Health
Nigeria vaccinates 18 million girls against cervical cancer
By Deborah Tolu-Kolawole
The Federal Government of Nigeria said it has vaccinated more than 18 million adolescent girls against the Human Papillomavirus, representing about 76 per cent of its target population, as it intensifies efforts to eliminate cervical cancer in Nigeria.
The Director of Disease Control and Immunisation at the National Primary Health Care Development Agency, Dr Rufai Garba, disclosed this on Tuesday at a strategic policy roundtable organised by MSD in partnership with Africa Health Business in Abuja.
The meeting, themed “Accelerating Cervical Cancer Elimination in Nigeria: Uniting Public and Private Sectors for Equitable Access,” focused on expanding HPV vaccination, improving access to screening and treatment, and strengthening collaboration between the public and private sectors.
Garba said Nigeria had recorded significant progress since introducing the HPV vaccine into its national immunisation programme in October 2023, but stressed that vaccination alone would not be sufficient to eliminate cervical cancer.
“Today, we are around 76 per cent coverage of our target, but in terms of numbers, we have crossed 18 million adolescent girls, which is equivalent to three countries in Africa,” he said.
Nigeria introduced HPV vaccination into routine immunisation in October 2023, initially targeting 7.7 million girls aged nine to 14 in the first phase. The rollout was supported by Gavi, UNICEF, WHO and other partners, with vaccination subsequently expanded nationwide.
HPV infection is the primary cause of cervical cancer, while vaccination and regular screening are among the key interventions for preventing the disease. WHO’s global elimination strategy sets a 90-70-90 target: 90 per cent of girls fully vaccinated against HPV by age 15, 70 per cent of women screened by ages 35 and 45, and 90 per cent of women with pre-cancer or invasive cancer receiving appropriate treatment.
Recent international estimates also show that Nigeria continues to carry a substantial cervical cancer burden. The International Agency for Research on Cancer estimated 13,676 new cervical cancer cases and 7,093 deaths in Nigeria in 2023.
Garba explained that the HPV vaccine was available free of charge to eligible nine-year-old girls at public health facilities, while private facilities could provide vaccination to people outside the routine target age.
He said Nigeria recorded about 12,000 new cervical cancer cases annually, with nearly 8,000 women dying from the disease each year.
“We see around 12,000 new cases every year in Nigeria, and we lose close to 8,000 women on a yearly basis. So, that’s how serious it is,” he said.
He added that efforts must extend beyond vaccination to screening, early diagnosis, treatment and follow-up.
“It is not just the vaccination, which NPHCDA does, but also how we are able to get women to screen them, to catch them early, treat them and follow them up till they actually get better,” he said.
The NPHCDA director identified the difficulty of getting healthy nine-year-old girls into health facilities for preventive vaccination as one of the challenges facing the programme.
He said the agency had adopted school-based vaccination, outreach campaigns and other public health initiatives to improve access and coverage.
Garba also called for stronger adolescent-friendly health services, including safe spaces where young people could access preventive healthcare without fear of judgment.
On concerns about vaccine shortages in some states, he said the agency monitored stock levels and consumption through a logistics dashboard, allowing vaccines to be redistributed to states with higher demand.
He described Nigeria’s cold-chain system as strong, noting that solar-powered equipment had been deployed to some primary healthcare centres, although efforts were ongoing to extend the facilities to more locations.
Garba also urged journalists to investigate reports of private health facilities charging patients for HPV vaccines supplied free of charge by the government.
“All of the health facilities that conduct routine immunisation have HPV vaccines. We give them,” he said.
He explained that although the agency lacked enforcement powers, it could withdraw supplies from facilities found to be selling government-provided vaccines.
“We will need you guys to bust that story. Unfortunately, NPHCDA does not have enforcement powers, but what we can do is we can stop giving them vaccines when we find out that they’re selling vaccines that are supposed to be free,” he added.
Meanwhile, the Director of External Affairs for Sub-Saharan Africa at MSD, Vuyo Mjekula, called for stronger private-sector participation in Nigeria’s efforts to eliminate cervical cancer, saying an integrated approach was needed to sustain gains in vaccination and expand access to screening and treatment.
Mjekula said the policy roundtable was designed to identify practical opportunities for investment, partnerships and coordinated action among government agencies, healthcare providers, civil society organisations and private companies.
She said Nigeria’s HPV vaccination programme had made substantial progress since its introduction, but gaps remained across the wider cancer-care continuum.
“The main thing was, how do we build upon that foundation and even the work of these various task groups? And one of the areas which we believe was a gap or is a gap is we see that there’s a great opportunity for the increased involvement of the private sector,” she said.
Mjekula said private-sector involvement could help mobilise additional resources, improve service delivery and reduce fragmentation across existing programmes.
She advocated integrating preventive healthcare into routine maternal and reproductive health services so women could access screening and other interventions during regular healthcare visits.
“We don’t look at women in a siloed way,” she said.
She also called for private-sector representatives to be included in relevant national cervical cancer task forces, partnerships and technical working groups to strengthen coordination.
Mjekula disclosed that MSD had supported catch-up HPV vaccination for girls up to age 20 who were not covered when Nigeria introduced its national programme.
She also said the company was working with Gavi and UNICEF to promote access to higher-valency HPV vaccines in Africa.
According to her, MSD had invested more than $44m in Nigeria over the past decade through its MSD for Mothers initiative, supporting civil society organisations working in maternal healthcare.
She added that the company was collaborating with City Cancer Challenge in Abuja to identify gaps and develop solutions to improve oncology services.
Also speaking, the Director of Cancer Prevention and Control at the National Institute for Cancer Research and Treatment, Dr Usman Muhammad Waziri, said inadequate awareness, affordability and access to quality healthcare continued to affect cancer prevention and treatment in Nigeria.
Waziri, who represented the institute’s Director-General, Professor Usman Malami Aliyu, said NICRAT was working with government agencies, international partners and other stakeholders to strengthen cancer prevention, research, screening, treatment and palliative care.
He said financial constraints often prevented patients from seeking medical attention early, increasing the likelihood of presenting at advanced stages of the disease.
“Affordability, because when people decide late, even if they go to the best of facilities, the disease will be late-stage,” he said.
Waziri disclosed that the institute was collaborating with the American Association for Cancer Research and other organisations to develop a community cancer communication strategy aimed at improving public understanding of the disease.
He said the initiative would address misconceptions and beliefs that discourage people from seeking appropriate medical care.
“We need to come together, streamline our efforts and standardise the information that goes out. Because most often, it’s not just the information that goes out, but appropriate information that is population- or community-centred,” he said.
On efforts to improve access to early diagnosis, Waziri disclosed that NICRAT had introduced the National Initiative for Cancer Early Detection, Screening and Coordinated Access to Network of Care, known as NISCAN.
According to him, the initiative seeks to make cancer screening more routine for people at risk through standardised national guidelines and a coordinated referral system.
He said the programme was being piloted in the Federal Capital Territory, with suspected cervical cancer cases referred to the Federal Medical Centre, Jabi, for further evaluation and diagnosis.
“Every woman with a suspected cervical lesion will get there and get evaluated to the point of histological diagnosis under one roof. If it is cancerous, she gets connected to treatment. If it is not cancerous, she gets counselled and continued on follow-up based on national guidelines,” he said.
Waziri said Nigeria was working towards the WHO’s 90-70-90 targets for eliminating cervical cancer as a public health problem by 2030.
He also disclosed that government-led cervical cancer screening had commenced in Imo State, with Niger State next in line for expansion.
“We want to have this cervical cancer rollout reach all the nooks and crannies of the country,” he said.
Waziri further said the Cancer Health Fund, which supports indigent Nigerians seeking cancer treatment, was being implemented in six facilities and covered breast, cervical and prostate cancers.
However, he identified inadequate funding as a major constraint to expanding the programme and reaching more vulnerable patients.
“The funding allocated to the programme is not yet optimal enough to go round and assist the bulk of the populace that is affected, especially the indigent,” he said.
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