Cervical cancer is preventable and treatable if diagnosed early and managed effectively. Yet in South Africa, it continues to claim the lives of thousands of women each year.

With the right tools and policies, elimination is within reach.

“Every life saved from cervical cancer strengthens families, communities, and the economy,” says Zwelethu Bashman, managing director of pharmaceutical company MSD South Africa.

Cervical Cancer Awareness Month reminds us that the time to act is now.

This illness is mainly caused by persistent infection with human papillomavirus (HPV), and regular screening through Pap smears or testing helps detect precancerous changes before they develop into cancer.

HPV vaccination also offers strong protection, especially when given before exposure to the virus.

Raising awareness encourages women to attend routine screenings, seek early medical care for symptoms like abnormal bleeding, and adopt healthy lifestyles.

Together, awareness, vaccination, and screening can significantly reduce cervical cancer incidence and save lives.

The collaboration between public and private sectors, civil society, and communities is essential for meaningful progress.

“We cannot wait until someone we know or love experiences the consequences of cervical cancer. It is a moral and socioeconomic responsibility,” emphasises Dr Ntombi Sigwebela of the Health Systems Trust.

Women living with HIV and those who have never received the HPV vaccine carry the greatest risk.

South Africa has about 5.2 million women living with HIV, compared to 2.6 million men, and these women face a six-fold higher likelihood of developing cervical cancer.

“We cannot look at numbers alone. Each number represents a life that must be protected,” says Bashman.

The national HPV vaccination programme targeting girls aged nine to 15 has achieved much, but many women remain unprotected, especially those who are HIV-positive or beyond the initial vaccination age cohort, who remain at high risk.

The risk for women living with HIV is further heightened by the faster progression from HPV infection to precancerous lesions and invasive cancer due to immune suppression.

“These women must be prioritised in prevention and screening programmes, including HPV vaccination, DNA-based screening, and timely treatment,” says Sigwebela.

Yet, significant gaps remain.

Women who were never vaccinated, particularly those in private schools before November 2024, often relied on out-of-pocket payment or partial reimbursement through medical schemes. These protection gaps must be urgently addressed.

International and regional guidance emphasises the need for a dedicated strategy for women living with HIV. This includes priority access to vaccination, screening, and treatment, with HPV DNA testing as the primary screening method.

Cervical cancer is also a clear socioeconomic issue.

Women contribute 35–45% of South Africa’s GDP and are often the primary caregivers in households.

When HIV-positive or unvaccinated women develop cervical cancer, families bear the burden: lost income, increased caregiving responsibilities, and reduced productivity.

“This disease affects not only health but the economic stability of families and communities,” says Bashman. Addressing it is, therefore, both a public health priority and a strategic economic choice.

Actionable steps include prioritising HIV-positive women in national strategies, implementing catch-up vaccination for those who missed adolescent doses, integrating prevention into reproductive and primary health services, scaling up HPV DNA testing, and establishing robust referral pathways.

Data collection and monitoring of vaccination coverage, screening uptake, and outcomes are critical for measuring progress toward elimination goals. Messaging must emphasise equity, focusing on women at highest risk, and frame cervical cancer elimination as both a health and social justice priority.

As Bashman said, “Every life protected from cervical cancer is a step toward healthier families and communities. Prevention is not optional; it is a responsibility.”

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