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UQk~]8Aaڊ /T7dqŦ})i|gkz~eNQּwq&I>o!r=O {ۋ9V{[EbUE7=+/~ۥl+eqF.}yinqv\CtGܤ*E̓`OҨyK<92h0sGQ(9f?LS]!ٹn9>L,sfBU *IbK?w֕ԳZF8Mg@4,y?$+ݒSaa:MdC/ ̤`vܴϔ GxێƓ_g_^,bgZlL/yd[ȱ[m+&P@9Ɍ#r^ҥQvlYdr+Ӵ؀nf`OSخS"'U{)IyLcbg9mi_`Fv"el#`5Pn$9M+t73H_*rscǧ- zt}Hv(ʸFs/ڣ2CX;VnŶ`㟕y'~uTv8 ix>g4%]UF9$ 8ORqR A6zjYĒ,m$v'j_ޘELg`\0{O㺠!1g?GGdp\MD{i8=;V&i(*$pOqߞNOj̑^HBCNz`*:fu׋m卭ߞG?);xwV_H櫒Z s7<"VEYIڗ ,qޖFl;Cs(! 998#xZK(w$Y(TG$5*?pZ~mf;9'?LúW g?ϽzS`q˦F*30 U&?yX|uv ;H|G8Ě|˻?b;r`myPjfw8V6z#[$ t9"C`s| ד.Nv3Rw1RcAP3'R>AYG/1ִ--ɊV!'9K%rn1ILS3EJۄU8sHd2\*6UA2v෠Rt ,pAL#]R{v.Dj Yp1ڳI"bp `6pCS2Rv{uadl[va'?ҩ=67S!Ut4<~Enj{ArȠ#?7Xr5|e 91Gg=\c:_qq]\Uqֹy5tsI=U- q!8'=WC@^ܱ$8c-kCu?'CT8viKj)7 60'qݽ@,mq֮4lįʀ/$AǵDg4ޣъDd艜FKg+S).;+9CMoU0Σ2q)l2.MU.Kz)+y'de$n~F84-.HVzu> 1*a=f F!9ڋR{*8H1;c*ұʬQ1$AQZmw1+O[{~UTC5_9df)C5v@#Zr-oaC!#?Qr&)C ( c#\S3yf#<(rI!OZRn8l4QLFO[YdZσN-mr(lt[%[0[%1NYPg'K[*sg;-^s2_>$07NEf#.Oe̸K;GwI6F/'QF"cWi:f6 vcsq8`&rŸE>3!0$GOkbL `h9+?Vg\G ]yyI5H.N#J(]|f WgY$VۂQEHof~ݷ+f'4QR8+\rF܈O8N:K(RP 8$g(gc_)<[G^ա1kwQtv>Oiђ71'+;{)T,,(@ / 0DArialNew Romantt? 0"DTimesNew Romantt? 0X DTimes New Romantt? 0F(0.  @n?" dd@  @@`` A P ;\.(' 456789;> ?@b$cnR$d 6Ac`<?2$e:7ڵdM.?fD2$eT8֞R"4XGdR$^ 4ryjS 2$!D70 Oa>R${0 w@V$R$w,.-uk~X9JaAW 0e0e     A@  A5% 8c8c     ?1 d0u0@Ty2 NP'p<'pA)BCD|E||S"P4f3f@8Dʚ;ʚ;g4GdGd? 0ppp@ <4dddd@k 0t? <4BdBd@l 0t___PPT10{ .,Vivien Tsu..&ncruver.6Z___PPT9<4B .%{Implementation of Programs for Prevention and Treatment of Cervical Cancer in Africa: Plans, Findings, and Lessons Learned||Robin Biellik, DrPH PATH/Europe, Ferney VITA Technology Meeting on Sexual and Reproductive Health Policies in Africa Barcelona, Spain8)(`()`b        _ +#JEstimated number of cases and incidence of cervical cancer by region, 2002KK3* The challenge$bCervical cancer incidence is lower today in industrialized and some middle-income countries due to success of multi-visit screening (PAP smear and cytology) and treatment PAP is poorly sensitive/specific, but repeated, often annually, so false negatives are eventually corrected Screening and treatment services are not available in most developing countries, esp. in Africa Developing countries need to follow another paradigm  single-visit screening and treatment with low-cost methods with high sensitivity/specificity, targeted at women 30-39 years of age.2`20'LCervical cancer surveillance: active cancer registries in sub-Saharan AfricaMM/Alliance for Cervical Cancer Prevention (ACCP) 0.$4ACCP was created in 1999 with funding from the Bill & Melinda Gates Foundation; funded to end-2007. The ACCP consists of five international agencies working to clarify, promote, and implement strategies for preventing cervical cancer in developing countries. The Alliance works with developing-country partners to: assess innovative approaches to screening and treatment. improve service delivery systems. ensure that community perspectives and needs are incorporated into program design. heighten awareness of cervical cancer and effective prevention strategies.8<`   <ACCP Partnerships$EngenderHealth The International Agency for Research on Cancer (IARC). Johns Hopkins University - JHPEIGO Pan American Health Organization (PAHO). PATH ACCP: Kenya $  :ACCP: South Africa Cervical Health Implementation Project;$' 'ACCP: South Africa Khayelitsha Project($     ACCP: Ghana $?START (Screening Technologies to Advance Rapid Testing) Project@@25,000 rural women in India and China screened and treated; specimens used to validate alternative tests Test development and field testing scheduled for completion during 2007 Introduction of the Digene test and clinical utility studies of the Arbor Vita test are planned for 2008 "1(NHPV Vaccine Project  vaccine component((Objective 1: Generate critical data and experience for evidence-based decision making, strengthening essential health system capabilities, and creating a supportive social and political environment for national readiness in 4 countries* Objective 2: Leverage country experience to inform and promote favorable global HPV vaccine policy, regional HPV vaccine strategies, and government introduction plans Objective 3: Develop strategic forecasts, investment cases, and decision-making tools to inform and influence industry supply and pricing decisions, international agency financing decisions, and government introduction plans *India, Peru, Uganda, Vietnam~uP 3fs9G s9G s9G2)LUganda: is it feasible to deliver HPV vaccine through school-based strategy?MZMObjective: To assess feasibility of school-based strategy for reaching girls in school aged 10-12 years, plus additional strategy for reaching girls out of school, possibly synchronized with semi-annual Child Health Days Primary outcome: 3-dose vaccination coverage in each group Secondary outcomes: 1- and 2-dose vaccination coverage Vaccination drop-out rate Cost of each strategy Data for cost-effectiveness estimates Acceptability (KAP) among recipients, familiesp-Pi0K s9Gs9G+s9G THPV Vaccine Project  secondary prevention++Limited funding towards strengthening secondary prevention in 4 project countries: Vietnam, India, Peru, and Uganda. Rapid assessments to understand current screening and treatment practices and priorities. Work with country leaders to plan and implement activities according to priorities, including: translation and dissemination of existing technical and IEC materials, training of trainers, policy and guideline drafting.P  ,WHO Reproductive Health initiative in Africa--Pilot implementation of VIA screening services at health centre level with treatment by cryotherapy at district hospitals in 7 countries in Africa (i.e., Madagascar, Malawi, Nigeria, Tanzania, Uganda, Zambia, Zimbabwe). Training conducted in 2003 for country representatives. Proposals from different countries solicited and homogenized into one proposal. Follow up meeting in Tanzania in April 2007.X    , ,WHO Reproductive Health initiative in Africa--uSpecific objectives of the WHO projects: Assess participation in a screening program. Assess acceptability of referral to the district hospital. Assess the VIA positive rate. Assess the agreement between VIA done at health centers and at referral level. Assess the number of invasive cancers detected (and stage of disease). Document operational problems. Estimate cost.*)` M` v.   ,$qTHANK YOU www.path.org/cervicalcancer Robin Biellik, DrPH PATH/Europe rbiellik@path.org tel: +41 78 890 45 77Jr  0$Ir    0 & /8-   0` ìLx>?" dd@(?" dd(@$e  e(@" `  n?" dd@   @@``PZa2    @ ` ` 2,p>  > @U(  `  s *s9G"`  s *̙"  6Hks9G" H0   Tk? ? "m` k T Click to edit Master title style! !  Hk? ?"= k w%Click to edit Master text styles $! &f  C 0Alogo40-wine"bzB  s *޽h ? ìLx80___PPT10.R`$. 8Pres_template_wine_030804[1]  0 ldP(    H]k? ?"?0 k T Click to edit Master title style! !  H`k? ?"p0  k X$Click to edit Master subtitle style % %j  C 4Awinebar-white" z`  s *̙"B  s *s9G޽h ? ìLx80___PPT10.R`$. 0 `(  ` ` Nl1kk z%  1 n*  K%%KKpp ` Nȕ1kk  ?% 1 p*  K%%KKppd ` c $ ?XK  14 ` N*kk  ) 1 RClick to edit Master text styles Second level Third level Fourth level Fifth level!     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NQ>@@                             `c"$     3 BGCDEFkY`YvYYYNYYNCC888--"v"v--8v8`NUNJCJ8J-3-(8-(-"""   "---8-8CNNYNNNN8C888CCCCCaCVC@C58*-8C*858CCNNYNNCNCCCC88-8W- "- - ""-""""-""-o-o8X8,-"8NYo!,7BMXz        + +++6+6+6B6BBBBMMMMMMMXMXXM XcXc c n+nAnWnxnnnnnnn5nVnlnnnnncnyyy(y?yU`v2S^^juyyynnnnuyjS^jy^yjyncXXXXM1BG6<6G6G+< 1 &  +  & 1       ujuujj^jjHSH='  6BMBMMMMB6+   v kU3z(3z?3z?zUo`o3ddJdUokYOP@c"$  Q]  3 BNC DEF"- " N -@`c"$  #CsP&  3 BCCDE$F. 8  -C88 @`c"$  ?  3 B!C DEF! ! @`c"$    3 B C DEF @`c"$  9E"  3 BCDEF  @`c"$  "4#  3 B C DEF @`c"$  /<  3 B CDE F  @`c"$    3 BnCMDEF''7B!BB 77 ,,!!,7B7 ,!77!B!7!B!B,M!M,X!X,X7c7X7XBc7cBnBcMXMXBMB7MMBBB7BPT@`c"$  4>  3 B"CDE0F: "      " @`c"$  a4N  3 B!C DEF !  @`c"$  44VA  3 B,C DEF",  ! , @`c"$  4a   3 B CDE F  @`c"$  V'a(  3 B!C DEF"! !  !@`c"$  V  3 BCoDEF//NzYdYoNCNCN-z-8-!!!N-!C-!!o!!CN  c  X!c- 8C CC NYYdooo-dNd8YzYN`d@`c"$  xlN  3 BC-DE8FB , "z"o-X-c-"X"  @`c"$  4f  3 B C!DEDFNX y 7 7B MX!!!! !$(@`c"$  E*N  3 BnCDE8FB7MXX n X7 !  ,7 @`c"$  ~  3 "BYC!DEPFZ!   B!!!N!NYNN B7 ! , ! *,@`c"$  *  3 B8CDEF 8  @`c"$  ?  3 B,C DEF , @`c"$  )V*  zB*CDEFBB !,!,,,!7,,,,7,B7B,B7B,B7MBBBMMMBMMXMMMXXMXXcdXXMdXdcdXdMoXoMocooocoooozooozzzzozz +Abx**@`c"$  c   BCDEF "CCNYz     6BBMcny *5*  *5KaVKK@5* ** z*zKzmzodXXXMBBBxBmMaBmB7xB7,x,m7x,m,a,m,m!a,a!V!K!V!KVKVV K K@5Xc cc!X,B767BBMXBdBoBd6oBo+o o+dX M B ,,,!! oo ddNPT@`c"$  c  3 zBCDE|FMB7,v!k!`,T7TBIM(MMXcccoozzzzccMB7w7l,V!K!5     b L +  n M 7 ! !!!,!!,!! , 77 7 BXcz !,,,7BXnz         ++66AAWLW6mAxLWmxxbbbWLLLLAA66A6AA)A)L5A)A)66)6@6@+@6K6V+K6a6V6a6l6lA6ALWbbmxxbWLWLA6+ (3IIzT`zTzTo`XkXvMvXvMXM@`c"$  b  3 B C DE F* @`c"$  9|E  3 BC DEF  @`c"$  .&  3 BC,DEF))o dd YN CC 8- 8 ""   " " "!-!"!-!,-,C,d,z,! TX@`c"$   s V  3 BnC,DE<FFM!B7!!,!! !, Xn!c!M! $@`c"$  .  3 B,CDEF,  , @`c"$  \  rBVCDEFYYYYYNYY N CC 8 88 -- ""--88NNC8--8--"o"z"dd NCN8 - 8--"d-Y-N-N8Y-Y8CCCN8N8Y8NCN8N-N88-C-88 8C"CC CCKVKVVKK@@5@55** nyXMXXXXMccooddYNNNCNYYdozooYYzzzzzoodddoYDH@`c"$  ]a|  BCDE F*HH!!,,,a,V,@,5!*!,*!5!,,77B77,7,,,,!!!W       oo!X!, !7BXny!,7BMXz!@`c"$  Qx|  3 rBCDEF+8 868+, 8 ,+,, ,,!,,,!!!!!!!!!!!!!! d Y N dNdCN!Y!d!N!Y,8,Y,8!C N" ,-, 8"88C88NCCo8CCC88CCCNYNNY YY oz+z+oMzBz6z++z zz   + +BcycMcyynncXznnzcznzyzzzzzzzozzozooooooodddydndnYcYnYXYcYMYcYXNcNXNMNcNMNyNXNBNnCc8MCBCXCBCX8B8+8+C+8~@`c"$  6a"F  3 B CNDEF--CCCCNYNYC"8N8z-C-- !8! !!!  " CNC Y z oz ! !-- 88 8CC CC\`@`c"$  C^  3 BC,DE@FJX!M,,,!! !Mcn cX!"$@`c"$  K6jv  3 BC,DELFVN,-!d-" -  N o !!o!N,(,@`c"$  66  3 BdC!DE,F6 Y,, !N!Bdd Y@`c"$  C)j>  3 BXC!DE0F: B!! ! XM B@`c"$  46]n  3 BoC!DEHFRBB 7,!! ! 7Yod o d YMB&(@`c"$    3 B,C DEF !, @`c"$  ~CP  3 :BVC DEFVVK5*zdNC-yW+ z z dN"7"-BCdCdNzNdNNCdNoNdY7NBN!NYd doNoodoodoozYzB7,7,!!,,,B7,,BYYYYdzzodNYdodz         +66A6AWLWLWWbnny  ****5@555KKK Vpt@`c"$  jF  3 B"CDE4F> " "    "  @`c"$  xb|  3 B"C DEF"  " @`c"$    3 BCDEF  @`c"$  <=  3 BC DEF   @`c"$    3 BCDEF  @`c"$  bd  3 BC DEF  @`c"$     XByCDEHFzo?RRD' !#'155=;P?P?aKzLWZ_abeemoqvzUJ_}c$Yar?t.u)yvqZPF=9BGOS.B3:>+EI"W'h/t&v { uxtmg^(31'(%qWTD:<@                           `c"$  [   `3c MMMԔ?O$; ]N. AMERICA 14,670      `X9c MMMԔ? ? mC-S. AMERICA 71,862     `  0 >=:=(  r  S c`  c <|  0  #"."#0 N Hpc ?"o 0RJB___PPT9$ D *Age-standardized cervical cancer incidence rate per 100,000 women @E1` "C" @`W M Hc ?"R 0o RJB___PPT9$ o1993-9761h " @`\ L H|c ?"R o RJB___PPT9$ t55.0>1h & @`S K H c ?" R o RJB___PPT9$ k61361h " @`T J Hc ?" R  o RJB___PPT9$ l1.4961h " @`Q I H,c ?"R  o RJB___PPT9$ i161h " @`V H Hc ?"R o RJB___PPT9$ nZimbabwe4 1` " @`W G HLc ?"5 0R RJB___PPT9$ o1993-9761h " @`\ F Hwc ?"5 R RJB___PPT9$ t41.7>1h & @`S E HXc ?" 5 R RJB___PPT9$ k46561h " @`T D HLc ?" 5  R RJB___PPT9$ l1.1461h " @`Q C Hhc ?"5  R RJB___PPT9$ i161h " @`T B Hc ?"5 R RJB___PPT9$ lUganda41` " @`W A H\c ?" 05 RJB___PPT9$ o1993-9461h " @`\ @ Hc ?" 5 RJB___PPT9$ t17.7>1h & @`S ? Hc ?"  5 RJB___PPT9$ k10961h " @`T > Hc ?"   5 RJB___PPT9$ l0.6461h " @`Q = Hc ?"  5 RJB___PPT9$ i161h " @`U < Hc ?" 5 RJB___PPT9$ mReunion41` " @`W ; HTc ?"0 RJB___PPT9$ o1994-9661h " @`\ : H c ?" RJB___PPT9$ t35.9>1h & @`S 9 HO. ?"  RJB___PPT9$ k18261h " @`T 8 H|T. ?"   RJB___PPT9$ l1.0261h " @`Q 7 H$Y. ?"  RJB___PPT9$ i161h " @`R 6 H]. ?" RJB___PPT9$ jMali41` " @`W 5 Ha. ?"0RJB___PPT9$ o1997-9861h " @`\ 4 HXf. ?"RJB___PPT9$ t29.8>1h & @`S 3 Hj. ?" RJB___PPT9$ k17161h " @`T 2 Hn. ?"  RJB___PPT9$ l1.0461h " @`Q 1 Hds. ?" RJB___PPT9$ i161h " @`T 0 Hw. ?"RJB___PPT9$ lGambia41` " @`[ / H{. ?" 0RJB___PPT9$ s Data period6 1h  " @`U . Hp. ?" RJB___PPT9$ mASIR*61h " @`\ - H. ?" RJB___PPT9$ t Number cases6 1h  " @` , H. ?"  RJB___PPT9$ Popn. Base (millions)61h " @`Z + Hȍ. ?"  RJB___PPT9$ r Registries6 1h  " @`W * Ht. ?" RJB___PPT9$ oCountry61h " @`zB T <1 ?" 0 nB U 0?"0zB V <1 ?" o zB W <1 ?"0 0o zB Z <1 ?"0zB \ <1 ?" o zB _ <1 ?"  o zB b <1 ?"  o zB e <1 ?" o zB h <1 ?" o zB k <1 ?"0zB ~ <1 ?" 0 zB  <1 ?"5 05 zB  <1 ?"R 0R zB  <1 ?"o 0o nB  0?"o nB  0?"0o 0  N. ?"0* PSource: IARC, 2002"0 B  s *޽h ? ìLx80___PPT10.\1X,  0 `2(  r  S c`  c   S z c B  s *޽h ? ìLx80___PPT10.R{  0  $(   r  S Hm`   r  S H   B  s *޽h ? ìLx80___PPT10.Ro5  0 O$;(  $r $ S 4vm`        O$ #"t     $ Hh| ?"U   sProject study period: 2000-2004"   @` $ H ?"* U  Demonstration project on district level. Research on screening and triage tests, cryotherapy safety and effectiveness, costs, and women s attitudes toward service. Advocacy at provincial and national levels.*@,` @` $ Bp ?"*U  ] Purposes:"  @` $ HP ?" * n"Busia District in Western Province#@# @` $ H ?"* S Location:   @`B  $ Bo?"B $ Bo?"  B $ Bo?"*B $ Bo?"  *B 4$ Bo?" B 5$ Bo?"*U B 7$ Bo?" * U B 9$ Bo?"U  B ;$ Bo?" U  . ($ <  ?"0@P tCollaborating partners: PATH, Kenya Ministry of Health, Maendeleo ya Wanawake Organization, Kenya Cancer Association$u0 2u  ?$ HA ;?#" ` U5@B $ s *޽h ? ìLx80___PPT10.RW  0 :,(  ,r , S  m`     W  :, #"W    , H ?"W  >Project study period: 2001 2003"   @` , HD ?"0I To demonstrate how cervical cancer screening and treatment services can be improved through a rational and logical program of policy, management, service and community inputs.@ @` , B ?"I0 _ Purposes:$ @ @`  , H ?"0I ?3 districts: Gauteng, Western Cape, Northern (Limpopo) Province@@@ @`  , B ?"0I V Locations: @  @`B  , Bo?"0B , Bo?"W W B , Bo?"IB , Bo?"IB ', Bo?"0B (, Bo?"IB *, Bo?"IB ,, Bo?"W B ., Bo?"W  , < ?"0@P ZCollaborating partners: EngenderHealth, Women s Health Project/Witwatersrand University, Women s Health Research Unit/University of Cape Town$0 2  1, HA ;?#" ` B , s *޽h ? ìLx80___PPT10.Rʊs  0 [<y(  <x < c $m`     P  [< #"P  , < H4( ?" P  >Project study period: 1996 2005.   @` < H; ?"@P F>6___PPT9 @To conduct a 3-arm clinical trial to determine reduction in prevalence of biopsy-confirmed high-grade lesions (SIL) when screening -- by visual inspection with acetic acid (VIA) or HPV DNA testing -- when followed by immediate treatment with cryotherapy. To extend follow-up for all women recruited to 36 months to learn whether treatment of HPV DNA positive women without cervical lesions has a prophylactic effect against future development of disease."  5m}M < BL ?"@  ] Purposes:"  @`! < HF ?"P@ /Kyayelitsha township 30 km outside of Cape Town00 % @`  < HX ?"@ S Location:   @`B  < Bo?"B  < Bo?" P B < Bo?"@B < Bo?"PP@B E< Bo?"PB F< Bo?"@ B H< Bo?"P@P B J< Bo?"  B L< Bo?"P P  < <c ?"0@ TCollaborating partners: EngenderHealth, Columbia University, University of Cape Town$U0 2U B < s *޽h ? ìLx80___PPT10.RʊL  0   -DR (  Dx D c $\mm`     @ `  +D #"s`P    D H ?"@ `  >Project study period: 2005 2007"   @` D H䂰 ?"|`  To contribute to the evidence base on the single visit approach (SVA) as a feasible, effective, and sustainable means of secondary prevention of cervical cancer in developing countries. @` D BD ?"@|  ] Purposes:"  @` D HX ?" `| Accra, Amasaman, Kumasi  @`  D Hl ?"@ | T Locations:   @`B  D Bo?"@  B  D Bo?"@ ` B D Bo?"@ @|B D Bo?"` `|B #D Bo?" ` B $D Bo?"@|@ B &D Bo?"`|` B (D Bo?"@ @ B *D Bo?"` `  D <X ?"0@ u5Collaborating partners: JHPEIGO, Ghana Health Service$60 26  -D ZH 0A p?#" ` -B D s *޽h ? ìLx80___PPT10.Rʊ0  0 WOp(  p~ p s *Tk`0  k ~ p s *k  k b p C :A"Sellors 045 9-03%  ? p B5A ?"Z yGoal: To develop rapid biochemical tests appropriate for low-resource settings that detect precancerous cervical lesions.*z_3fuB p s *޽h ? ̙33y___PPT10Y+D=' .= @B +_2 0 v1n1@D 1(    NAA ?"``0 n>Rapid tests are being developed by two private-sector partners??  ZtA?t H0  . `  #"2& ba` A  NAf?@  [>US$5$(f @`  NAf?@-  X13$(f @`  Np#Af?@' -  c 96-well batch$(f @`  Nx,Af?@H '  oLab Refrigeration needed$(f @`   N^Af?@u H ]HPV-DNA$(f @`   NDAf?@x u ]7 hours$(f @`   NlAf?@ x [Batch$(f @`*   N|nAf?@`  8Digene Hybrid Capture 2 (existing test) Gaithersburg, MD:9h8ff @`   N A?  X< US$5 (b @`  N`Af?  \< US$5$(f @`  NA? @ kTarget price per specimen (b @`  NlA?-   bTo be determined (b @`  NAf? -   a At least 13$ ( f @`  NA?- @  Number oncogenic HPV strains (b   @`  NPA?' -  _ One at a time (b @`  NdAf? ' -  j24- or 48-well batch$(f @`  NA?' @-  cNumber of samples (b @`  NA?H'  ~,Near patient testing No refrigeration needed -(-b @`   NAf? H'  /Static or mobile clinic No refrigeration needed$0(0f @`  NA?H@'  YSetting (b @`  NpA?uH \ E6 protein ( b @`  NT1f? uH ]HPV-DNA$(f @`  N1?u@H YDetects (b @`   N 1?xu Less than 20 mins (b  @`  NR1f? xu gLess than 2 hours$(f @`  N0\1?x@u VTime (b @`  Ne1?x ] Rapid-strip ( b @`   N(o1f? x a Rapid-batch$ ( f @` ! Nx1?@x ] Test format ( b @` " Nz1?` 'Arbor Vita E6 strip test Sunnyvale, CA2(h'bb @`  # N(1f? ` Digene FASThpv8(ff @` $ Nx1?`@ Z  @`rB % B 1 ?`@`rB & B 1 ?@rB ' B 1 ?`rB ( B 1 ?@rB * B 1 ?x@xrB + B 1 ?u@urB , B 1 ?H@HrB - B 1 ?' @' rB . B 1 ?- @- rB / B 1 ? @ rB 0 B 1 ?rB 1 B 1 ?xxrB 2 B 1 ?uurB 3 B 1 ?HHrB 4 B 1 ?' ' rB 5 B 1 ?- - xB 6 H 1 ?`xB 7 H 1 ?`rB 8 B 1 ?  xB 9 H 1 ?``xB : H 1 ?zB ; <1 ?" ` rB F B 1 ?@rB K B 1 ?@xxrB P B 1 ?@uurB U B 1 ?@HHrB Z B 1 ?@' ' rB _ B 1 ?@- - xB ) H 1 ?@`@rB d B 1 ?@  xB A H 1 ?@``xB f H 1 ?@B  s *޽h ? ìLx___PPT10i.)lE+D=' .= @B +  0 &(  x  c $A`2  A    <A c"$`  A *8xB  BD?"````rB  <D?"`rB  <D?"000B  ND3f?"0@NNN?NP P B  s *޽h ? ìLx___PPT10i./+D=' .= @B +  0 f(  `  s *s9G"   6wAS" `  A x  c $xAP A   XA " ?CVP_Immunization"G B  s *޽h ? ìLx___PPT10i.;+D=' .= @B +8  0 @P>(  Pr P S 112p  1  P S 1 1 &xBbB P s *޽h ? ìLx80___PPT10.RPۀ0  0 0L6(  Lr L S 1m`  1  L S 1  1  %B L s *޽h ? ìLx80___PPT10.R008  0  H>(  Hr H S 1m`  1  H s *1"`@ 1 B H s *޽h ? ìLx80___PPT10.R 0L0 ,$(     010  1 H  0޽h ? ̙33y___PPT10Y+D=' .= @B +$ 0 tt(  td t c $`XK   * t s *4*` M)  * ^,China. 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    OPresentacin en pantallaPATHp ArialTimesTimes New RomanPres_template_wine_030804[1]|Implementation of Programs for Prevention and Treatment of Cervical Cancer in Africa: Plans, Findings, and Lessons LearnedKEstimated number of cases and incidence of cervical cancer by region, 2002The challengeMCervical cancer surveillance: active cancer registries in sub-Saharan Africa0Alliance for Cervical Cancer Prevention (ACCP) ACCP Partnerships ACCP: Kenya;ACCP: South Africa Cervical Health Implementation Project(ACCP: South Africa Khayelitsha Project ACCP: Ghana@START (Screening Technologies to Advance Rapid Testing) ProjectDiapositiva 12(HPV Vaccine Project vaccine componentMUganda: is it feasible to deliver HPV vaccine through school-based strategy?+HPV Vaccine Project secondary prevention-WHO Reproductive Health initiative in Africa-WHO Reproductive Health initiative in AfricarTHANK YOU www.path.org/cervicalcancer Robin Biellik, DrPH PATH/Europe rbiellik@path.org tel: +41 78 890 45 77 Fuentes usadasPlantilla de diseoTtulos de diapositiva/_z0Cristina Ruiz FernndezCristina Ruiz Fernndez  !"#$%&'()*+,-./0123456789:;<=>?@ABCDEFGHIJKLMNOPQRSTUVWXYZ[\]^_`abcdefghijklmnopqrstuvwxyz{|}~      !"#$%&'()*+,-./0123456789:;<=>?@ABCDEFGHIJKLMNOPQRSTUVWXYZ[\^_`abcdefghijklmnopqrstuvwxyz{|}~      !"#$%&'()*+,-./0123456789:;<=>?@ABCDEFGHIJKLMNOPQRSTUVWXYZ[\]^_`abcdefghijklmnopqrstuvwxyz{|}~      !"#$%&'()*+,-./0123456789:;<=>?@ABCDEFGHIJKLMNOPQRSTUVWXYZ[\]^_`abcdfghijklmnopqrstuvwxyz{|}~Root EntrydO)PicturesҸCurrent UserSummaryInformation(eUPowerPoint Document(]DocumentSummaryInformation8