cervical cancer: global facts to file

Cervical cancer is central to the emerging cancer pandemic in low- and middle-income countries. This malignancy is caused by a chronic infection of selected types of the human papilloma virus (HPV). In 2008 cervical cancer was the fourth leading cause of cancer death in women worldwide, and the leading cause of cancer death in Africa and Southeast Asia.  The number of lives lost to this preventable disease is a global failure of the largest scale if one considers that the health system in western and high income countries have developed very efficient programmes to prevent, detect, and treat cervical cancer which, in fact, have reduced disease incidence and mortality. In 2008, cervical cancer caused an estimated 275,100 deaths globally. Ninety percent of these deaths occurred in developing parts of the world, where access to screening and treatment are often non-existent and adolescent girls are not receiving vaccination for HPV. The HPV vaccine represents a major tool for primary prevention of the disease as it can prevent up to 70 percent of cervical cancer cases. Moreover, cost-effective procedures are now available to detect and treat cervical pre-cancer thus promoting secondary prevention. We ought to promote public awareness about cervical cancer in African countries, educate health professionals, and improve access to screening.  Issues that are critical to cervical cancer screening are public awareness (by women and local general practitioners), diagnostic capacity (in terms of availability of properly trained people in cytology and gynaecologists capable of managing cervical cancer and precancer), updating treatment modalities and outlets, the network of referral centres, and HIV coinfection.

countdown to zero cases of newborn HIV infections

A baby is born with HIV nearly every minute, almost all of them in sub-Saharan Africa. In 2009, an estimated 370,000 children were infected at birth with HIV, almost all in low- and middle-income countries. The United Nations (UN) and the United States (US) government have recently launched an initiative to eliminate HIV among babies by 2015 by treating HIV-positive pregnant women, cutting infection among their babies to less than 5%. The plan, called Countdown to Zero, was developed by a team led by UNAids and the US President's Emergency Plan for AIDS Relief. It will cost an estimated $2.5bn (£1.5bn) to care for 15 million women, double those currently being treated. A key element of the campaign is to ensure that all women, especially pregnant ones, have access to quality life-saving HIV prevention and treatment services for themselves and their children. Achieving the goal could be "the beginning of the end of the story, because that opens the prospect for an Aids-free generation," said Michel Kazatchkine, head of the Global Fund to Fight AIDS, Tuberculosis and Malaria."We are here today to ensure that all children are born healthy and free of disease. We are here to ensure that their mothers live to see them grow," UN Secretary General Ban Ki-moon said at the launch of the plan."We believe that by 2015 children everywhere can be born free of HIV and that their mothers can remain healthy," said Michel Sidibe, executive director of UNAids.  Cutting the number of new cases of HIV infection will also play a major role in reducing the number of immunodepression-related cancers in the developing world. In women, it will result in the reduction of new cases of cancer of the uterine cervix as HIV and HPV coinfection represents a major risk for the tumor to develop and behave aggressively. An HIV-infection free generation is really a major goal for mankind. 

Quasi ogni minuto nell’Africa sub sahariana nasce un bambino portatore di infezione da HIV acquisita per trasmissione materno-fetale. Si stima che nel 2009 ne siano nati 370000, la maggioranza di essi nei Paesi in via di sviluppo. I governi delle Nazioni Unite e degli Stati Uniti hanno recentemente lanciato l’iniziativa di ridurre per il 2015 l’incidenza di infezione neonatale da HIV al di sotto del 5%. Per fare ciò si tenterà di fornire alle donne Africane, in particolar modo quelle in gravidanza, l' accesso a cure efficaci dell'infezione con l’intento di trattare soprattutto i loro bambini. Questo programma denominato “cowntdown to zero” è stato concepito dalla UNAids e dal Piano di Emergenza anti-AIDS del Presidente degli Stati Uniti, dovrebbe interessare 15 milioni di donne e costerà 2.5 miliardi di dollari. Ottenere questo risultato potrebbe rappresentare l’inizio della fine dell’AIDS e la creazione della prima generazione Africana senza la malattia. La riduzione dell’incidenza dei nuovi casi di AIDS contribuirà inoltre ad abbattere l'incidenza dei tumori correlati all’immunodeficienza acquisita che colpiscono duramente le popolazioni dei paesi più poveri. Per ciò che riguarda le donne si potrà anche verificare la riduzione dei nuovi casi di carcinoma della cervice uterina in quanto questo tumore, dovuto all'infezione cronica da virus papilloma umano (HPV), si sviluppa con particolare frequenza nelle donne portatrici di infezione da HIV. In conclusione, la sconfitta dell’AIDS rappresenta un obiettivo primario per l’umanità intera.