1. Introduction

Launched by the WHO on November 17, 2020, this is the first global health strategy to target the elimination of a cancer as a public health problem. It represents a coordinated global effort to reduce the burden of a disease that is almost entirely preventable and curable if detected early.

2. The "Elimination" Threshold

Cervical cancer is considered "eliminated" as a public health problem when all countries reach an annual incidence rate of $\le$ 4 cases per 100,000 women.

3. The "90-70-90" Targets (By 2030)

To reach the elimination goal within the century, every country must meet three key targets by the year 2030:

• 90% Vaccination (Primary Prevention): 90% of girls should be fully vaccinated with the HPV vaccine by the age of 15 years.
• 70% Screening (Secondary Prevention): 70% of women should be screened using a high-performance test (e.g., HPV DNA test) at least twice in their lifetime—once by age 35 and again by age 45.
• 90% Treatment (Tertiary Prevention): 90% of women identified with cervical disease should receive treatment:

• • 90% of women with pre-cancer treated.

  • 90% of women with invasive cancer managed with surgery, radiotherapy, chemotherapy, and palliative care.

     

4. The Three-Pillar Approach

The strategy is built on three interconnected pillars that must be implemented simultaneously:

1. Prevention: Expanding HPV vaccination.
2. Screening: Transitioning from cytology (Pap smear) to High-Performance HPV DNA testing, which has higher sensitivity and allows for longer screening intervals (every 5-10 years).
3. Treatment: Strengthening surgical, oncological, and palliative care services to ensure those diagnosed are not just identified but cured.

5. Significance of "High-Performance Tests"

The WHO recommends HPV DNA testing over Visual Inspection with Acetic Acid (VIA) or Cytology (Pap) because it is more objective, allows for self-sampling (increasing coverage), and is more effective at detecting high-risk HPV strains (16 and 18).

6. Expected Impact

• Short-term (By 2030): Avert an estimated 300,000 deaths.
• Long-term: Reduce the median cervical cancer incidence rate by 42% by 2045 and by 95% by 2120, preventing over 62 million deaths worldwide.