Co-host commitments | Organizing partner commitments | Country commitments – new | Country commitments – re-affirmation of existing | Other

Government of Colombia

• 90%
  • By 2031, Colombia will increase HPV vaccination coverage to 90% in 9-year-old boys and girls
• 70%
  • By 2031, 70% of women aged 25 to 29 will be screened for cervical cancer with cervical cytology.
  • By 2031, 70% of women aged 30 to 65 will be screened for cervical cancer with DNA/HPV tests
• 90%
  • 90% of diagnosed women will receive treatment
  • By 2031, an average of 30 days or less will elapse between medical suspicion and diagnostic confirmation of cervical cancer
  • By 2031, an average of 30 days or less will elapse between diagnostic confirmation and the start of treatment for cervical cancer

Government of Spain

Spain is deeply committed to accelerating the elimination of cervical cancer and is working both internally and externally to achieve this goal. In Spain, the incidence of cervical cancer is 5.3 cases per 100,000 women, which is close to the WHO's elimination target of 4 cases per 100,000 women.

In 2022, vaccination coverage for women aged 15 years was achieved at 92% for the first dose and 87.5% for the second dose nationwide. In addition, it is recommended to identify and vaccinate unvaccinated women up to the age of 18, as well as to vaccinate people with certain risk conditions. Since 2023, systematic vaccination of boys at the age of 12 has also been implemented. Currently, the introduction of a single-dose schedule for systematic vaccination is being evaluated for next year.

In the last three years, population-based screening has been implemented throughout the country and it is expected that coverage will reach close to 100% by the end of 2029.

In terms of working with our partners, Spanish Cooperation is committed to collaborating with them to eliminate cervical cancer, applying the WHO strategy: increasing equitable and sustainable access to vaccines against the human papillomavirus (HPV), supporting the formulation and implementation of screening and early treatment programs, and treating invasive lesions in low- and middle-income countries, making available to our partner countries the experience gained in the fight against this cancer, as well as working in alliance with actors such as WHO-OPS, as well as other key allies in vaccination and innovation in screening programs such as Gavi, UNICEF and UNITAID. In order to support countries in their efforts to advance towards the elimination of cervical cancer, the Spanish Agency for International Development Cooperation is making available to countries up to 10 million euros over the next 3 years to work on improving coverage, training professionals in the subject, raising awareness in prevention and early detection work, and improving treatment.

However, it is important to remember that in order for these programs to be successful, it is necessary to increase the capacity and effectiveness of the healthcare and public health system in a central way, which remains a priority objective for our country.

Given the Universal Health Coverage approach of our healthcare system and our commitment to health equity, all women have access to treatment for precancerous and invasive lesions. However, we will continue to work to reduce both the incidence and mortality of the disease, with a focus on primary care and addressing social determinants of health and gender perspectives, as well as intersectoral collaboration.

Bill & Melinda Gates Foundation

The Bill & Melinda Gates Foundation stands behind WHO’s Global Strategy to Accelerate the Elimination of Cervical Cancer as a Public Health Problem and its comprehensive approach to cervical cancer elimination. The foundation supports this effort across all three pillars of prevention, screening and treatment. We are committed to protecting the next generation of women from cervical cancer by increasing equitable, sustainable access to HPV vaccines in low- and middle-income countries and are proud to support Gavi, the Vaccine Alliance, and countries in the ongoing work to accelerate the introduction and scale up of HPV vaccines. We are supporting research to help countries design and implement sustainable, equitable vaccination programs that reach all girls, including the most vulnerable. We are dedicated to building and strengthening partnerships with governments, non-governmental organizations, including UNICEF and the World Bank, and the private sector to increase access to vaccination. We fully embrace innovation in this area, including the implementation of the WHO-recommended one-dose HPV vaccine regimen, which makes these life-saving vaccines more accessible by lowering costs and simplifying delivery. 

Over four years, the foundation intends to commit up to US$100 million to help accelerate the global uptake of HPV vaccines to immunize 242 million girls against HPV. Over the next four years, we also intend to commit up to US$50 million to the development of new prophylactic HPV vaccines, further studies investigating the durability of protection after single-dose vaccination, and tools to help countries better understand how vaccines might be used beyond current target populations. In addition, the foundation is investing in the development of HPV therapeutic/cervical cancer prevention vaccines for women who have already acquired HPV, with a combined commitment of up to US$30 million over the next four years in discovery research. As part of this work, we are developing low-cost, point-of-care HPV diagnostics to support both the anticipated HPV therapeutic vaccine and screen and treat programs.

Gavi, the Vaccine Alliance

Gavi strongly affirms its commitment to the Cervical Cancer Elimination agenda by supporting countries to introduce, finance and scale up coverage of HPV vaccines to drive equitable and sustainable access.

As part of its HPV vaccine revitalisation programme, Gavi is investing over US$600 million from 2022 towards accelerating the number of girls reached with the HPV vaccine and to achieve the ambitious target of reaching 86 million adolescent girls by the end of 2025. Through this effort, Gavi commits to:

• Support the acceleration of high-quality HPV vaccine introductions that transition to effective and sustained delivery and uptake, to reach 27 countries.
• Support multi-age HPV vaccination campaigns to fast track the protective effects of the vaccine in the next generation, to reach 28 countries.
• Foster sustainability of the HPV immunisation programme by collaborating with governments, Vaccine Alliance partners, faith-based and civil society organisations, women’s groups, youth-led organisations and the private sector.
• Ensure HPV vaccination is included as part of a holistic package of care for adolescent girls by increasing intersectoral collaboration and engagement with Ministries of Health, Ministries of Education and other essential services.
• Provide technical assistance to countries through partners that draws on best practices and enhances regional and global learning on: funding application development, one-dose decision-making, cost-effectiveness, forecasting and budgeting, launch planning, microplanning, quality training, social and behavioural change, advocacy, and communication. 

The Gavi Board is considering plans for 2026-2030 to further extend the protection provided by HPV vaccines, and subject to these discussions and the availability of funding, millions more women and girls could be protected.

Pan American Health Organization

The Pan American Health Organization (PAHO) is committed to supporting its Member States to equitably scale up HPV vaccination coverage and to introduce HPV testing and ablative pre-cancer treatment to achieve the global 90-70-90 targets for HPV vaccination, screening, and treatment. The Organization’s support for cervical cancer elimination is demonstrated in the PAHO’s Disease Elimination Initiative, which aims to eliminate as many as 30 communicable diseases and related conditions in the Americas by 2030. More specifically, PAHO commits to:

• Provide technical cooperation to national immunization programs for sustainable and equitable HPV vaccination to girls, and boys where possible, following national guidelines, and including during Vaccination Week in the Americas. 
• Support national immunization technical advisory groups with the provision of current evidence to facilitate their decision making on HPV vaccination strategies.
• Provide technical cooperation on the introduction and scaling up of HPV testing as the primary screening test for cervical cancer, including support for self-sampling strategies, and the introduction of ablative precancer treatment, according to the recent WHO guidelines for cervical cancer screening and treatment.
• Offer high quality HPV vaccines, HPV diagnostic tests and ablative pre-cancer treatment devices to Member States through the PAHO Regional Revolving Funds.
• Work with global and regional partner organizations, including professional associations and civil society, to continue to build political will and strengthen the prioritization of cervical cancer elimination in the public health agenda of countries.

UNICEF

“For the first time, the end of an entire category of cancer is in sight. With the necessary tools at our disposal, commitment and political will are the next critical steps to a future free of cervical cancer for generations to come. UNICEF is dedicated to the shared global target of protecting the lives of 86 million girls by next year and pledges US $10 million to support 21 countries in vaccinating girls against HPV, in addition to our existing commitments to this important and urgent cause. The impact of these new funds will be amplified as a result of UNICEF’s multi-sectoral approach making the most of our school and community platforms and partnerships with girls’ and women’s rights organizations to ensure success in demand generation.”

     -    Helga Fogstad, Director of Health, UNICEF.

Unitaid

To achieve cervical cancer elimination in our lifetimes, we need to see urgent action to extend HPV vaccination to all who are eligible, while accelerating efforts to ensure effective screening and treatment methods are widely available. Unitaid remains committed to advancing the tools and treatments necessary to extend protection to the millions of women and girls who are unable to benefit from the preventative vaccine.

Between 2019 and 2023, Unitaid-supported cervical cancer programmes reached approximately 1.5 million women across three continents, trained tens of thousands of health workers and greatly expanded the number of healthcare facilities offering lifesaving screening, detection, and preventive treatment. Through a catalytic procurement of over 6000 thermal ablation devices, Unitaid secured the introduction and adoption of this critical tool in one-fifth of all low- and middle-income countries globally. Unitaid’s commitment to accessibility led to agreements that have reduced the cost of HPV tests and treatment devices significantly. With over US$ 80 million invested since 2019, Unitaid remains the largest funder of innovative tools to find and treat women with precancer living in low-resource settings.

Over the next three years, Unitaid commits to:

• Provide funding to support countries in designing effective programs to reach women in urban and remote areas by developing and implementing tailored initiatives, including those centered on self-care approaches such as self-sampling in community settings rather than health facilities.
• Provide funding to assist countries in enhancing their systems and refining screening services, including laboratory networks and information systems, to minimize delays between screening and result delivery. Additionally, focus on bridging the treatment gap by strengthening the utilization of existing tools at primary healthcare levels.
• Engage with manufacturers of screening, detection, and treatment tools to optimize the cost and expand the coverage of access pricing agreements, as well as engaging in upstream investments to expand the availability and affordability of key products, such as HPV diagnostics.
• Support WHO’s cervical cancer elimination initiative through dedicated funding, thus enabling the normative guidance and technical support that can benefit countries in need as they initiate and grow their programs.
• Support WHO’s prequalification program through dedicated funding, thus contributing to increased access to quality-assured HPV screening and detection tests.
• Scope potential new investment areas by comprehensively assessing the landscape of innovative health products for secondary prevention of cervical cancer. Unitaid maintains its focus on accessible and affordable products that are tailored to meet the needs of low-and-middle-income countries (LMICs) where most of the women affected by cervical cancer live.

USAID

USAID strives to create a world where every woman and child not only survives but thrives, fostering community and national prosperity. We know that progress on cervical cancer elimination is possible and within reach when proven interventions are in place. USAID is committed to accelerating efforts towards ending cervical cancer, which uniquely burdens women and their families. USAID stands with partner countries and organizations to advance progress towards the World Health Organization’s goal to meet the 90-70-90 targets by 2030 for prevention, screening, and treatment of cervical cancer.

We commit to:

• Increase the availability and use of the HPV vaccine: Annually, the United States contributes $290 million (FY23) to Gavi, the Vaccine Alliance, aiming to expand access to new and underutilized high-impact vaccines, such as HPV. Our contribution directly supports low- and middle-income countries to access, introduce, and increase coverage of HPV vaccines to reach girls, especially in countries with high burdens of cervical cancer. USAID will continue to support partner countries to incorporate the HPV vaccine into national policies and routine immunization systems. We will innovate, test, and implement new ways to introduce the HPV vaccine in harder-to-reach sub-populations, such as out-of-school girls, to break down barriers and build confidence in and uptake of the vaccine
• Expand prevention, screening, and treatment of cervical cancer for populations living with HIV that are at higher risk of cervical cancer through the U.S. Presidential Emergency Plan for AIDS Relief (PEPFAR): USAID, with PEPFAR resources, aims to reach adolescent girls and young women who face a double burden of epidemics through shared risk factors associated with HPV and HIV. Starting this year, USAID will support the integration of existing HPV vaccine services with the Go Further Partnership to End AIDS and Cervical Cancer, DREAMS, and orphans and vulnerable children programs to prevent cervical cancer and HIV transmission at an early stage, and to enhance comprehensive access to cervical cancer screening and treatment services for girls and women.

World Bank/Global Financing Facility

The World Bank and the Global Financing Facility for Women, Children and Adolescents (GFF) fully support cervical cancer elimination, and the Global Strategy to Accelerate the Elimination of Cervical Cancer as a Public Health Problem (WHO’s “90-70-90 strategy”).

The World Bank and GFF have invested more than $400 million for countries to provide HPV screening, vaccination and treatment and we expect to invest at least $400 million for HPV-related programs over the next 3 years. We extend our full commitment to this pressing cause, specifically by:

• Strengthening countries’ programmatic and policy responses to cervical cancer to advance their development objectives and bring evidence and knowledge to reach more women and adolescents with prevention, screening and treatment for cervical cancer.
• Supporting countries in eliminating cervical cancer through WB-GFF funded operations including through the scaling up of school-based vaccination, addressing gender-related barriers, increasing access to treatment and care for the most vulnerable, as well as building demand and trust, and supporting integration of HPV vaccination and screening within primary health care.
• Partnering globally and locally to support cervical cancer elimination: We commit to convening and deepening collaboration with key partners on this agenda, including WHO, PAHO, UNICEF, GAVI, Gates, and UNITAID, USAID, Spain and Colombia to continue to galvanize support for this important cause through global and country fora and build momentum for action.

World Health Organization (WHO)

The World Health Organization stands by its Member States in their efforts to scale up services and pursue the 90-70-90 targets of the Global Strategy to Accelerate the Elimination of Cervical Cancer as a Public Health Problem. 

Working across all levels of the organization, WHO commits to:

• Support countries to develop tailored national strategies, policies and guidelines.
• Support countries with their planning, budgets and proposals for funding cervical cancer prevention and treatment services.
• Support countries in the selection and national adoption of new products and services.
• Support countries to design systems for integrated, scalable and quality service delivery across the life course.
• Support countries to train the health workforce to introduce and scale up services.
• Support countries’ efforts to mobilize demand for cervical cancer prevention services.
• Support countries with monitoring, evaluation, and reporting of progress and improving information systems across programmes.
• Support the meaningful engagement of civil society and people with lived experience in the public health response for cervical cancer elimination.
• Support south-south collaborations to share best practices and lessons learned across countries.
• Support partners at country, regional and global level to be aligned in their actions to accelerate impact at country level and achieve the 90-70-90 targets utilizing the Global Strategy to accelerate the elimination of cervical cancer as a public health problem CCEI.

Chile

POLITICAL DECLARATION: FORUM ON CERVICAL CANCER ELIMINATION

Cartagena de Indias, Colombia, 6 March 2024

It is an honor to share with you this space for improving the quality of life of girls and women around the world. Chile has been developing a feminist foreign policy and it is along that line that the Ministry of Health is here today. We know that by addressing the challenges of half the population, we are on the path to the prosperity of nations.

In Chile, cervical cancer is the third most common cancer among women (5.9%) and the fifth most lethal, leading the country to be an active promotor of the World Health Organization’s proposed strategies for vaccination, screening, and treatment.

In relation to the target of having 90% of girls vaccinated against HPV before the age of 15: We are committed to the strategy of switching to the two-dose nonavalent vaccine, starting in the second half of 2024.

Regarding the target of having 70% of women between the ages of 35 and 45 years screened with a high-precision test: Our country is progressively universalizing primary health care, which poses immense challenges for our country. However, we are clear about our priorities and we understand that this is how we can make the WHO strategy effective. Consequently, starting in 2024, we are committed to implementing HPV self-sampling as a screening method. This involves an investment of $2 million, including, among other aspects, training for health personnel who provide direct care to patients, and more communication campaigns covering the greatest variety of means to reach everyone who requires it, especially the most vulnerable populations.

Along these same lines, we are in the process of modifying the national standards that govern health benefits in Chile, with explicit health guarantees for the period 2025-2027. This will guarantee access, opportunity, financial protection, and quality from the screening stage to follow-up for this disease. During this period, cervical cancer screening for people between 25 and 64 years old will rely on the Pap test, in addition to molecular diagnosis of HPV for people between 35 and 45 years old.

Finally, regarding the target of treatment for 90% of women diagnosed with precancerous lesions: In our preeminently public health system, in 2023 we achieved 97.9% and 96.9% compliance, respectively, with the guarantee that people with low- and high-grade precancerous lesions have the opportunity for treatment. We are committed to maintaining the work our teams are doing and to advancing health for all, without leaving anyone behind.

Democratic Republic of the Congo

Democratic Republic of Congo commits to start introducing the HPV vaccine as early as possible using the WHO-recommended single-dose schedule. We also commit to do everything to get, as early as possible, to the cervical cancer elimination strategy immunization’s coverage target for girls aged 9 to 14 years. We call all of our partners to increase their support to make those commitments a success.

Ethiopia

Ethiopia is committed to reducing cancer incidence and mortality. To realize this goal, the country has endorsed the WHO elimination target in 2020 (90-70-90) and is working hard to achieve this target. HPV vaccination national rollout was launched in 2018, targeting 14 years old girls. Further, HPV single dose has been approved to be introduced this year and scaled up as part of the country’s Expanded Program on Immunization plans.

Ethiopia commits to implementing a robust vaccine delivery strategy across the country, targeting at least 95% coverage in 2024 for all 14-year-old girls, regardless of their socioeconomic status, whether in school or out of school.

In addition to scale-up of HPV vaccination, the government commits rapidly expand the Screening and treatment service which was initiated in 2015. So far, over 1.66 million women that have been screened at least once in their lifetime. We are committed to screen 1million eligible women every year and committed to treat 90% of those screened with positive precancerous lesions. To accelerate these efforts, the Ministry calls BMGF, USAID, GAVI, CDC, UNICEF, WHO, PATH, JSI, UNFPA, Global Fund, Jhpiego, and others for technical and financial support. Together we can achieve cervical cancer elimination in Ethiopia.

Nicaragua

• By 2031, Nicaragua will maintain at least 95% HPV vaccination coverage of girls aged 10 to 14 years.
• By 2031, 70% of women aged 25 to 65 years will be screened for cervical cancer using cervical cytology.
• By 2031, 100% of women will have the guarantee that an average of 15 days or less will elapse between medical suspicion of cervical cancer and diagnostic confirmation.
• By 2031, 100% of women will have the guarantee that an average of 15 days or less will elapse between diagnostic confirmation of cervical cancer and the start of treatment.

Nigeria

Nigeria is committed to reducing deaths from cervical cancer. We launched the national program of HPV vaccine this year, targeting girls 9 to 14 years old. We are committed to continuing to increase coverage of the recently launched HPV vaccine through a robust delivery strategy that will meet the girls where they are. For girls that are in school, we will concentrate on school-based delivery; for girls that are not in school, we will commit to implementing outreach activities at key moments in the year, with the target of at least 80% coverage of girls targeted by 2026. The inclusion of the single dose HPV vaccine into routine immunization is an attestation of this commitment.

Indonesia

Indonesia aspires to become a nation where cervical cancer is eliminated as a public health concern. Together, as a united Indonesia, we envision a future where cervical cancer is a disease of the past, and every woman – across all socioeconomic demographics - can live a healthy life free from its threat.

The Indonesian Government has started its kick-off on its National Action Plan in 2023, including the introduction of HPV in its mandatory vaccine program nationwide. This is a clear commitment that Indonesia is progressing toward eliminating cervical cancer by 2030.

Reducing Indonesia’s cervical cancer incidence and mortality rates will require a comprehensive, multi-stakeholder approach to strengthen health system capacity, increase the availability of advanced treatment technologies, and address social, financial, cultural, societal, and structural barriers to prevention and treatment. Indonesia has developed four pillars of the action plan for Cervical Cancer Elimination: service delivery, education training and outreach, key enablers of progress, and governance and policy.

Through robust local and national leadership, evidence-based programming, and multi-stakeholder collaboration, these pillars lay the foundation for specific priority areas and corresponding strategies and actions to “leapfrog” Indonesia to cervical cancer elimination.

ACHA (African Cervical Health Alliance)

As a network of grassroots civil society organisations, activists and allies committed to advancing the health and wellbeing of African women, communities, and nations, the African Cervical Health Alliance (ACHA) is committed to using our voices, experience, and skills in our advocacy with and for cervical cancer survivors, caregivers and allies in the achievement of the WHO 90/70/90 targets by 2030. We see the implementation of WHO guidance on a single dose HPV vaccine as a game-changer. It offers us a pragmatic and cost-effective solution to reach underserved populations, especially in resource-constrained settings in Africa and other LMICs. By simplifying the vaccination process and reducing logistical barriers, single-dose HPV vaccination holds immense promise in increasing vaccine uptake and coverage, thereby bolstering our efforts towards cervical cancer prevention. Civil society organizations (CSOs) are uniquely positioned to bridge the gap between policy and implementation, effectively reaching every woman and girl with critical information about cervical cancer prevention and control. Therefore, even as we appeal to our governments and international health actors to better resource cervical cancer elimination efforts, ACHA stands ready to increase the ability of grassroots civil society organisations to support our governments in the reaching of these targets. This includes increasing our work in spearheading the dissemination of accurate, relevant, accessible, and widespread culturally acceptable - community focused information on prevention and response to HPV.

Jhpiego

Jhpiego reaffirms our priority to support countries in progress toward the WHO 90-70-90 Global Elimination Strategy targets and we will continue to embrace transformative solutions, quality service delivery, innovative approaches on generating demand and increasing access- including in community settings and fostering integration linkages between primary and secondary prevention.

In Pakistan, we will provide technical assistance to the Federal Directorate of Immunization in the introduction of HPV vaccine for girls between 9-14 years old, implementation of school-based adolescent health programs and rollout of the national cervical cancer registry system. In the Philippines, we will generate lessons learned and factors associated with successful primary and secondary prevention programs from health systems, facility and community perspectives and carry out targeted dissemination for countries in similar settings. Jhpiego is also committed in supporting at least five other countries for HPV vaccine coverage improvement and/or implementation of tailored interventions to increase HPV vaccine coverage.

Through the Unitaid funded SUCCESS project led by Expertise France, Jhpiego will pilot community-based HPV self-sampling approaches in Burkina Faso, Guatemala, and the Philippines following on country experiences generated by the current project.  We have also supported four SUCCESS countries with introducing and integrating HPV testing and thermal ablation for precancer treatment into country health systems and are committed to support implementation research and the development of government transition plans for long term inclusion HPV screening as a screening method.  Jhpiego will continue to provide technical assistance in secondary prevention across ten countries in areas of capacity enhancement, evidence generation on the introduction and scaling up of HPV molecular testing and thermal ablation for treatment of precancers and enhancing efficient referral pathways.