Sixteen women die from cervical cancer every day in South Africa; a sobering reality which calls for authorities to take stock of its approach to the disease.
In May 2025, South Africa and Nigeria successfully sponsored a World Health Assembly resolution declaring 17 November as World Cervical Cancer Elimination Day. A proud achievement, but if we are serious about elimination, we must take stock of our own progress, writes Salomé Meyer in Daily Maverick.
Cervical cancer is South Africa’s second-most-common cancer among women, predominantly affecting black women who rely on public health services. The National Cancer Registry reported 7 644 new cases in 2023; a lifetime risk of one in 27.
The reality behind these statistics is sobering: 29 women are diagnosed with cervical cancer every day – one every 82 minutes; and 16 women die of the disease daily – one every 67 minutes.
The late Professor Lyn Denny reminded us that “no woman should die of cervical cancer because she did not have the opportunity to be screened”.
Bur we need to consider the reality.
90% of girls vaccinated by 2030
South Africa’s school-based HPV vaccination programme, launched in 2014, remains a global success story. The 2024 transition to the WHO-recommended one-dose strategy expanded access to private schools and enabled catch-up for those missed during Covid-19. With a reported 83% vaccination rate, we are on track, but can still do better.
However, we continue to use the bivalent vaccine, missing the opportunity to transition to the nonavalent vaccine, which provides broader protection. This was detailed in a recent policy brief submitted to the Department of Health before the 2027 HPV vaccine tender closed.
70% of women screened with a high-performance test
Despite a cervical cancer policy dating to 1998, South Africa’s screening coverage is only 38%. The system remains inefficient – women often make many clinic visits before receiving care, burdened by transport costs and lost income.
While several provinces have shifted to HPV DNA testing, the potential of self-sampling, proven successful in countries such as Malaysia through Program ROSE, remains largely untapped.
In Global Fund Round 6, nearly R15m allocated for self-sampling pilots was returned unspent as the Networking HIV and Aids Community of Southern Africa (Nacosa), the Aids Foundation SA and Beyond Zero failed to act, effectively deprioritising cervical cancer.
Yogan Pillay has proposed an integrated approach to South Africa’s HIV response, a crucial step, given that we have 5.3m women with HIV. These women must be prioritised for regular HPV screening as part of a comprehensive prevention and treatment pathway.
Integration is not optional; it is essential. In Round 7, only R3.5m has been reallocated to Nacosa and the Centre for Community Impact for cervical cancer screening through self-sampling. Whether they will deliver remains to be seen.
With R70m from the Lotto allocated to the South African National Aids Council (Sanac), civil society has urged Sanac – in the spirit of Mphare ke go phare (you do your part as we have done ours) – to match these funds and show genuine commitment to the Cervical Cancer Elimination Strategy, being launched this month.
90% of women treated for pre-cancer or invasive disease
Access to timely treatment remains dismal. Women wait three to nine months for a colposcopy at tertiary hospitals. The consequences are deadly.
Implementing a “screen and treat” approach using thermal ablation at primary health facilities is essential. Unitaid is investing in this model, funding equipment across seven provinces over two years.
However, for this to succeed, the South African Nursing Council must recognise thermal ablation as part of registered nurses’ core competencies backed by provincial training and funding. Encouragingly, the Eastern Cape is already leading by example.
US funding cuts have also affected critical research projects such as the Khayelitsha Screening Project and the Clinical HIV Research Unit, which played key roles in building evidence for integrated screening models. These cuts further undermine the country’s capacity to innovate and scale what works.
A call to act now
The Cervical Cancer Elimination Strategy, initiated by the Cancer Alliance through a 2022 Solution Lab, will finally be launched this month with a proposed budget of R1.6m for a public event the Department of Health cannot afford.
Instead of costly launches, we should convene the nation’s top experts on the three elimination pillars at a media roundtable focused on accountability and solutions.
Furthermore, instead of spending on a launch, we should walk the talk and use those funds to vaccinate women with HIV who have been missed by the national programme.
That would demonstrate real commitment to elimination, not just celebration.
South Africa can and must do better.
If we are to honour our commitments and save women’s lives, we must move beyond declarations and start delivering on action.
Salomé Meyer is an activist associated with the Cancer Alliance.
See more from MedicalBrief archives:
Low screening, weak referrals, drive SA’s high cervical cancer rates
Cervical cancer self-screening the answer to reduce fatalities
Vaccine could have prevented over 90% of HPV-related cancers