The Cervical Cancer Elimination Movement

CERVICAL cancer is killing about 11 Filipino women every day, according to the World Health Organization.

Every two hours, cervical cancer will kill a mother, a wife, a daughter, or a friend.

According to data from the International Agency for Research on Cancer (IARC), next to breast cancer, “cervical cancer ranks as the 2nd most frequent cancer among women in Philippines and the 2nd most frequent cancer among women between 15 and 44 years of age.”

The data also shows global mortality statistics have increased and likely to continue growing with 90 percent of cases occurring in low- and middle-income countries because their female population has poor access to early detection, screening, and precancer and cancer treatment.

Thanks to innovative developments in cancer treatments, “Cervical cancer is one of the most preventable and successfully treatable forms of cancer, if it is detected and diagnosed early, and managed effectively.”

It is in these circumstances that the country’s cancer stakeholders have united to launch the Cervical Cancer Elimination Movement (CCEM) to push for the nationwide execution of the World Health Organization Global Strategy for the Elimination of Cervical Cancer released in 2020 to which the Philippines has signed on to implement.

The new advocacy was launched May 25 during the hybrid event organized by the Stratbase ADR Institute in partnership with Jhpiego Philppines, Cancer Coalition of the Philippines, and UHC Watch.

The strategy has a 3-pillar “90-70-90” approach that aims to accelerate the prevention, screening, and management of cervical cancer thru the full vaccination of 90 percent girls with Human papillomavirus (HPV) vaccine by 15 years old; 70 percent of women screened with a high-performance test by the age of 35, and again, by the age of 45; 90 percent of women with pre-cancerous lesions treated early, and 90 percent of women with invasive cancer receive treatment.

Stratbase ADRi President Prof. Victor Andres “Dindo” Manhit highlighted the importance of partnerships, advocacy, communication, and the role of civil society, women’s groups, non-government organizations, and local networks to the successful uptake of health services at the community level.

“Effective advocacy and communication strategies can overcome the many challenges that impede access to and use of cervical cancer prevention and care services, if culturally relevant and contextspecific content is produced. Such strategies should reflect national policy and be integrated into all levels of the health system,” Manhit said.

Dr. Efren Domingo, President of the Philippine Obstetrical and Gynecological Society said, “The utility of the cervical cancer screening program unfortunately is low still in this country. And there is a need to increase the budget as well as to convince the government to put in personnel as well instrumentations necessary to achieve the goal.”

Manager of Jhpiego Philippines said that “that cervical cancer is caused by a virus and that virus affecting our body can be prevented, just like what we have done with COVID-19 virus.”

“Let’s not be caught with the hype of this month of May (Cervical Cancer Month) celebration but rather, let’s take, let’s look at this as a continuing approach, or actions that we need to do.”

“We have a long way to go so in terms of vaccination, in terms of vaccination, in terms of women who are screened … If this country wants to move towards cervical cancer elimination, we have to have good data… be systematic on how we are going to move forward this vision to have cervical cancer eliminated in the Philippines,” Magnata said.

WHO Country Representative, Dr. Rui Paulo De Jesus for his part said that “deaths are unnecessary because there is compelling evidence that cervical cancer is one of the most preventable and treatable forms of cancer if this is detected early and managed effectively.”

“It is important to introduce vaccination early and the target should really be to include it in the community as well as in the school venues,” Domingo said.

Dr. Jan Aura Laurelle Llavado, DOH Cancer Control & Mental Health Division Division Chief pointed out that going to 2022 the Philippines “really stumbled with our vaccination rates” A key factor that she identified is that though there is budget for treatment and management, there is no budget for screening or even training for screening.

“One of the things that we should really communicate with our legislators, (is) that if you give us budget, give us budget for the entire continuum of care,” Llavado said.

Dr. Ingrid Magnata, Country Program

Chinese diaspora bears brunt of Canada-China tensions

for Democracy in China, told AFP recently.

Kwan, clad in a black leather jacket, said this includes “death threats, verbal intimidation, or something as simple as saying: ‘We know where your parents live.’”

Dilnur Anwar, a Uyghur who fled persecution in China and moved to Canada in 2019, has experienced such calls firsthand for years —on an almost daily basis.

“I blocked the (phone) numbers but it doesn’t change anything because they call all the time using other numbers,” said the woman, who now lives in Montreal.

“Sometimes I’m asked to come to the embassy, sometimes it’s an automated message,” she explained.

“I’m very worried because I haven’t heard from my family in six years.”

‘We have lived in fear’

Ottawa and Beijing have been at loggerheads since 2018, when a Huawei executive was arrested on a US warrant in Vancouver and two Canadian nationals were detained in China in apparent retaliation.

Then there was the COVID-19 pandemic, Chinese “spy balloons” over North America, clandestine Chinese police stations

A top Canadian official also concluded that China sought to interfere in Canada’s 2019 and 2021 elections discovered in Canadian cities and allegations of Beijing’s interference in Canada’s elections.

Canada’s Chinese immigrants and their descendants often endure extra scrutiny amid such controversies.

“We will always be deemed to be from China, even though many of us have no connections with China,” lamented Amy Go, co-founder of the Chinese Canadian National Council for Social Justice.

“In the past, we have lived in fear,” several dozen Chinese-Canadian associations wrote in an open letter recalling discrimination faced by early Chinese immigrants to North America.

“Today, let’s not let it happen again.”

“In recent years, the social pressure exerted on members of our community is such that it is difficult to remain insensitive to it,” they continued, pointing to diplomatic tensions that “are now having a direct impact on our community.” The first immigrants from China settled in Canada more than 200 years ago. Several waves followed, notably at the end of the 19th century to help build Canada’s transcontinental railway.

The Canadian Pacific Railroad united a nascent country, but at a severe cost:

Hundreds of Chinese workers died from accidents, winter cold, illness and malnutrition.

Today nearly 1.7 million Canadians, almost five percent of the population, trace their roots to China, census figures show.

‘Tip of the iceberg’

There is an urgent need for Ottawa to act to

“The WHO Philippines reaffirms its commitment to the Philippine government, through the Department of Health on cancer prevention and control. Our team will continue to provide evidence-based technical guidance to implement strategic actions to reduce the cancer burden in the country,” stem a recent rise in racism, many members of the community believe.

Dr. Fatima Gimenez, President of Pediatric Infectious Disease Society shared findings of their survey showing vaccine hesitancy because of cost and fear and emphasized the need to work on acceptance and understanding to reach the grassroots level.

The key message of this advocacy is that no one has to die of cervical cancer for the simple reason that vaccines are available. Investing on HPV vaccines is more cost effective that paying for treatments. Something legislators should keep in mind when they take up the budget for the Cancer Assistance Fund for 2023.

It is also important that the government “ensure that Canadians, but also newcomers, are not interviewed (by Chinese agents) or potentially exposed to risks or threats from foreign countries,” said Go.

Ottawa has been gripped of late by revelations that a Canadian MP, Michael Chong, and his relatives in Hong Kong were targeted by Beijing for sanctions over his strong criticisms of China.

On Tuesday, a top Canadian official also concluded that China sought to interfere in Canada’s 2019 and 2021 elections.

Beijing has rejected both accusations as “groundless slander and defamation,” and warned Ottawa against seeking to “sabotage” relations with its second-largest trading partner.

Meanwhile, intimidation like that faced by Anwar, the Uyghur woman in Montreal, might be more extensive than realized, the Toronto association’s Kwan said.

This sort of behavior by China is only “the tip of the iceberg,” he suggested. “We don’t see 90 percent of the iceberg.” AFP