Beating cervical cancer in the developing world is a huge undertaking and one that requires a fundamentally new way of approaching the problem - combining vital supply of vaccinations with demand for these vaccinations from the girls whose lives could be saved.
Let’s begin with the scale of the problem.
In a year’s time, hundreds of thousands of girls and women will have lost their lives to a disease that many of them aren’t even aware of.
Recent trends show that, without intervention, cervical cancer is set to overtake maternal mortality as the leading killer of adult women in developing countries.
More than 266,000 women are killed by cervical cancer each year. 85% of them live in the developing world.
Although these statistics make for difficult reading, what’s even more astonishing is that many of these lives could be saved by an efficient and cost-effective vaccine called HPV. A vaccine that’s often within reach.
So: what’s stopping girls from getting this vaccine?
Sometimes, girls don’t even know about it. In many cases, the last time they visited a health centre was when they were a baby.
Too often, negative social norms about what girls should and shouldn’t do, as well as myths and misconceptions, act as barriers preventing adolescent girls from accessing health services like HPV vaccines, even when they are available.
At times, this stems from their families, who don’t understand vaccinations or aren’t even aware they may be available. Sometimes, they get mixed messages from their friends. In some communities, services related to sexual and reproductive health have a stigma attached to them.
Girls can sometimes feel uncomfortable talking about their health, even amongst each other.
There is a critical need to address the underlying negative social norms that are preventing girls from accessing life-changing vaccines.
It has often been the case that major initiatives to transform girls’ health have focused on the supply side - making vaccines and health services available to them.While this is undoubtedly important, for a critical initiative like the HPV vaccine, making the vaccine available on its own will not necessarily do the job.
This is why Girl Effect and Gavi, the Vaccine Alliance, are partnering in an initiative to address this challenge in a new and pioneering way.
We recognise that, in order to make real and lasting change, supply and demand need to be integrated in a non-siloed, holistic approach. Enlightened thinking is absolutely critical here - and it’s thanks to people like Seth Berkley, the CEO of Gavi, who see the potential of combining demand generation through social norm change with supply side interventions that we’re able to pioneer this new way of tackling complex development challenges.
What do we mean by unlocking demand? At Girl Effect we do this by reframing what it means to be a girl in her community - inspiring, connecting and informing girls, helping to change their own perception of themselves and how they’re viewed by the people around them.
When we do this, we start to see shifts in perception and shifts in behaviour, where girls are actively supported by their communities, and where they’re visible, vocal and valued participants in society. A world where they have the information and inspiration they need and are not held back from seeking out and demanding the services they require to lead better, healthier lives.
We call this a ‘new normal’.
So, while Gavi will support countries in procuring the HPV vaccines to ensure supply is available, Girl Effect will unlock demand by catalysing and inspiring girls to get vaccinated.
We will do this by leveraging our culture brands, which are tangible assets in the countries where we work. Our brands are rooted in local culture, and reflect girls’ realities, their stories and the challenges they face every day. They create change from within - by girls, with girls and for all.
These brands work through integrating social and mass media - like radio shows and magazines - mobile apps, girl-driven insights and safe spaces, both virtual and analogue.
For example, Girl Effect’s brand in Rwanda Ni Nymapinga - meaning ‘beautiful girl inside and out’ in Kinyarwanda - is the country’s first youth brand, reaching about half of Rwanda’s entire population. It’s a magazine, mobile app, radio show, and safe spaces programme, created by girls and for girls. One of Ni Nyampinga’s most popular features in Baza Shangazi - the agony aunt, who gives Rwandan girls information and views about things they might be too embarrassed to talk about with parents and friends. Having Baza Shangazi discuss issues around vaccination and HPV will be extremely powerful in shifting perceptions and understanding.
At the same time, our Technology Enabled Girl Ambassadors (TEGAs), trained girl-researchers using mobile technology to better and more accurately collect data, will help us better understand the impact we’re having on the ground and how to better deploy our resources.
While our intention is to increase uptake of the HPV vaccine, longer term the partnership has a much bigger ambition. We want to leverage the power of culture brands to create greater trust in health systems, leading to more girls using integrated health services more often throughout their lives - especially as they become mothers of the next generation.
By opening the minds, hearts and actions of girls and their communities we can unlock demand, and help to deliver an experience that will make health interventions more efficient, focussed and incisive.
An audacious ambition requires a new, sometimes unusual and brave approach. That may just be the vital, missing ingredient to saving girls’ lives - now and in the future.