In Kyrgyzstan, cervical cancer is a critical health concern, being the second most common cancer among women of reproductive age and the leading cause of cancer-related deaths in women aged between 15 and 44.[1] According to WHO estimates, in Kyrgyzstan, approximately 600 women develop cervical cancer every year, of which 300 cases are fatal.[2] To combat this, the Government, supported by WHO, implemented a robust public health intervention, introducing the HPV vaccine in 2022.[3] During the first year after introduction - by November 2023 - the programme had achieved impressive coverage, with approximately 63 percent of the 200 000 adolescent girls aged 9 to 14 years targeted to receive the vaccine nationwide having received both recommended doses, signalling a significant step in disease prevention.[4] By bolstering healthcare worker training, advocacy, and public awareness, the National Immunoprophylaxis Programme has not only promoted widespread vaccine acceptance but has also positioned the country on a hopeful trajectory to potentially eliminate cervical cancer, thus protecting future generations from this devastating disease. Kyrgyzstan’s adoption of the HPV vaccine is a key move toward achieving its health goals and global health standards as per the WHO Country Cooperation Strategy. It is also a clear example of WHO’s tailored support to the Member States it serves, as agreed in “Delivering United Action for Better Health – a strategy for collaboration between the WHO Regional Office for Europe and Member States in the WHO European Region.” By including the vaccine in its National Immunoprophylaxis Programme, Kyrgyzstan is enhancing primary healthcare and supporting key areas like immunization and maternal health. This initiative not only addresses a major health challenge at the national level but also contributes to global efforts in fighting the disease.
"Cervical cancer, which is caused by the human papillomavirus, in Kyrgyzstan ranks second among the leading causes of women's mortality from cancer. This planned preventive work is for the health of our children, the health of the whole nation and future generations."
- Asel Chynbaeva, representative of the Ombudsman for Children's Rights of the Kyrgyz Republic
WHO's Key Contributions
- Technical support for the inclusion of the HPV vaccine into Kyrgyzstan's national immunization schedule as part of the broader Immunoprophylaxis Programme.
- Training healthcare workers on vaccine administration and effective communication strategies to address public concerns about HPV vaccination.
- Contributing to advocacy and information dissemination efforts, significantly raising public awareness about the importance of the HPV vaccine for cervical cancer prevention.
- Collaborating with local and international partners to conduct health promotion, reinforcing the country's commitment to combating cervical cancer.
How did Kyrgyzstan, with the support of WHO, achieve this?
In recent years, Kyrgyzstan has made significant strides in public health with technical support and funding from WHO, enabling several vaccines to be introduced into its national immunization schedule. This began with the introduction of the pneumococcal conjugate vaccine in 2016, followed by the inactivated polio vaccine in 2018, and the rotavirus vaccine in 2019. Then, in a concerted effort to combat cervical cancer, the WHO Country Office in Kyrgyzstan facilitated the introduction of human papillomavirus (HPV) vaccination in November 2022.[5] This introduction was a key component of the country's National Immunoprophylaxis Programme for 2020–2024.
Kyrgyzstan received 368 000 doses of HPV vaccine from Gavi, the Vaccine Alliance, and distributed them across the country.[6] Leading up to the vaccine rollout, 2284 health workers received training to not only administer the HPV vaccine but also to engage in effective communication with the public, addressing potential questions and concerns about the vaccine and related issues. WHO provided global guidelines and training materials and helped adapt them to the local context; funded, organized, and facilitated trainings of master trainers; and funded, developed, and disseminated information materials to educate parents about the benefits of vaccinating their children against HPV.
This preparation paid off when the vaccine was officially introduced in the national immunization calendar in the fall of 2022, as part of routine immunization efforts. Of the first cohort of 200 000 adolescent girls aged 9 to 14 years targeted to receive the vaccine nationwide, by November 2023, 72 percent had been reached with the first dose of the 2-dose series, and 63 percent had also received the second dose.[7]
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Saikal Kydyrshaeva, an 11-year-old schoolgirl, and her mother Elnura Duishenalieva, a WHO national immunization officer, talk about HPV after Saikal received her first HPV vaccination.
Photo credit: WHO Kyrgyzstan
Kyrgyzstan also marked its commitment to preventing cervical cancer by participating in the European Cervical Cancer Prevention Week, raising awareness about the disease and the importance of HPV vaccination.[8] The WHO Country Office in Kyrgyzstan, in close collaboration with the Ministry of Health, the United Nations Population Fund (UNFPA) Kyrgyzstan, and Médecins Sans Frontières, organized health promotion activities and awareness-raising events. These included meetings with parents in schools, the Spiritual Administration of Muslims of Kyrgyzstan (DUMK), press meetings with journalists, social media campaigns, and briefings.
“Vaccination against human papillomavirus is more than disease prevention. It is about protecting adolescent girls from cervical cancer and expanding the opportunity for them to lead healthy and productive lives."
- Gulbara Ishenapysova, Director of the Republican Center for Immunoprophylaxis
Kyrgyzstan aims to embed the HPV vaccine firmly within the fabric of the country’s public health measures.
In November and December 2023, WHO Kyrgyzstan organized refresher trainings on HPV vaccine communication, engaging over 70 healthcare professionals from diverse regions across the country. This initiative involved collaboration with prominent entities including the Republican Center for Immunoprophylaxis, the Republican Health Promotion Center, the United Nations Children's Fund (UNICEF), and the Red Crescent Society of Kyrgyzstan. Due to the enthusiastic response and evident need for such training, WHO is now working to sustain ongoing support for regular immunization training sessions tailored to healthcare workers.
In February 2024, WHO Kyrgyzstan, alongside the Republican Center for Immunoprophylaxis, the Republican Health Promotion Center, and the Association of Family Doctors Group hosted a comprehensive four-day Train-the-Trainer workshop on the HPV vaccine for 80 health professionals nationwide. The training covered medical information on the HPV vaccine and strategies for communicating about HPV vaccination, split into two two-day sessions for different groups. Learning modules for these trainings were developed with support provided through the WHO-European Union Central Asia COVID-19 Crisis Response (CACCR) project in Kyrgyzstan.
While it may require a minimum of 10 years for a comprehensive evaluation of the vaccination programme's impact in reducing cervical cancer incidence, there is increasing awareness regarding HPV and its consequences among both the intended recipients and key stakeholders. There is hope that these ongoing efforts will ultimately lead to the elimination of the disease in Kyrgyzstan.
References
- The Catalan Institute of Oncology (ICO) and the International Agency for Research on Cancer (IARC) Information Centre on HPV and Cancer: Kyrgyzstan. Human Papillomavirus and Related Cancers, Fact Sheet 2023 [fact sheet]. HPV and Cancer in Kyrgyzstan Fact Sheet 2023, accessed 8 February 2024.
- World Health Organization. Kyrgyzstan joins European Cervical Cancer Prevention Week [news release]. Kyrgyzstan Joins European Cervical Cancer Prevention Week, accessed 8 February 2024.
- UNICEF Kyrgyzstan. European Immunization Week in Kyrgyzstan: Every vaccine dose matters to protect you and those you love. European Immunization Week in Kyrgyzstan, accessed 8 February 2024.
- Republican Center for Immunoprophylaxis Kyrgyzstan. Kyrgyzstan shares experience in introducing human papillomavirus vaccination in Astana. Kyrgyzstan Shares Experience in HPV Vaccination, accessed 6 March 2024.
