Human papillomavirus: role of HPV2 and HPV9 in reducing the burden of cervical cancer in sub-Saharan Africa

Abstract

Cervical cancer remains a leading cause of death among women in sub-Saharan Africa, accounting for nearly a quarter of global deaths from this disease. Its high incidence is due to the high prevalence of HIV, the persistence of human papillomavirus (HPV) infections, and inadequate screening and treatment systems. Prophylactic HPV vaccines, notably Cervarix® (bivalent) and Gardasil 9® (nonavalent), have profoundly transformed primary prevention of cervical cancer. Cervarix® targets genotypes 16 and 18, which are responsible for 70% of cervical cancers, while Gardasil 9® offers broad coverage against nine oncogenic HPV types, preventing up to 90% of invasive cancers. Major clinical trials have demonstrated efficacy exceeding 90% against precancerous lesions, even after a single dose. However, the implementation of vaccination programs in sub-Saharan Africa remains hampered by logistical, economic, and socio-cultural constraints. Integrating vaccination into school curricula, strengthening cold chains, and combating misinformation are essential levers for increasing vaccination coverage. A coordinated strategy between governments, international partners, and local communities is indispensable to achieving the WHO's goal of eliminating cervical cancer by 2030.