points for screening, while specialised centres provide diagnosis and treatment.
Waziri said women suspected of having cervical cancer could be referred to the Federal Medical Centre, Jabi, for further evaluation, histological diagnosis and appropriate treatment or follow-up.
He said Nigeria was working towards achieving the WHO's 90-70-90 cervical cancer elimination targets by 2030.
The National Task Force on Cervical Cancer Elimination has also established PECAN, with support from First Lady Oluremi Tinubu.
Waziri said government-led screening was ongoing in Imo State, with Niger State scheduled to follow.
He added that the Cancer Health Fund for indigent patients with breast, cervical and prostate cancers was being implemented in six facilities but required additional funding to expand its reach.
Cost, Information Gaps Hamper Access
Waziri identified inadequate information, affordability and limited access to quality healthcare as some of the major barriers to effective cancer prevention and treatment in Nigeria.
He said NICRAT was collaborating with the American Association for Cancer Research and other organisations to develop community-focused communication strategies aimed at tackling misinformation and cultural misconceptions surrounding cancer and its treatment.
NPHCDA Targets Hard-to-Reach Girls
Director of Disease Control and Immunisation at NPHCDA, Dr Ahmed Rufai Garba, said the HPV vaccine, introduced nationally in October 2023, had now become part of routine immunisation.
The vaccine is provided free of charge to nine-year-old girls at public health facilities.
Garba, however, said reaching healthy nine-year-olds presented a particular challenge because they do not routinely visit health facilities.
To address the gap, NPHCDA has expanded vaccination through schools, Maternal, Newborn and Child Health Week activities and other community outreach platforms.
He also warned healthcare facilities against charging members of the public for government-supplied HPV vaccines.
Garba said facilities found engaging in such practices could have their vaccine supplies stopped and urged members of the public to report cases of illegal charges.
According to him, Nigeria records approximately 12,000 new cervical cancer cases and nearly 8,000 deaths annually, underscoring the need to complement vaccination with screening and timely treatment.
“This is not just about vaccination. It is also about how we are able to get women screened, catch the disease early, treat them and follow them up until they actually get better,” he said.
Stakeholders at the roundtable agreed that sustaining Nigeria's HPV vaccination gains while expanding screening, diagnosis and treatment would require coordinated action across government, healthcare providers, communities, civil society and the private sector.
For Nigeria to move closer to eliminating cervical cancer as a public-health problem, they said, women must be able to access care at every stage—from prevention and screening to diagnosis, treatment and follow-up.