A study in change - South Africa’s next chapter in cervical cancer elimination

By Merilynn Steenkamp, Managing Director, Southern Africa, Multi-Country Network, Roche Diagnostics

As a nation, South Africans have proved consistently that we are willing to enable meaningful change. This is a significant point of pride for many of us, and unique to the national mindset.

Cervical cancer is the second-most common cancer affecting women in South Africa, and one of the few that is largely preventable. It is also notable that cervical cancer is the leading cause of women’s cancer-related mortality in our country1.

Cervical cancer is caused by persistent infection with the human papillomavirus, or HPV, a common virus transmitted through intimate or skin-to-skin contact. When detected early, however, cervical cancer is highly treatable, and in many cases, can be prevented altogether through vaccination and/or screening1.

However, if cervical cancer is not diagnosed at an earlier stage, choices narrow, and treatment becomes harder, negatively affecting outcomes. This is not a question of knowledge or intent. It is a question of whether prevention and early detection reach women in time2.

This is where South Africans have a new opportunity to effect change now. And, true to form, they are paying attention.

Changing the conversation

Having recently joined discussions at the G20 Summit and at sideline events (B20 and the European House Ambrosetti (TEHA) CEO Dialogue), I saw firsthand that our national dialogue has shifted. Policy alignment has deepened and cervical cancer is now firmly recognised as a priority linked to women’s health, equity and long-term development.

In healthcare, the space between what we know and what reaches patients is where outcomes are decided. South Africa is now working in that space. The conversation has moved on from whether cervical cancer can be eliminated to how that goal is delivered through the health system.

South Africa is formally aligned with the World Health Organization’s global framework to eliminate cervical cancer, and our government is moving toward a formal national strategic framework for cervical cancer elimination, building on recent high-level dialogue and policy alignment3.

From commitment to delivery

The next phase of South Africa’s cervical cancer response is about coordination. Turning national intent into action requires clarity on how screening is organised, how women move from testing to follow-up care and how different parts of the health system work together. 

Cervical cancer has long been an example of the importance of early diagnosis and accessible screening. Strengthening those pathways means making screening simple to access, trusted by communities and clearly linked to care when results require follow-up4.

Screening as the point of change

HPV vaccination remains essential for long-term prevention. At the same time, screening offers the most immediate opportunity to change outcomes for women who are already at risk.

South Africa has a strong foundation to build on. Molecular diagnostic capacity is already embedded across the country through the National Health Laboratory Service. These platforms support large-scale testing every day and are familiar to healthcare workers. Using existing infrastructure allows screening to expand in a way that is sustainable and practical.

This focus supports universal health coverage by strengthening systems rather than creating parallel ones. Screening works best when it is easy to reach and clearly connected to treatment.

Designing access that works for women

Time away from work, distance to clinics and uncertainty around procedures all influence whether women come forward for screening.

Self-sampling has an important role within the screening ecosystem, offering women greater choice while supporting reach and participation. While this is not a replacement for clinical care, it is a complementary access route that can help bring more women into screening programmes when implemented alongside clear referral pathways.

What progress looks like

Globally, momentum around cervical cancer elimination continues to grow. The World Health Assembly’s endorsement of a World Cervical Cancer Elimination Day signals growing international focus, with South Africa contributing to that agenda4.

At home, progress will be measured in practical ways. By screening that reaches women earlier, clear pathways from testing to treatment and systems that work together across provinces and levels of care.

Dr Precious Moloi-Motsepe, a prominent South African physician, philanthropist and entrepreneur, is quoted as saying, “Change, and advocacy, by men and women begins within our immediate household and workplace environments.” 

Circling back to South Africa’s “super power” this is how we can take the power back from cervical cancer. We can remind those we care about to get tested, vaccinate their children and tell others to do the same. 

Cervical cancer will not disappear overnight. But when screening becomes routine, accessible and trusted, fewer women will learn about the disease only when symptoms can no longer be ignored. That is how commitment becomes care, and how elimination moves from intention to lived reality.

References

1. Cancer Association of South Africa (CANSA). Cervical cancer. https://cansa.org.za/cervical-cancer/ 

2. University of Pretoria. Women’s Month: New plan to close South Africa’s cervical cancer and STI diagnosis gap. https://www.up.ac.za/news/expert-opinion-womens-month-new-plan-close-south-africas-cervical-cancer-and-sti-diagnosis-gap 

3. National Department of Health. Cervical cancer elimination is critical to advancing gender equality, poverty reduction and global health goals (27 March 2025). https://www.health.gov.za/wp-content/uploads/2025/03/Cervical-cancer-elimination-is-critical-to-advancing-gender-equality-poverty-reduction-and-global-health-goals-27-March-2025.pdf 

4. World Health Organization Regional Office for Africa. World Health Assembly endorses 17 November as World Cervical Cancer Elimination Day. https://www.afro.who.int/countries/south-africa/news/world-health-assembly-endorses-17-november-world-cervical-cancer-elimination-day-south-africa-and