Nigeria Hits 76% of HPV Vaccination Goal, Inoculates Over 18 Million Girls

More than 18 million adolescent girls in Nigeria have received the Human Papillomavirus vaccine, the Federal Government has said, putting the country at roughly 76 per cent of its target population as it pushes to eradicate cervical cancer.

Dr Rufai Garba, Director of Disease Control and Immunisation at the National Primary Health Care Development Agency, made the disclosure on Tuesday in Abuja during a strategic policy roundtable. The event was organised by MSD alongside Africa Health Business under the theme "Accelerating Cervical Cancer Elimination in Nigeria: Uniting Public and Private Sectors for Equitable Access."

Discussions at the meeting centred on widening HPV vaccination coverage, easing access to screening and treatment, and deepening cooperation between government and private actors.

Garba noted that Nigeria has made considerable headway since adding the HPV vaccine to its national immunisation schedule in October 2023, but warned that immunisation on its own cannot wipe out cervical cancer.

"Today, we are around 76 per cent coverage of our target, but in terms of numbers, we have crossed 18 million adolescent girls, which is equivalent to three countries in Africa," he said.

The first phase of the rollout, launched in October 2023, aimed at 7.7 million girls aged nine to 14, with backing from Gavi, UNICEF, WHO and other partners. The programme was later extended across the country.

HPV infection is the leading cause of cervical cancer, and vaccination alongside routine screening remains central to prevention. The World Health Organization's elimination strategy sets a 90-70-90 goal: fully vaccinating 90 per cent of girls against HPV by age 15, screening 70 per cent of women by ages 35 and 45, and ensuring 90 per cent of women with pre-cancer or invasive cancer receive appropriate treatment.

International figures indicate Nigeria still faces a heavy cervical cancer burden. The International Agency for Research on Cancer estimated 13,676 new cases and 7,093 deaths in the country in 2023.

Garba said the vaccine is offered at no cost to eligible nine-year-old girls at public health facilities, while private facilities may vaccinate those outside the routine target age.

He stated that Nigeria records approximately 12,000 new cervical cancer cases each year, with close to 8,000 women dying annually from the disease.

"We see around 12,000 new cases every year in Nigeria, and we lose close to 8,000 women on a yearly basis. So, that's how serious it is," he said.

He stressed that the response must go beyond vaccination to include screening, early diagnosis, treatment and follow-up.

"It is not just the vaccination, which NPHCDA does, but also how we are able to get women to screen them, to catch them early, treat them and follow them up till they actually get better," he said.

Among the obstacles, Garba identified the challenge of bringing healthy nine-year-old girls into health facilities for preventive vaccination. To address this, he said the agency has turned to school-based vaccination, outreach campaigns and other public health measures to boost access and coverage.

He also advocated for adolescent-friendly health services, including safe spaces where young people can seek preventive care without fear of stigma.

On reports of vaccine shortages in certain states, Garba said the agency tracks stock levels and consumption via a logistics dashboard, enabling redistribution of doses to states with greater demand.

He described Nigeria's cold-chain system as robust, noting that solar-powered equipment has been installed at some primary healthcare centres, though expansion to more locations is still underway.

Garba further encouraged journalists to probe allegations that private health facilities are charging patients for HPV vaccines that the government provides free of charge.

"All of the health facilities that conduct routine immunisation have HPV vaccines. We give them," he said.

He acknowledged that the agency lacks enforcement authority, but said it can cut off supplies to facilities caught selling government-provided vaccines.

"We will need you guys to bust that story. Unfortunately, NPHCDA does not have enforcement powers, but what we can do is we can stop giving them vaccines when we find out that they're selling vaccines that are supposed to be free," he added.

Also speaking, Vuyo Mjekula, Director of External Affairs for Sub-Saharan Africa at MSD, urged greater private-sector engagement in Nigeria's cervical cancer elimination drive, arguing that an integrated approach is needed to preserve vaccination gains and broaden access to screening and treatment.

Mjekula said the roundtable was intended to pinpoint practical avenues for investment, partnerships and coordinated action involving government agencies, healthcare providers, civil society organisations and private companies.

She acknowledged that Nigeria's HPV vaccination programme has achieved significant progress since its launch, but noted that gaps persist along the broader cancer-care continuum.

"The main thing was, how do we build upon that foundation and even the work of these various task groups? And one of the areas which we believe was a gap or is a gap is we see that there's a great opportunity for the increased involvement of the private sector," she said.

According to Mjekula, private-sector participation could help draw in additional resources, enhance service delivery and reduce fragmentation across existing programmes.

She made the case for embedding preventive healthcare within routine maternal and reproductive health services, so that women can access screening and other interventions during regular visits.

"We don't look at women in a siloed way," she said.

She also pushed for private-sector representatives to sit on relevant national cervical cancer task forces, partnerships and technical working groups to improve coordination.

Mjekula revealed that MSD has backed catch-up HPV vaccination for girls up to age 20 who were missed when Nigeria rolled out its national programme.

She added that the company is collaborating with Gavi and UNICEF to advance access to higher-valency HPV vaccines in Africa.

Over the past decade, she said, MSD has invested more than $44m in Nigeria through its MSD for Mothers initiative, supporting civil society organisations active in maternal healthcare.

She also said the company is working with City Cancer Challenge in Abuja to identify gaps and devise solutions for improving oncology services.

In another presentation, Dr Usman Muhammad Waziri, Director of Cancer Prevention and Control at the National Institute for Cancer Research and Treatment, said insufficient awareness, cost barriers and limited access to quality healthcare continue to hamper cancer prevention and treatment in Nigeria.

Waziri, who stood in for the institute's Director-General, Professor Usman Malami Aliyu, said NICRAT is partnering with government agencies, international partners and other stakeholders to bolster cancer prevention, research, screening, treatment and palliative care.

He noted that financial difficulties often stop patients from seeking care early, raising the odds of presenting at advanced stages of the disease.

"Affordability, because when people decide late, even if they go to the best of facilities, the disease will be late-stage," he said.

Waziri said the institute is working with the American Association for Cancer Research and other organisations to craft a community cancer communication strategy aimed at deepening public understanding of the disease.

He said the effort would tackle misconceptions and beliefs that deter people from seeking appropriate medical care.

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