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The Lancet

Cervical cancer is the most common cancer in women in sub-Saharan Africa and is a leading cause of death in women in southern Africa. The disease is a prime example of global inequality in health. Mortality from cervical cancer in developed countries is substantially lower than in developing nations because of the availability of prevention, early detection, and treatment. How vast is the gap in services? A new report by the Southern Africa Litigation Centre (SALC), which promotes and advances human rights in the region, assessed this issue, examining policies and services for cervical cancer in Namibia and Zambia.

They found that neither country has a comprehensive national policy on cervical cancer. Vaccines against the human papillomaviruses that cause cervical cancer are not available (as in the rest of the region). Meanwhile, screening services are absent or infrequently available, apart from in major cities. Both countries have a dearth of treatment options, with hysterectomy being the most prevalent form of treatment. Few treatment options are available to women who want to preserve their fertility. Poor laboratory facilities and personnel shortages mean that treatment options are often chosen without a proper diagnosis or adequate information. Furthermore, neither Namibia nor Zambia had a comprehensive national palliative care policy. The report concludes that failure to provide access to cervical cancer services results in the violation of fundamental rights and recommends that southern African countries develop comprehensive national policies on cervical cancer management.

In 2009, The Lancet noted a growing trend for human rights groups such as Amnesty to work on health issues.  That such work is continuing with groups such as SALC at a regional level is welcome. National cervical cancer plans would certainly help address the urgent need to improve services for the disease in the region. The medical profession in southern African nations should assist their governments in developing these plans to ensure they are evidence based. They must also work with legal groups to promote one of the most neglected rights—the right to the highest level of health—for cervical cancer and other diseases. The Lancet



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