India’s Path to Cervical Cancer Control: From Obstacles to Opportunities in HPV Vaccine Uptake

Abstract Background: Cervical cancer is a major global public health challenge, with an alarmingly high burden in low- and middle-income countries (LMICs), where approximately 88% of deaths occur. The singular, well-established agent that causes invasive cervical cancer is an oncogenic type of human papillomavirus (HPV) infection. Cervical cancer is both highly preventable and highly treatable when detected at early and pre-invasive stages. Nearly all cases of cervical cancer can be avoided through vaccination against the HPV virus. Aim: In this perspective article, we track India’s efforts in the HPV immunization program for primary prevention, supplementing early detection and screening programs. Also, we discuss the roadblocks that may interfere with this mission and highlight the assets that will pave the way for a better understanding of how to eliminate cervical cancer. Method: This perspective article utilizes the World Health Organization’s Building Blocks for Effective Health Systems framework to examine India’s current HPV immunization efforts. This framework was contextualized with insights from peer-reviewed research and relevant grey literature to identify key facilitators and obstacles influencing the implementation of the HPV vaccination program. Results: Globally available and approved HPV vaccines, although successful, are still expensive in LMICs. Therefore, India has been putting efforts into a locally produced HPV vaccine. The affordability of this vaccine makes the impact potentially transformative, but its future success depends on scaling up and utilizing effective strategies for nationwide implementation.