On February 1, 2025, Rwanda launched a mission entitled Mission 2027, where they are trying to sustain a goal of reducing the number of cases of cervical cancer in women in Rwanda. This goal aims to reach fruition three years ahead of the World Health Organization’s (WHO) mission of 2030.

Rwanda is a country in East Africa with a population of around 14.26 million people. Famous for its scenery, exceptional tea and coffee, rich culture, and wildlife. Despite these positive reinforcements, Rwanda struggled for a long time with its health system and keeping women in Rwanda safe against certain diseases, particularly cervical cancer.

In the late 2000s, cervical cancer became a major health concern for people living in Rwanda because life expectancy for people grew, and non-communicable diseases (NCDs) were more prominent. With this in mind, cervical cancer became a high priority to stop in Rwanda, and it became the first country in Africa to launch free HPV (Human Papillomavirus) vaccination in 2011. The steps that government and health care workers are taking, and have taken, have given Rwanda the ability and steps to stay on track with Mission 2027.

Mission 2027, also known as the Accelerated Plan for Cervical Cancer Elimination 2024-2027, is just how it sounds. It is a national strategy to eliminate cervical cancer three years before the World Health Organization’s goal for the world by 2030. This program includes expanding vaccination, having advanced screening and improving access to treatment.

History of Cervical Cancer in Rwanda

Cervical cancer is the most common cancer that exists in women in Rwanda, followed by breast and stomach cancer. According to the WHO, cervical cancer ranked fourth for the most common cancer in women in 2022. In 2023, the Global Cancer Observatory estimated 866 new cases of cervical cancer, with 609 deaths.

Some of the most difficult steps in eliminating this disease are getting women to screen for the disease, not just getting the vaccination. One of the biggest blockades of this was the 1994 genocide that left the health system of Rwanda in shambles.

The genocide had an estimated 800,000 people murdered, in the span of 100 days, including the majority of health care workers, like doctors and nurses, who either died or fled the country. This incident hurt an already struggling country with its health care, especially during a time where their rates of cervical cancer were growing and are continuing. The use of wartime rape as a method against women did not help the growing numbers of cervical cancer and HIV.

Ever since this incident, the Rwanda government has been working towards rebuilding the health care system and prioritizing health for people. Cancer care for people in Rwanda is continuing to grow with the opening of the Butaro Cancer Center of Excellence that was on July 1, 2012, from the collaboration with Partners in Health (PIH).

This service originated because there were not a lot of available cancer treatments in Rwanda for women to go to, along with a lack of treatment for women who received diagnoses. Taking the steps toward Mission 2027 has the ability to keep Rwandans grounded and help younger women stay healthier and get the treatment and care that they need.

Poverty and Cervical Cancer

Before the Rwandan genocide happened, the health care system of Rwanda was extremely weak. The hospitals that already existed were too expensive for the average citizen and were not located where the majority of people lived, which is the rural regions.

After the Rwandan genocide, the Rwanda health care system became more strained and almost too far gone. The genocide destroyed more than 80% of the health infrastructure along with most doctors fleeing the country or dying in attacks. The genocide interrupted vaccinations and prenatal care, along with many other programs, and had little to no coverage.

Despite the hardships that Rwanda faced after the genocide, health care became pushed to the front for the public and the government. According to an article from Harvard, the use of genocidal rape increased the spread of HIV/AIDS and cervical cancer, which brought to light the lack of clinicians who could address the health issues on the ground.

Rebuilding the Health Care System in Rwanda

The RPF-led government rebuilt the shattered health care system of Rwanda. RPF, which stands for the Rwandan Patriotic Front, prioritized the training and provision of local health care workers in each of Rwanda’s villages. Ever since the RPF pushed their focus for creating a more stable health care system, vaccinations for cervical cancer have increased to more than 90% coverage for girls.

Rwanda has continued to maintain this high number of vaccinations since 2011, along with implementing a system where four health care workers are elected in each of the 15,000 villages in Rwanda. The RPF even prioritized the building of rural health centers, where the majority of people in Rwanda live.

All of these changes and developments occurred with the establishment of Mutuelle. Mutuelle offers insurance at an average U.S. cost of $2 with a guaranteed out of pocket cost of up to 10%. This number changes for the wealthier in the country, but Mutuelle covers 91% of Rwandans, compared to less than 7% of the population in 2003.

Steps To Eliminate Cervical Cancer

According to the International Agency for Research on Cancer (IARC), the World Health Organization launched a plan entitled 90-70-90 as part of Mission 2027 to eliminate cervical cancer by 2030:

• 90% of girls are fully vaccinated with the HPV vaccine by age 15.
• 70% of women are screened with a high-performance test by 35, and again by 45 years. 
• 90% of women identified with cervical precancer or cervical cancer receive adequate treatment and care.

Once a country reaches a certain threshold of cervical cancer cases being below four per 100,000 women to years, that is when a country is considered to have eliminated cervical cancer.

Mission 2027 has already passed many milestones; 93% of girls in Rwanda are vaccinated, 31% of women screened and 81% of women with precancerous lesions and cervical cancer are receiving treatment.

Despite the setbacks that Rwanda has faced over many years, these setbacks are what is keeping Rwanda on the right track to accomplishing Mission 2027. Rwanda continues to showcase its resilience and passion for helping its people and keeping its health system up to date. With the perseverance of the government in Rwanda, and working closely with the WHO and many hospitals, women are at a point where they can get the help that they need and keep their health taken care of.

– Elizabeth Fryer

Elizabeth is based in Philadelphia, PA, USA and focuses on Technology and Global Health for The Borgen Project.

Photo: Unsplash