Cervical cancer is an example of a glaring health disparity between wealthy and poor countries, and remains an immediate health threat to many women in low- and middle-income countries (LMICs). Evidence-based, cost-effective protocols recommended by the World Health Organization have not been widely implemented due to limited health care infrastructure augmented by a lack of funding and political will. Although there are some unique factors contributing to the disparity in cervical cancer outcomes between high and LMICs, there are some common root causes shared across health systems: poor health care infrastructure, lack of awareness of early signs or symptoms, lack of funding prioritization within local governments, and limited operationalization of proven technologies used in high-income countries. These root causes must be addressed through both innovation and adaptation of successful interventions to fit the target community and the priorities of local governments (i.e. be both low-cost and cost-effective). To achieve this, clinicians and researchers need to partner with policy experts and implementers to ensure that effective interventions reach the target communities in a way that is both sustainable and has high impact. The challenge of adapting programs and solutions to fit individual communities is not a unique challenge to cervical cancer prevention. Multi-discipline discussions are needed to address the challenge of identifying novel technologies, programs and health policy changes that can address health disparities.
At the Triangle Global Health Consortium Annual Conference in September, a team of Duke and UNC researchers convened a panel to discuss how the strategies they have employed to impact cervical cancer can be translated to address other global health disparities. This panel illustrated the strengths of using a multi-disciplinary approach to address health disparities, with a focus on impacting the social determinants of health that lead to cervical cancer. The panel included experts in innovative health technologies (Nimmi Ramanujam), health disparities research (Gita Suneja), health policy and financing (Gavin Yamey), and HPV epidemiology (Jennifer Smith). The panel was moderated by a researcher with a longtime focus on challenges in implementing cervical cancer prevention programs (Megan Huchko). The panel addressed the interplay between the social, political and economic factors that determine cervical cancer outcomes, and how this interplay may be used to impact other global health disparities. This lively panel was well-attended and will hopefully inspire a coalition of people interested in addressing the remaining challenges to achieving an end to cervical cancer in this generation.