Johns Hopkins affiliate Jhpiego receives $914,000 from Bill & Melinda Gates Foundation
for cervical cancer prevention programs in Thailand and Ghana
08 September 2005
Baltimore, Md. – Jhpiego, an international
health affiliate of The Johns Hopkins University, has received a two-year award of
more than $914,000 from the Bill & Melinda Gates Foundation to continue life-saving
cervical cancer prevention work in Thailand and Ghana. Through the Cervical Cancer
Prevention Outcomes Project, Jhpiego will produce new findings on the feasibility,
effectiveness and sustainability of strategies to prevent cervical cancer in
low-resource settings.
Cervical cancer remains the number one cause of cancer deaths among
women in many developing countries. Each year more than 233,000 women worldwide die
from cervical cancer—the majority in developing countries, where approximately 80%
of deaths from cervical cancer occur. This disproportionate burden of disease results
from women's lack of access to affordable and effective services for prevention,
testing and treatment.
For the last 50 years, large-scale, cytology-based screening programs
(Pap smears) have contributed significantly to the marked reduction in the incidence
of cervical cancer among women in industrialized countries. But numerous obstacles
hamper developing countries in maintaining such programs, which require extensive
financial resources and health infrastructure.
Jhpiego has championed innovative approaches to cervical cancer
prevention in low-resource settings. Working closely with partners in Thailand and
Ghana, Jhpiego has demonstrated that innovative approaches are safe, acceptable and
cost-effective, and can be successfully implemented in developing countries.
For example, in 1999, researchers from Jhpiego and the University of
Zimbabwe helped to establish the feasibility of Visual Inspection with Acetic Acid (VIA),
as an acceptable alternative to Pap smears. This large-scale clinical study involved
more than 10,000 women attending primary health care clinics in Zimbabwe. It demonstrated
that VIA could identify true precancerous disease as well as or better than the
Pap smear. These results, published in The Lancet
(University of Zimbabwe/Jhpiego Cervical Cancer Project. Visual
inspection with acetic acid for cervical cancer screening: test qualities in a
primary care setting. Lancet. 1999;353:869-873) contributed to the growing
evidence base on VIA’s test qualities, and furthermore helped to demonstrate the
programmatic potential of cervical cancer prevention based on VIA.
In 1999, through the Alliance for Cervical Cancer Prevention, the
Bill & Melinda Gates Foundation awarded Jhpiego $10 million dollars to build on results
from the Zimbabwe study by exploring an innovative VIA-based approach to cervical
cancer prevention in low-resource settings. This approach—a single visit approach
linking VIA with the offer of immediate cryotherapy for abnormal cells that may be
precancerous—was assessed over a five-year period, through demonstration projects
in Thailand and Ghana. (During this period, Jhpiego also offered technical assistance
in cervical cancer prevention to partners in Malawi and Peru.)
In 2003 researchers from Jhpiego and the Royal Thai College of Obstetrics
& Gynaecology (RTCOG) reported that a single visit approach using VIA and cryotherapy is
safe, acceptable and feasible in low-resource settings (RTCOG/Jhpiego
Cervical Cancer Prevention Project. Safety, acceptability and feasibility of a Single
Visit Approach to cervical cancer prevention: results from a demonstration project in
rural Thailand. Lancet. 2003;361:814-819). As a result of these findings,
both Thailand and Ghana have endorsed a single visit approach using VIA and cryotherapy
as an acceptable alternative to cytology-based screening.
The Bill & Melinda Gates Foundation continues its support of Jhpiego's
global cervical cancer prevention efforts. With the new award, Jhpiego will conduct an
operations research study to assess programmatic outcomes of our demonstration projects
in Thailand and Ghana, which were supported by the earlier award from the Foundation.
This new project will assess trends in service utilization, and identify key
programmatic elements that influence screening coverage.
"We are very pleased that the Bill & Melinda Gates Foundation has been
so generous in supporting our innovative work in cervical cancer," said Dr. Leslie
Mancuso, President and CEO of Jhpiego. "This award has given Jhpiego the ability to
continue our efforts with partners in Thailand and Ghana to develop new evidence in
the fight against cervical cancer in low-resource countries. As a result, the lives
of countless women will be saved."
About Jhpiego
For nearly 40 years, Jhpiego, (pronounced "ja-pie-go"), has empowered front-line health
workers by designing and implementing simple, low-cost, hands-on solutions that
strengthen the delivery of health care services, following the
household-to-hospital continuum of care. We partner with community- to
national-level organizations to build sustainable, local capacity through
advocacy, policy and guidelines development, and quality and performance
improvement approaches.
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