Eliminating cervical cancer is about more than just spending money. It requires reckoning with the many intangibles that get in the way of this cause. Widespread adherence to patriarchal value systems, for instance, not only threatens women’s health and well-being, but discourages them from freely pursuing the means to a cure. Persons with cervixes must confrontnot only archaic notions about their worth, but also many other hidden barriers to prevention. These include the fear and superstition that arise from lack of knowledge and medical misinformation, a lack of appreciation for self-care, the burden of unpaid work, and the vulnerability resulting from racial and gender inequality. Challenging these societal factors will increase the volume of women’s voices and ultimately save thousands of lives. But until society is ready to acknowledge and address these barriers – the patriarchal structures thwarting women’s autonomy and decision-making power, the stigma associated with this disease, the religious intolerances and traditional values contrary to its prevention – a cancer that strikes only those with a cervix will continue to kill.

If cervical cancer ravages a woman’s body like fire, then screening acts like a smoke alarm – detecting and even stopping that fire before it starts. Cervical screening tests also save hundreds of thousands of lives every year, are generally more affordable, and target a much greater age range than HPV vaccination. Still, limited access to comprehensive screening and follow-up leaves women across the world vulnerable to being burned by cervical cancer. In Africa, India, and parts of Asia and South America, less than 10 percent of women receive any screening at all. Higher-income countries, where cervical screening is widely available, face innumerable obstacles to increased participation. Screening is available in name only in many U.S. states, which limit eligibility for public health insurance or withdraw funding for low-cost clinics. In higher-income countries, non-White, immigrant, or low-income women typically receive less screening. Researchers attribute low uptake to racial biases, geographic challenges, medical illiteracy, and cultural irrelevancy. But as long as citizens tolerate inequity, thousands of persons with cervixes will forgo lifesaving screening measures.

The potency of a vaccine against cancer-causing HPV – and the body’s ability to clear it – offers many women a fighting chance. But extinguishing this source of cervical cancer overlooks another sexually transmitted virus that’s been raging around the globe for decades: the human immunodeficiency virus (HIV). The lethal effects of HPV mixed with HIV can be like setting gasoline on fire. HPV infections in HIV-positive women last longer, progress more quickly, recur more frequently, and are harder to eradicate. Cervical cancer in HIV-positive women – many of them in lower-income countries – strikes younger, is more aggressive, and harder to cure. Women with HIV are six times more likely to die of cervical cancer. They face a particular threat in Africa, home to two-thirds of the world’s 40 million HIV cases. Without a concerted effort to overcome the dual stigma of HIV and HPV through education, appropriate medical care to all persons with cervixes, and a means to address the vulnerability of the continent’s child brides, Africa will remain at the core of the HIV-HPV inferno – undermining the quest for global cervical cancer elimination.

While countries with soaring cervical cancer rates would dearly love to offer citizens the HPV vaccine, their governments struggle most to afford it. In the poorest parts of the world, shortages, dosage costs, and barriers to distribution and delivery have made HPV vaccine access like winning a “life lottery” – garnering them no more than 13 percent of the global share. Despite the efforts of nonprofit agencies like Gavi – a vaccine-funding provider for the world’s poorest countries – this potent source of prevention remains elusive for “caught-in-the-middle” nations deemed above the funding cut-off. No such shortage exists in the United States, which pays $160 USD a dose and recently expanded vaccine eligibility in females up to forty-five, despite peak efficacy in teen girls. Market forces perpetuate the battle for this precious resource, even though widespread screening and pre-cancer treatment won’t be enough to stop the disease. In the absence of widespread HPV vaccination, global cervical cancer elimination remains a distant hope.

Doing away with cervical cancer worldwide turns out to be far more nuanced and difficult than it first appears. Despite the body’s ability to shed itself relatively easily of HPV and cervical pre-cancer, hundreds of thousands of persons with cervixes are dying and will continue to die. Too many have suffered already. The losses of these individuals strike a devasting blow, reverberating beyond families and through the heart of communities, tearing gashes in our social fabric – we are not built to lose so many women in the prime of their lives. Thankfully, we have what it takes: enough insight and tolerance to shift priorities and beliefs about preventing and treating a “woman’s cancer.” We have enough skills, resources, and determination to educate the world about the importance of cervical cancer prevention. We have enough disease-fighting resources to share with the people and places that need them most. We have enough to stop wasting women’s lives and begin treasuring them instead. We can take the exasperated cry of “enough” and use it to fuel our collective capacity to free the world of a disease that need no longer exist. We have enough to stop cervical cancer.

It can be painful to witness the toll of cervical cancer on women offered next-to-no treatment options. Persons with cervixes who acquire the disease in places like Africa or Southeast Asia often experience a brutal life trajectory. In the absence of highly trained professionals, sophisticated medical facilities, and expensive surgical or radiation equipment, most cervical cancer patients in lower-income countries are sent home to die. These deaths can be protracted and lonely, with little access to palliative care. What’s more, the stigma of the disease – associated with “dirty” female reproductive organs and the smell of advanced cancer – can lead to social banishment in a sufferer’s final days. In higher-income countries, greater availability of treatment is still no guarantee of equity. Low-income patients in the United States are often cut off from insurance once cancer goes into remission, excluding them from critical follow-up. Pockets of inequity, the rural–urban divide, and inconsistent access to care mean women from affluent countries die inexcusably from a preventable cancer. The inhumane circumstances cervical cancer sufferers face worldwide remind us of this mission’s urgency.

Every year, more than 600,000 persons with cervixes end up with cervical cancer. Without treatment, these people will die. And yet, treatment for cervical cancer remains is scarce enough in lower-income countries to typically make a cervical cancer diagnosis a terminal one. Women who can’t afford to travel for their treatment are left to die painful, lonely deaths, stigmatized, and with next-to-no palliative care. In higher-income countries, surgery, radiation, chemotherapy, as well as immunotherapy can prolong or even save lives. But these treatments can be arduous and even torturous, with life-altering consequences, such as loss of fertility and physical disfigurement, along with chronic or debilitating health conditions and radical lifestyle changes. In affluent regions, treatment is often seen as a last-ditch option, while marginalized women around the globe consider it a luxury. Cervical cancer prevention is the most cost-effective, sustainable, and humane approach toward eliminating the disease. But until treatment can be offered equitably alongside prevention, thousands more will suffer and die.

Aversion to the highly effective HPV vaccine has hobbled the global fight against cervical cancer. Nearly twenty years after introducing this vaccine – which, when given to young girls before they have sex, extinguishes the virus causing most forms of cervical cancer – many higher-income countries are reluctant to make sweeping use of its powers. In lower-income countries, high costs and low supplies have obstructed access to HPV vaccination. As a result, despite the combination of the HPV vaccine and cervical screening to eliminate cancer by catching or curing pre-cancer and early cancer, cervical cancer kills more persons with cervixes every year. In the absence of a significant intervention, the World Health Organization estimates that by 2030, nearly 700,000 women will be diagnosed yearly with cervical cancer – and 400,000 of those persons with cervixes will die. But there is no reason to lose hope. The very potency of the scientific tools currently available for cervical cancer prevention, along with a public commitment toward eliminating this disease, offers us the means to do away with this cancer for good.

On paper, eliminating cervical cancer looks doable. Given the effectiveness of the three pillars of prevention: primary, secondary, and tertiary, virtually no person with a cervix should die of the disease. HPV vaccination provides near-perfect protection, and for those who missed the vaccine’s age cut-off or who live in countries that can’t afford to provide it, cervical screening and follow-up resolve 90 percent of early cervical pre-cancer. Cancer can even be cured via treatment if it’s found early enough. And yet, despite the reliability of these prevention pillars, myriad obstacles stand in the way of providing consistent, well-attended programs – including widespread misunderstandings and misgivings about the HPV vaccine, a universal aversion to pelvic exams, and cultural restrictions against exposing women’s bodies to strangers. These underlying issues have long undermined efforts to eradicate the disease and diminished political will toward investing in this cause, particularly in countries or regions with meager health care budgets. Until these obstacles are addressed, simply throwing money at the problem will never be enough.

Cervical cancer is a disease of inequity. Ethnic minorities – regardless of where they live – are screened less often, diagnosed later, and die more often from this preventable cancer. While most cervical cancer deaths happen in lower-income countries, persons with cervixes are increasingly dying in marginalized communities within higher-income countries. In these parts of the world, preventing and treating cervical cancer is considered a privilege rather than a right – a lofty ideal rather than a budget staple. The COVID-19 pandemic only exacerbated disparities in cervical cancer prevention and care, as fighting this illness took priority over issues like cervical screening and HPV vaccination. The pandemic laid bare the fragile state of women’s reproductive health care: how easily it could be disrupted by global public health emergencies. And yet, until global citizens call attention to worldwide political and financial disparities, it’s clear that geography, skin color, and the most emergent global health priority will continue to foster a wholly unacceptable rate of death by cervical cancer.

The most ardent warriors against cervical cancer are its survivors – even after being ravaged and beaten back by the disease. Imagine what strides would be possible if more of us – including those who’ve never had a brush with the disease – assumed the role of advocate. In fact, you don’t need to be a survivor or doctor or policy consultant to tackle cervical cancer elimination. Opportunities abound for lending your voice and your support toward the cause. Social media is a great starting point for expanding education and awareness about HPV vaccination and cervical cancer screening. Other initiatives include advocating for HPV education in school health curriculums; exercising voices and votes for policy change in cervical cancer prevention and treatment; and donating time, energy, or money, either locally, nationally, or internationally, to like-minded organizations and individuals. Eliminating this stealth killer requires innovation and creativity. But no effort is too small; the sum of all of our differences creates a sea change. Cervical cancer survivors inspire us to remember that we are “stronger together,” and that together, we can strike down this preventable cancer.