...In recent decades, routine screening programmes have reduced cervical cancer morbidity and mortality in high-income countries, and this trend is expected to accelerate as vaccination coverage is scaled up. As a result, 77% of new cases and 88% of deaths from the disease now occur in developing countries.A five-year delay in introducing the HPV vaccine to these countries would result in 1.5 to 2 million preventable deaths.

Cervical cancer is the most common cancer among women in Rwanda,a country in eastern African with more than 11 million inhabitants. In 2010, 986 cases of cervical cancer were diagnosed in Rwanda and 678 women died from the disease. That same year, Rwanda evaluated options for HPV vaccination rollout and decided to pursue a partnership with Merck to offer Rwanda’s young girls the opportunity to receive a life-saving vaccine.

A growing body of scientific literature has emerged in recent years concerning the use of the HPV vaccine in the developing world,but very little evidence on the success and replicability of nationwide delivery programmes, like Rwanda’s, has been published. In this article, the authors describe the process by which Rwanda became the world’s first low-income country to provide universal access to the HPV vaccine.

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