Experts: Philippines drive to eliminate cervical cancer hinges on LGU implementation

CEBU, Philippines — The Philippines’ ambition to eliminate cervical cancer as a public health problem will depend increasingly on the ability of local governments to turn national prevention targets into sustained vaccination, screening and treatment programs, health experts said.

While medical science has established a clear pathway to preventing most cervical cancer cases, gaps in vaccine coverage, fragmented vaccination data and uneven access to healthcare remain obstacles to translating that potential into wider public health protection.

At the center of the prevention effort is the human papillomavirus (HPV), a common sexually transmitted virus. Although most infections clear naturally, persistent infection with high-risk HPV types causes about 95 percent of cervical cancer cases, according to the World Health Organization (WHO).

The WHO has set a 90-70-90 target for eliminating cervical cancer by 2030: vaccinating 90 percent of girls against HPV by age 15, screening 70 percent of women with high-performance tests by ages 35 and 45, and ensuring 90 percent of women diagnosed with cervical disease receive treatment.

The challenge for the Philippines is increasingly one of implementation — ensuring that vaccination and screening programs reach populations beyond major urban centers and extend across public and private healthcare systems.

This was a central theme at the recent symposium of the Association of Municipal Health Officers of the Philippines (AMHOP), titled “Leading Disease Prevention at the Local Level: The Role of LGUs in Protecting Communities”.

Fragmented data complicate vaccination efforts

Dr. Fejelia D. Faulan, a pediatric infectious disease specialist and symposium resource speaker, said HPV vaccination gaps stem from several interconnected factors, including parental resistance, community attitudes, misinformation and limitations in vaccine access.

She also identified fragmented vaccination data as a constraint on more effective program implementation.

Government records largely capture vaccinations administered through public health programs, leaving a gap in accounting for doses delivered through private practitioners and schools.

This makes it difficult for health authorities to establish actual vaccination coverage and identify populations that remain unprotected.

In Western Visayas, members of the Philippine Pediatric Society have begun consolidating vaccination information from private practitioners to help address the information gap and provide government agencies with a more complete picture of coverage.

“We started that program because we wanted to share our data with the government so that we can address and minimize the gap,” Faulan said, expressing hope that other municipalities would adopt the initiative and eventually contribute to a national database covering private-sector vaccination.

The lack of comprehensive data has implications beyond reporting. Without a reliable picture of vaccination across healthcare providers, local governments risk duplicating efforts in some communities while overlooking eligible children in others.

Faulan also called attention to the broader health implications of HPV, which is associated not only with cervical cancer but also with anal, penile and oropharyngeal cancers.

While the government’s current vaccination program prioritizes girls aged nine to 14, expanding public awareness of HPV-related diseases could strengthen acceptance of prevention and vaccination efforts.

Some local governments have demonstrated that high coverage is achievable. Faulan cited Banna in Ilocos Norte and Sampaloc in Quezon as examples of areas that reached the 90 percent HPV vaccination target. Ilocos Norte subsequently achieved the target across the province.

“If Ilocos Norte has done this, and one municipality in Quezon has done this, I think we can do this,” she told local health officials.

Mandaue puts local funding behind prevention

For Dr. Debra Maria Catulong, city health officer of Mandaue City, the bigger policy shift is moving local healthcare systems away from a predominantly treatment-oriented approach towards prevention.

“Why are we waiting for people to get sick and diagnose or screen? Why can’t we do something before that?” Catulong said, describing the city’s approach to strengthening primary healthcare.

Mandaue has complemented the national HPV vaccination program by allocating local resources to cover girls aged nine to 14 enrolled in private schools, a segment that could otherwise be missed by government-led vaccination activities.

The city is also working to establish a mechanism for collecting vaccination data from private healthcare providers to improve its assessment of coverage.

But Catulong said the effectiveness of such initiatives will depend on whether local governments institutionalize prevention programs rather than treat them as temporary campaigns.

This means incorporating cervical cancer elimination into annual local health plans and securing recurring funding to support vaccination, public education and patient care.

Mandaue is drawing on several financing sources, including its general fund, Special Health Fund and Gender and Development (GAD) Fund, to augment its healthcare budget.

“Marami kayong pwedeng ma-source out na funds. Ang importante lang, the willingness, awareness and acknowledgement na gusto mong ipasok ’yan na budget should be coming from us,” she told municipal health officers.

Catulong also stressed the importance of partnerships with private companies, civil society organizations and other community stakeholders, particularly in extending health promotion and helping patients diagnosed with cervical disease navigate treatment.

“It should be something that’s sustainable. As much as possible, embed it in the plans annually,” she said, adding that eliminating cervical cancer would require coordinated action across sectors.

“Hindi kaya ito ng isang sektor lang. We all need to work together if we really want to eliminate cervical cancer.”

From national targets to local investment

The discussions underscore a broader challenge facing the Philippine healthcare system: translating national health commitments into measurable outcomes at the community level.

For local governments, this requires more than vaccine procurement. It involves building reliable patient and vaccination records, addressing misinformation, reaching children outside public schools, allocating predictable funding and ensuring that screening and treatment services are accessible.

The economic and public health case for prevention is equally significant. Preventing HPV infections can reduce future demand for costly cancer treatment, lessen the financial burden on households and help protect women’s ability to participate in the workforce and community life.

The WHO’s 90-70-90 framework provides a measurable benchmark, but achieving it will depend on the capacity of local health systems to sustain interventions beyond individual campaigns.

For the Philippines, the next phase of cervical cancer elimination will therefore be determined not simply by the ambition of its national targets, but by how effectively municipalities and cities convert those targets into funded, coordinated and accessible healthcare services.