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The need to build on recent progress

Chapter 3: Care delivery

Addressing cancer at the early stages

Immunisation is a first measure in preventing

certain types of cancer. A positive finding

of the ICP is that most countries are taking

advantage of immunisation to address cervical

and liver cancer, through HPV and hepatitis

B vaccination. All countries have a coverage

of above 80% for hepatitis B immunisation

among one-year olds, according to WHO

data for 2017. Until recently, all countries but

Costa Rica had a national HPV vaccination

programme. But this has changed, as the

Ministry of Health launched a programme for

vaccination of all ten-year-old girls in schools

starting June 2019.^58 However, according to

Dr Vargas, “vaccination for both boys and girls

Key takeaways

• Public health systems have adopted good practices of prevention, such as
  immunisation and screening for early detection of common types of cancer. However,
  there are great challenges in adherence and in reaching underserved areas.


• Although disparities exist, there are important gaps in most countries when it comes
  to oncology equipment (such as for radiotherapy) and number of specialists. Universal
  health coverage programmes have in theory made essential treatment available, but
  this should be supported by better planning and distribution. There is a lag in palliative
  care adoption.


• Improving quality will require a review of the administrative aspects of the system
  and incentives for different actors. The development of standards for cancer care is
  emerging, as are patient-centred approaches.

is recommended, but unfortunately, boys

were left out. This is an example of weak co-

ordination with specialists.”

More than 80% of adolescent girls in Latin

America live in countries offering HPV through

public health systems, but challenges have

been noted in adherence for the second or

third doses.^59 According to PAHO, coverage

with the two doses has still not reached 80%

in most countries.^60 Education campaigns

and awareness of these initiatives are needed

to guarantee that the benefits of these

programmes materialise.61, 62 In Colombia,

for example, a controversial case of adverse

reactions from the vaccine in 2014 led to a

dramatic fall in uptake.^63

(^58) Ministerio de Salud, “Comenzó vacunación contra el virus papiloma para niñas de diez años en las escuelas”, 2019.
(^59) Angelica Nogueira-Rodrigues, “HPV Vaccination in Latin America: Global Challenges and Feasible Solutions”, American Society of Clinical Oncology
Educational, 2019.
(^60) PAHO, “El cáncer cervicouterino es el tercero más frecuente entre las mujeres de América Latina y Caribe, pero se puede prevenir”, 2019.
(^61) Angelica Nogueira-Rodrigues, “HPV Vaccination in Latin America: Global Challenges and Feasible Solutions”, American Society of Clinical Oncology
Educational, 2019.
(^62) PAHO, “El cáncer cervicouterino es el tercero más frecuente entre las mujeres de América Latina y Caribe, pero se puede prevenir”, 2019.
(^63) C Simas et al., “HPV vaccine confidence and cases of mass psychogenic illness following immunization in Carmen de Bolivar, Colombia.” Human
Vaccines and Immunotherapeutics, 2019.