Supporting the Cervical Cancer Elimination Program in Marshall Islands and Fiji

Chugai Pharmaceutical is supporting an umbrella program conducted in collaboration between the United Nations Population Fund (UNFPA) Pacific Sub-Regional Office and the Departments of Health in Fiji and Marshall Islands to eliminate cervical cancer as a major threat to women's health in Fiji and the Republic of Marshall Islands.

• Background
  Cervical cancer is the second leading cause of cancer-related deaths among women in the Pacific Island Countries and Territories (PICT). The region suffers from persistent late stage diagnoses due to a lack of robust, well-structured cervical screenings. Areas like Melanesia and Micronesia carry a disproportionately heavy burden, with incidence rates significantly exceeding the global average of 10.8 cases per 100,000 females per year (28.3 for Melanesia and 18.7 for Micronesia).
  The high incidence is exacerbated by insufficient access to public health services, sub-optimal HPV vaccination rates, and inadequate clinical management. Given that HPV causes 99% of cases, successful elimination requires sustained focus on vaccination, timely treatment of HPV infections, and the use of high-performance screening methods.
  
  
• Results
  Building on the foundation established in 2024, the comprehensive programme to eliminate cervical cancer in Fiji and the RMI has continued throughout 2025. This vital initiative is driven by the United Nations Population Fund (UNFPA) Pacific in partnership with the respective Ministries of Health. The programme continues its focus on the "Test and Treat" model, prioritizing the early detection of cervical precancerous lesions and early-stage cancers using high-performance HPV testing. The three-pronged approach—procurement and distribution of necessary supplies, capacity building of healthcare workers, and extensive community engagement—remains the core framework for action in 2025. The transition from the programme's initial implementation phase into the current period is characterized by scaling up service delivery, embedding sustainable practices, and utilizing 2024 data to refine outreach and clinical protocols. This collaborative effort continues to offer tangible hope for reducing the burden of cervical cancer and improving health outcomes for women in both Fiji and the RMI. The key achievements in each country are as follows.
  
  
• Key Achievements in RMI:
  Following the Chugai funded support through UNFPA in 2024 for the development and launch of the RMI cervical cancer elimination policy/strategy and UNFPA’s focused advocacy for its implementation, an Australian private philanthropy provided dedicated funds in 2025 to the RMI government for the roll-out of the cervical cancer HPV test and treat meme, with UNFPA and other partners providing technical support.
  
  
• Key Achievements in Fiji:

1. Supply Procurement and Handover
   Building on a successful HPV pilot testing conducted in June 2024 at sites including Levuka, Galoa, and Lyndhurst, which demonstrated the feasibility and effectiveness of the gold standard HPV/DNA screen-and-treat model, UNFPA procured HPV kits and supplies for the national rollout of the "Test and Treat" programme in 2025. On June 13, 2025, a handover of cervical cancer HPV testing kits and essential supplies to the Ministry of Health and Medical Services (MHMS) took place. the Hon. Minister for Health and Medical Services in Fiji, Dr. Ratu Atonio Rabici Lalabalavu. During the ceremony, emphasized the critical importance of these kits in strengthening cervical cancer elimination efforts through early detection and treatment of precancerous lesions.
   
   
2. Commencement of the National “Test and Treat” Programme
   1) HPV Master Training and Clinical Practice (Northern Division)
   The implementation of the HPV screen-and-treat programme commenced with a Master Training Programme in Labasa town, for all the 4 sub-divisions of the Northern Division, from July 28 to August 1, 2025. This intensive five-day clinical course trained 56 multidisciplinary health personnel, including nurses, midwives, laboratory technicians, and medical officers. Immediately following this, supervised clinical practice was conducted at newly established HPV Screen-and-Treat Clinics in Labasa and Savusavu from August 4 to August 8, 2025. The structured week of clinical supervision effectively equipped nurses and midwives to independently manage their designated clinics and outreach activities.
   A total of 418 women were screened and treated during this period. Analysis of the results showed that out of the total screened, 351 women were Negative, while 64 women tested Positive for precancerous lesions. In line with the "Test and Treat" model, a total of 51 women who were eligible received thermal ablation treatment during this week. These results demonstrate the delivery of high-quality screening and treatment services to the targeted population.
   
   2) Awareness Campaign in Northern Division
   On October 22, 2025, the Fiji MHMS, with support from UNFPA Pacific, hosted a high impact
   awareness programme in Labasa. Themed “Early Detection Saves Lives,” the event kicked off with a vibrant march led by the Nabala Secondary School Band, the Fiji Police Force, and various community stakeholders. The campaign successfully reached approximately 1,200 people, featuring expert presentations on cervical cancer and mental health. A key focus was placed on the HPV Self-Test and Treat Programme, with interactive Q&A sessions ensuring the public left with a better understanding of preventive health practices.
   
   3) Programme Rollout in Northern Division
   Following the successful completion of comprehensive training, clinical preparedness, and awareness-raising campaigns, the HPV screening and treatment programme is currently being implemented in three districts in the Northern Division: Macuata Subdivision (1,688 women screened, of whom 1,446 tested negative and 242 tested positive), Savusavu Subdivision (931 women screened, including 808 negative, 108 positive cases, and 18 cases pending diagnosis), and Taveuni Subdivision (336 women screened, with 289 negative results, 42 positive results, and 5 cases pending diagnosis). Notably, as in all subdivisions, there were no reported inconclusive or unsatisfactory results. Screening services are scheduled to commence in the remaining northern Bua Subdivision in early 2026.

Photo: Provided by UNFPA Pacific Sub-Regional Office
Photo1: Handover ceremony- HPV testing kits on 13 June 2025
(Left: Hon. Minister for Health and Medical Services in Fiji, Dr. Ratu Atonio Rabici Lalabalavu, Right: Ms. Bidisha Pillai, Representative of the UNFPA Pacific Sub-Regional Office)
Photo 2: Community members and health officials take to the streets in Labasa to advocate for the HPV screen-and-treat program, emphasizing that early detection saves lives
Photo 3: Healthcare professionals in the Northern Division practice processing cervical specimens using the GeneXpert system during a clinical practice session
Photo 4: A client in the Northern Division receives specialized care from trained health workers as part of the HPV test and treat program rollout

Reference
The Global Cancer Observatory https://gco.iarc.fr/en
Supporting the Cervical Cancer Elimination Program in Marshall Islands and Fiji  2024 Activity Report (Mar 27, 2025)