Rwanda to use technology to boost access to cervical cancer treatment

Rwanda is among high burden cervical cancer countries with an incident rate of 31.9 per 100,000 women and a mortality rate of 24.1 for every 100,000 last year.
Lelio Marmora (L) the Executive Director of UNITAID signs the deal with minister Diane Gashumba.

After registering 93 per cent coverage of vaccination against cervical cancer, Rwanda has signed a deal aimed at rolling out new technologies to improve accessibility to screening and diagnosis of the disease.

On Tuesday, a grant was signed between the Ministry of Health, the Clinton Health Access Initiative (CHAI) and the International Drug Purchase Facility (UNITAID) to make Rwanda part of the USD24 million pilot aimed at using new technologies to improve access to screening of cervical cancer.

The project is being rolled out in five other countries from Africa and Asia.

Rwanda is among high burden cervical cancer countries with an incident rate of 31.9 per 100,000 women and a mortality rate of 24.1 for every 100,000 last year.

1,304 new cases of cervical cancer were registered in 2018, and 921 deaths were registered.

In Rwanda, the two and half year project will be piloted in 77 health centres and seven hospitals in six districts of Gatsibo, Nyamasheke, Musanze, Huye and Nyarugenge.

As part of the project, the medical facilities will receive mobile testing and treatment equipment; as well as trainings for local care providers so that they can continue providing services at the end of the campaign.

In the pilot period, 72,000 women are expected to be screened for the Human Papillomavirus across the five districts.

According to officials, the findings from the five districts where the project will be piloted will inform the decision to scale it up to all health facilities in all parts of the country.

Other countries where the project will be piloted are Malawi, Nigeria, South Africa, Kenya, and India.

The main target group are women in the high-risk age group of 30-49 year bracket.

In Rwanda, the programme is expected to start towards the end of this month with training of health care providers and procurement of laboratory equipment and other necessary materials.

Screening will start by October.

Dr. Diane Gahumba, the Minister of Health said that the programme will give opportunity for women in the targeted age bracket to be screened, and if found positive get treatment.

Under the programme, women who will test positive will be treated for precancerous lesions at health centres. However, cases with high suspicion of invasive cancer will be referred to referral hospitals for further investigations and management.

The programme will also prioritise women living with HIV enrolled in help facilities located in the pilot districts, since women living with HIV are about five times more likely to develop invasive cervical cancers.

Use of artificial intelligence

It will also see mobile screening teams composed of doctors, nurses, laboratory technicians go to different facilities for sample collection, testing and treatment of those found to be positive.

Commenting about the project, Lelio Marmora the Executive Director of UNITAID said that the project is “revolutionary,” since among other things, it will employ artificial intelligence where mobile phones will be used in diagnosis.

He said that one of the reasons Rwanda is among the countries selected is the government’s capacity to deliver; the presence of “a very solid and sustainable health structure” that is very close to the patients; and the incredible responsiveness of the population.

Today, cancer accounts for about one in every six deaths worldwide – more than HIV/AIDS, tuberculosis, and malaria combined.

In 2018, there were an estimated 18.1 million new cancer cases and 9.5 million cancer deaths were estimated worldwide, and this number increased from 14.1 million new cases and 8.2 million deaths in 2012.

Cervical cancer is the top fourth affecting women globally, contributing to 6.6% of all cancers in women. As it is the case with many other diseases, cervical cancer disproportionately affects the poorest populations.