Both human papillomavirus (HPV) vaccination and screening/treatment are relatively simple and inexpensive to implement at all resource levels, and cervical cancer screening has been acknowledged as a "best buy" by the WHO. However, coverage with these interventions is low where they are needed most. Failure to launch or expand cervical cancer prevention programs is by and large due to the absence of dedicated funding, along with a lack of recognition of the urgent need to update policies that can hinder access to services. Clear and sustained communication, robust advocacy, and strategic partnerships are needed to inspire national governments and international bodies to action, including identifying and allocating sustainable program resources. There is significant momentum for expanding coverage of HPV vaccination and screening/preventive treatment in low-resource settings as evidenced by new global partnerships espousing this goal, and the participation of groups that previously had not focused on this critical health issue.
Noncommunicable diseases (NCDs) -primarily cancer, cardiovascular disease, diabetes and chronic respiratory diseases -represent a major health, social, and economic burden that affects women globally, yet their impact on women in low-and middle-income countries (LMICs) has not been fully recognized.1 NCDs cause premature death and disability among women of all socioeconomic strata worldwide. This burden is expected to increase substantially in the coming decades, especially in LMICs, because of a combination of factors, primarily the "ageing" of the population, improvements in maternal health in LMICs and a projected increase in smoking, obesity and other risk factors for NCDs among women. 2Discussions surrounding the post-2015 development agenda provide an important and timely opportunity to realign policies and resources in trying to meet the complex and shifting health problems faced by women globally. The focus of the realignment should be on ensuring that health systems have the capacity to equitably provide health services to women throughout their lifecourse and on maximizing collective efforts to meet women's health needs in all settings, even the poorest. Achieving this will require strengthening the control of NCDs and integrating it into women's health frameworks and platforms, allocating resources optimally and promoting the development of health systems that serve the needs of women throughout all stages of life.3 NCDs, communicable diseases and maternal conditions are interrelated in complex ways. One can lead to the other. For example, hormonal changes during pregnancy can induce the appearance of diabetes and hypertension. A pregnant woman who has diabetes, hypertension or infection with the human immunodeficiency virus (HIV) as an underlying condition is at greater risk of suffering complications during pregnancy and delivery than a woman who has none of these conditions. 4 Because of these interrelations, the limited availability and accessibility of NCD prevention and control services makes it even harder to make headway in addressing established global health priorities.Opportunities to prevent and treat NCDs and reduce their financial and social burden on women abound, but most of the time they are missed. NCDs develop over years; it takes frequent contact with the health system to detect them at an early stage. In many settings, maternal and reproductive health services are the only potential points of contact for the secondary prevention of NCDs.Health systems are ill-equipped to keep pace with changing patterns of disease and the need for an expanded range of health services for women of all ages. Many women who have some type of NCD also have HIV infection or a pregnancy-related health problem. Integration of NCD prevention and control efforts within existing health services is becoming increasingly necessary to bolster future progress in women's health and socioeconomic well-being and to safeguard the progress made so far in attaining the goals and targets set in the area of women's he...
This chapter describes the increasingly critical role of cancer vaccines in preventing, and potentially even treating, cancers in all resource settings. At this time, there are three cancer vaccines, two of which protect against cancer-causing viruses—hepatitis B virus (HBV) and the human papillomavirus (HPV); the third is an immunostimulant treatment virus for late-stage prostate cancer. Few advances in medicine and public health have had as substantial an impact on morbidity and mortality worldwide as vaccines. The potential public health impact of cancer vaccines is particularly significant in developing countries, where limited resources make prevention, screening, and disease management especially challenging. Numerous strategies are being employed to improve access to cancer vaccines in low- and middle-income settings. These efforts are beginning to demonstrate impact on cancer rates, indicating how innovative mechanisms may be used to expand access to HPV and other future cancer vaccines in the decades to come.
This chapter describes the increasingly critical role of cancer vaccines in preventing, and potentially even treating, cancers in all resource settings. At this time, there are three cancer vaccines, two of which protect against cancer-causing viruses—hepatitis B virus (HBV) and the human papillomavirus (HPV); the third is an immunostimulant treatment virus for late-stage prostate cancer. Few advances in medicine and public health have had as substantial an impact on morbidity and mortality worldwide as vaccines. The potential public health impact of cancer vaccines is particularly significant in developing countries, where limited resources make prevention, screening, and disease management especially challenging. Numerous strategies are being employed to improve access to cancer vaccines in low- and middle-income settings. These efforts are beginning to demonstrate impact on cancer rates, indicating how innovative mechanisms may be used to expand access to HPV and other future cancer vaccines in the decades to come.
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