- Reduce deaths from cervical cancer by 25% among women screened and treated in partner countries;
- Achieve at least 80% coverage of vaccination against the human papillomavirus (HPV);
- Reach at least 80% coverage of screening and treatment for pre-invasive cervical cancer cases within the appropriate target populations;
- Increase awareness of, and reduce stigma about, breast and cervical cancer among the health community and the general population, and promote the early detection of disease;
- Screen, detect, treat, manage, and reduce suffering from women’s cancers, by leveraging other health platforms, including for HIV;
- Create and test innovative models and approaches to sustainability, financing, service delivery, and laboratory and data systems that can be scaled up and used globally.
What are the health needs and challenges?
Cervical cancer is the most common women’s cancer in sub-Saharan Africa and is the third-most common cancer in women, with 530,000 new cases and 275,000 deaths each year. An estimated 80-90% of women in sub-Saharan Africa never have pelvic exams. More than 85% of the global burden of cervical cancer occurs in developing countries, yet the World Health Organization estimates fewer than 5% of these women have access to screening even once in a lifetime. Cervical cancer is four to five times more common among women who are HIV-positive.
Description of partnership activities and how they address needs and challenges
Pink Ribbon Red Ribbon (PRRR) is an innovative partnership to leverage public and private investments in global health to combat cervical and breast cancer – two of the leading causes of cancer death in women - in developing nations in Sub-Saharan Africa and Latin America.
The cervical cancer partnership leverages the platform and resources of PEPFAR and draws from lessons learned in the significant scaling-up of access to HIV interventions in recent years. Since breast cancer has not been linked to HIV, PEPFAR funds will not be used for direct support of breast cancer activities. However, other Pink Ribbon Red Ribbon partners will leverage the PEPFAR platforms, using other sources of funding, to support breast cancer efforts.
The Bristol-Myers Squibb Foundation has committed $1.2 million over three years, abnd will work with its Secure the Future Technical Assistance Program faculty in the region to expand the availability of vital cervical cancer screening and treatment and breast care education and detection especially for women most at risk of getting these cancers in Secure the Future target countries because they are HIV-positive. In Tanzania, with the Foundation’s support, five community-based organizations will screen more than 50,000 women between ages 30 and 50 years and those living with HIV for cervical and breast cancer as well as refer 600 for treatment at regional hospitals.
In September 2011, MSD* announced that it would contribute USD 3 million over three years to the Pink Ribbon-Red Ribbon initiative to help address both cervical and breast cancer in sub-Saharan African nations by supporting disease education, screening and treatment efforts as well as increased access to cervical cancer vaccination. Through this three-year partnership, MSD is working with Susan G. Komen for the Cure to support the first phase of the program to raise awareness in Zambia and Tanzania about the burden of breast and cervical cancer, mobilize additional program partners and donors, advocate for increased access to screening, treatment and cervical cancer vaccination as well as to promote follow-up care among women in sub-Saharan Africa. In addition, MSD has provided in-kind donations and technical support to the national cervical cancer vaccination programs in both Zambia and Botswana.
In September 2011 GSK agreed to donate USD1 million worth of the cervical cancer vaccine Cervarix to the US-based Pink Ribbon Red Ribbon partnership so that more than 10,000 girls and women in the partnerships target countries in Africa will have access to vaccination over the next five years. GSK also pledged USD 50,000 to support Pink Ribbon Red Ribbon’s program operations, helping the partnership expand the availability of vital prevention, screening and treatment programs for cervical and breast cancer in developing countries. The partnership is also focusing on integrating low-cost screening and treatment services and aims to reduce deaths from cervical cancer in participating areas of Africa by 25% over the next five years.
- Flexibility is key to successful programming and partnership with countries.
- While a phased approach to implementation makes sense, it is important to be cognizant of the need for partner engagement in countries of focus for particular member organizations.
- Ensuring communication and coordination among and between all levels of engagement is crucial to the success of the partnership.
- Partnerships need to be results-oriented to succeed, and it is important that evaluation is informed by country programs.
- An efficient country coordination mechanism is very important.
Summary of impact and forward looking information
Through PEPFAR, there is already screening and treatment of women at more than 250 clinics in 11 African countries. Through Pink Ribbon Red Ribbon, PEPFAR has committed an additional USD 10 million, which will bring the total PEPFAR investment to USD 30 million over the next five years and ensure more women will be able to be screened and saved. (Bush Center press release - Sept. 2011).
Since its launch at the September 2011 Summit to Save Lives in Washington, D.C., Pink Ribbon Red Ribbon (PRRR) has evolved from an ambitious vision of public-private sector collaboration to address women’s cancers in developing countries to a robust, multi-partner initiative focused on advancing prevention, screening and treatment for breast and cervical cancer in sub-Saharan Africa.
In 2013, and through the efforts of the PRRR partners, over 18,000 girls were vaccinated against HPV, over 73,000 women were screened for cervical cancer, and more than 4,800 women were treated with cryotherapy or loop electrosurgical excision procedure (LEEP) in PRRR partner countries.
In 2014 and beyond, Pink Ribbon Red Ribbon is committed to strategic expansion in new countries through a tiered strategy that involves full engagement in certain places and more-targeted technical assistance, advocacy building, and limited direct financial contributions in others.
* MSD is known as Merck in the U.S. and Canada.