Bridging the Gap: Increasing HPV Vaccine Access in Low- and Middle-Income Countries

By Olivia lewis

Cervical cancer is the fourth most common cancer in women worldwide, according to the World Health Organization.

The disease, which develops from continuous human papillomavirus (HPV) infections, is preventable through the HPV vaccine. Though, access to the vaccine is limited or unavailable in some countries. Ongoing barriers like misinformation, limited geographic and economic mobility, and cultural beliefs have made it arduous to inform women and girls of health risks. Across many low- and middle-income countries, where access to care is expensive and constrained, health advocates and providers are creating pathways to health literacy and cancer prevention for hard-to-reach populations.

If prosperous, these efforts could decrease rates of HPV, breast cancer, and cervical cancer.

But first, health providers must work to overcome misinformation and educate caregivers, said Lawreen Sakini, social enterprise lead at Reproductive Health Network Kenya (RPHK).

RPHK provides complete reproductive and sexual health details to communities across Kenya. In partnerships with 43 counties, RPHK has implemented community-focused initiatives across Kenya for the last 15 years. In 2023, they joined the Africa Action Network to dispel misinformation on HPV, provide the vaccine, and ultimately decrease rates of cervical cancer.

In some Kenyan communities, it’s culturally inappropriate for young people to be sexually active and for anyone to discuss young people doing so, which can complicate conversations around receiving the vaccine.

According to Sakini, parents are frequently enough misinformed about the risk of cancer but are willing to engage in conversation and ask questions.

“The first step is to inform them on ‘what is HPV?’,” said Sakini. “‘What does HPV mean and what can HPV lead to?'”

RPHK trains young people to become community health promoters to meet residents where they are and discuss the issue. Dozens of these young people have helped bridge the gap in health literacy among their Nairobi and Kakamega residents. They meet with young people one-on-one, in small group settings, and with their parents.

They’ve created awareness of the issue and are de-stigmatizing HPV to encourage consent for the vaccine and ultimately prevent cervical cancer later in life.

“There was a lot of stigma around getting HPV information, let alone the vaccine,” she said. “People would look at (the kids) like, ‘you’re so young, why are you having sex?'”

In Bangladesh, health providers face similar challenges and a need to raise health literacy around cervical cancer.

“[Bangladesh is] also a very conservative society,” said Dr. Iftikhar Mahmood of HOPE Foundation for Women and Children of Bangladesh. “Even though they have the problem, they don’t talk to their relatives or partners, and they don’t come to the doctors.”

HOPE operates a field hospital with