Today, the United States, Australia, India, and Japan are launching a groundbreaking effort to help end cancer as we know it in the Indo-Pacific, starting with cervical cancer, a largely preventable disease that continues to be a major health crisis in the region, and laying the groundwork to address other forms of cancer as well. This initiative is part of a broader set of announcements made at the Quad Leaders Summit .
The Quad Cancer Moonshot will serve to strengthen the overall cancer care ecosystem in the Indo-Pacific by improving health infrastructure, expanding research collaborations, building data systems, and providing greater support for cancer prevention, detection, treatment, and care.
Cervical cancer, while preventable through vaccination and usually treatable if detected early, remains the third leading cause of cancer deaths among women in the Indo-Pacific region. Fewer than one in 10 women in the Indo-Pacific have completed their human papillomavirus (HPV) vaccination series, and fewer than 10% have undergone recent screening. Many countries in the region face challenges related to healthcare access, limited resources, and disparities in vaccination rates. Through this initiative, Quad countries will work to address these gaps by promoting HPV vaccination, increasing access to screenings, and expanding treatment options and care in underserved areas.
Altogether, our scientific experts assess that the Quad Cancer Moonshot will save hundreds of thousands of lives over the coming decades. These steps build on the Biden-Harris Administration’s steadfast commitment to ending cancer as we know it. More than two years ago, President Joe Biden and First Lady Jill Biden reignited the Cancer Moonshot with the goals of reducing the cancer death rate in the United States by at least half—preventing more than 4 million cancer deaths—by 2047, and improving the experience of people who are touched by cancer.
Cancer is a global challenge that requires collective action and cooperation beyond any single nation’s effort. By working together, the Quad aims to implement innovative strategies to prevent, detect, treat and alleviate the impact of cancer on patients and their families. Quad partners also intend to work, within respective national contexts, to collaborate in advancing research and development in the area of cancer and to increase private sector and non-governmental sector activities in support of reducing the burden of cervical cancer in the region. Today Quad countries are pleased to announce the following ambitious commitments from our governments and non-government contributors:
QUAD COUNTRIES
Quad countries intend to continue their strong commitments to Gavi including with HPV vaccines in the Indo-Pacific, with the United States making an early pledge of at least $1.58 billion over five years.
In addition, Quad countries will work together with United Nations agencies on bulk purchasing of HPV diagnostics to bring down the cost of cervical cancer screening, and work with the International Atomic Energy Agency to improve access to and quality of medical imaging and radiation therapy.
United States
The Department of Defense, through the U.S. Navy, intends to support HPV vaccine expert exchanges with Indo-Pacific partners, starting in 2025. This partnership will enable healthcare professionals from partner nations to receive hands-on training, build capacity, and strengthen healthcare systems across the Indo-Pacific, focusing on preventive health services like HPV vaccination. The initiative aims to bolster regional cooperation on cancer and promote health security in the region.
The Food and Drug Administration’s (FDA) Oncology Center of Excellence intends to arrange a technical visit to India within the next twelve months to set up collaborations with stakeholders under FDA’s ‘Project Asha’. Working together with the FDA India Office, leading oncologists, patient advocacy groups, clinical trial sponsors, and government stakeholders, this new partnership will focus on capacity-building efforts, including education on the design, conduct, and management of clinical trials, promoting international standards, helping streamline approval processes, sharing regulatory expertise, and increasing cancer clinical trial access.
The U.S. National Cancer Institute (NCI) intends to expand its support as a leading funder of global cancer research and global cancer research training in the Indo-Pacific region. This portfolio currently includes nearly 400 active projects involving investigators and institutions in South Asia, East Asia, and the Pacific, including major investments specifically focused on testing cervical cancer vaccination, screening, and treatment interventions and strategies that can meet the needs of women and girls worldwide. The NCI will also expand its support for global cancer control efforts more broadly through scientific support provided to countries via the International Cancer Control Partnership, International Agency for Research on Cancer, and World Health Organization (WHO) Collaborating Center.
The NCI will expand ongoing collaborations with nations in the Indo-Pacific region to provide evidence-based cancer information for health professionals and people affected by cancer to this global audience. NCI will aim to support the public education needs of the Quad Cancer Moonshot Initiative by providing its expert-curated, comprehensive, and authoritative cancer information to health professionals and patients in the Indo-Pacific. This will include a comprehensive collection of information on cancer topics such as adult and pediatric cancer treatment, screening, prevention, genetics, supportive and palliative care, and integrative, alternative, and complementary therapies, including extensive information related to the screening, prevention, diagnosis, and treatment of cervical cancer.
The Centers for Disease Control and Prevention (CDC) will support HPV vaccination programs, improve vaccine distribution and strengthen cancer surveillance and prevention systems in the Indo-Pacific region. This will include working with the Philippines Ministry of Health on an HPV vaccination program evaluation, focusing on behavioral and social drivers to inform future vaccine distribution. CDC will also contribute to broader cancer control efforts by supporting cancer control plan development to strengthen the overall cancer care ecosystem in the region.
CDC intends to provide technical assistance and disseminate best practices informed by pilot cervical cancer screening studies in the U.S. Pacific territories and freely associated states, as well as continuing to support CDC-funded national cancer control programs in U.S. Pacific Island Jurisdictions (PIJs). These efforts will involve sharing evidence-based strategies to improve early detection of cervical cancer. In addition, CDC intends to disseminate an implementation guide that can assist PIJ efforts to improve their screening capacity and encourage partnerships to promote cervical cancer screening, including guidance on how to build medical and laboratory capacity to conduct primary HPV testing and follow-up tests, and improve data systems to monitor screening to enhance cancer prevention and care infrastructure.
The U.S. International Development Finance Corporation (DFC) will look to support eligible private sector-driven projects to prevent, diagnose, and treat cancer, including cervical cancer. In particular, DFC will look to accelerate the deployment of innovative approaches and technologies to underserved communities.
The U.S. Agency for International Development (USAID) will look to provide critical financial and technical support to expand HPV vaccination access. The U.S. government, through USAID has made an unprecedented pledge of at least $1.58 billion to Gavi, the Vaccine Alliance, which will bolster global efforts to increase vaccine coverage, including HPV vaccines, in low- and middle-income countries, helping to protect millions of women and girls from cervical cancer across the Indo-Pacific and beyond.
The State Department, through Global Health Security and Diplomacy (GHSD)-President’s Emergency Plan for Relief (PEPFAR), will share best practices on the rapid scale-up of cervical cancer screening and treatment efforts among people living with HIV, including commodity procurement and health system strengthening in low-and-middle-income countries. This collaboration will enhance the integration of cervical cancer screening into existing HIV treatment programs, increasing access to life-saving interventions. It will also focus on improving supply chains for essential medical supplies needed for screening and treatment.
Australia
Through Australian Government and philanthropic contributions, total funding commitments to the Elimination Partnership in the Indo-Pacific for Cervical Cancer (EPICC) consortium will expand to AUD $29.6 million. EPICC is a new program that builds on decades of research and clinician leadership to advance the elimination of cervical cancer across the Indo-Pacific by improving HPV-related policies, planning and readiness in any country in the region. EPICC is piloting HPV programs for future scale-up in Timor-Leste and Solomon Islands, expanding sub-national vaccination programs to support country readiness in Malaysia, Fiji and Papua New Guinea, and supporting the establishment of national sustained HPV elimination programs in Tuvalu, Vanuatu and Nauru. EPICC works across six priority areas to eliminate cervical cancer, including strengthening primary prevention through HPV vaccination support, secondary prevention of cervical cancer through HPV screening and treatment for pre-cancer, laboratory strengthening for cervical cancer screening and diagnosis, digital health work to generate data for decision making and strengthened models of care, supporting cervical cancer management (across both treatment and palliative care), and policy and modelling support across all pillars of the cervical cancer elimination pathway.
With a total Australian Government commitment of AUD 16.5 million [$11 million], the expanded EPICC project will extend its reach to more women in the Indo-Pacific. It will also support partner organizations in the region working on cervical cancer elimination to participate in the next Global Forum on Cervical Cancer Elimination, which will have a strong Indo-Pacific focus.
Through their charity Minderoo Foundation, Dr. Andrew Forrest AO and Nicola Forrest AO are expanding a lifesaving contribution to EPICC with a further AUD13.1 million [$8.81 million]. This additional funding will see EPICC expanded to up to 11 countries in the region and brings Minderoo’s total commitment to AUD21.7 million. The expanded program will see 140,000 women in the Pacific region screened over the next 4 years, as well as the establishment of national elimination programs and the empowerment of governments to sustain the program for future generations of women and girls.
India
India will share technical expertise in digital health through its National Non-Communicable Disease (NCD) portal. As part of its $10 million commitment to support the World Health Organization (WHO) led Global Initiative on Digital Health, India will provide technical assistance to the Indo-Pacific region. This includes offering technical support for the use of its National Non-Communicable Disease portal, which tracks long-term data on cancer screening and care.
India commits to providing HPV sampling kits, detection tools and cervical cancer vaccines worth $7.5 million to the Indo-Pacific region. This significant contribution aims to strengthen local efforts to prevent and detect cervical cancer and empower communities with affordable, accessible tools for early detection and prevention, while supporting vaccination programs to reduce the disease burden across the region.
India is scaling up population-based screening for oral, breast, and cervical cancers through its National Progamme for Prevention and Control of Non-Communicable Diseases. In particular, India uses the Visual Inspection with Acetic Acid (VIA) method for cervical cancer screening, which is simple, cost effective and efficient and allows healthcare workers to detect early signs of cervical cancer without the need for advanced laboratory infrastructure, making it a model for other regions in the Indo-Pacific.
India is expanding access to specialized cancer treatment centers under its “Strengthening of Tertiary Care Cancer Centres” program. The Government of India is supporting both states and union territories to improve treatment capacity across the county, ensuring that people from all parts of the country, including underserved areas, can receive high-quality care.
India is committed to affordable cancer treatment through Pradhan Mantri Jan Arogya Yojana (PMJAY). As part of its broader health coverage efforts, PMJAY, India is committed to providing affordable cancer treatments to its citizens, ensuring financial protection for those most in need.
India’s commitment to cervical cancer elimination is further supported by implementation research led by the Indian Council of Medical Research (ICMR). The research is focused on enhancing cervical cancer screening, early diagnosis and initiation of treatment. The results and findings will be shared with the Indo-Pacific countries in the coming years, to strengthen regional collaboration.
Japan
Japan is providing medical equipment, including Computed Tomography (CT) and Magnetic Resonance Imaging (MRI) scanners, and other assistance worth approximately $27 million, to countries in the Indo-Pacific region. These countries include Cambodia, Vietnam, and Timor-Leste, as well as contributing to international organizations.
Through the Japan International Cooperation Agency and other organizations, Japan has committed approximately $75 million from FY2019 to FY2023 in the Indo-Pacific to combatting cancer including cervical cancer. This includes providing relevant medical equipment and facilities, medical diagnosis, health system strengthening, and technical assistance.
Japan is committed to improving the access to vaccines and promoting the women’s health including the prevention and control of cervical cancer through Global Health Initiatives or International Organizations such as Gavi, UNFPA, IPPF. Japan intends to continue its commitment to support this initiative.
Toward the achievement of universal health coverage, Japan intends to strengthen capacity for addressing cancer including cervical cancer in the Indo-Pacific region by health system strengthening. Japan will also continue to support combatting cancer including cervical cancer in the region through National Cancer Center Japan’s partnership with each Quad country’s cancer related institution.
NON-GOVERNMENTAL ORGANIZATIONS
Collaboration with the private and non-profit sectors of all Quad countries is indispensable to the success of this initiative, as their collective innovation, resources, and commitment will be critical in advancing progress against cancer in the Indo-Pacific region. Quad countries are pleased to announce the following actions from non-government contributors:
Improving Access to Cancer Screening and Prevention
The World Bank is significantly increasing its commitment to cervical cancer prevention and treatment in the Indo-Pacific region through a comprehensive health systems approach, including $400 million in HPV-related investments globally over the next three years. In line with its broader goal to provide quality, affordable health services to 1.5 billion people by 2030, the World Bank, along with the Global Financing Facility (GFF) for Women, Children, and cervical cancer. With projects in countries such as Vietnam, Laos, Cambodia, Bangladesh, Indonesia, and the Philippines, the World Bank is supporting cervical cancer screening, HPV vaccination, and treatment by integrating these services into primary healthcare systems. This includes expanding access to screening for underserved populations, strengthening service delivery, and leveraging partnerships to improve diagnostics and treatment. In addition, the World Bank is working to address supply chain challenges and ensure the sustainable production and distribution of HPV vaccines, with a focus on increasing access across the region. Through this approach, the World Bank aims to create sustainable and equitable health systems that can address the growing burden of cervical cancer and support long-term health outcomes for women and girls across the Indo-Pacific.
Women investors and philanthropists of the Women Health and Economic Empowerment Network (WHEN) will deploy a joint investment of more than $100 million over the next three years, with funding targeted for cervical cancer in Southeast Asia. These funds will be working to fill essential gaps for improving the prevention, screening, diagnosis, and treatment of cervical cancer. WHEN’s women investors and philanthropists will deploy grant, concessional, and investment capital into HPV screening, medical imaging, pathology, radiotherapy, training for healthcare workers, and the solarization of health facilities.
The Serum Institute of India, in partnership with Gavi, will support the procurement of up to 40 million doses of the HPV vaccine for distribution across the Indo-Pacific region. This commitment can be expanded based on demand, ensuring a steady supply of vaccines to address the cervical cancer burden in underserved areas. By increasing access to lifesaving vaccines, this commitment will help prevent cervical cancer and promote equitable healthcare across the region.
The Bill and Melinda Gates Foundation, alongside other donors and countries earlier this year, committed to support cervical cancer elimination. The foundation announced it intends to commit up to US$180 million over four years to help accelerate the global uptake of HPV vaccines, develop new prophylactic HPV and therapeutic vaccines and diagnostic tools and fund clinical studies.
Sabin Vaccine Institute, through the Global HPV Consortium (GHC), will support a new country-based coalition to promote cervical cancer elimination. The Cervical Cancer Elimination Consortium-India (CCEC-I) will collaborate with the Government of India, wherever appropriate, to pilot “100 Cervical Cancer Mukt (Cancer Free) Districts” through their integrated SAVE Strategy: Screening, Access to Treatment, Vaccination, Education. This is in continuation of GHC’s commitment to the Indo-Pacific region, having previously collaborated with Indonesia’s Ministry of Health to support development of their National Cervical Cancer Elimination Plan.
Jhpiego, in partnership with the Philippines Department of Health and with support from Roche, is increasing awareness, demand and access for cervical cancer screening by educating women on the importance of HPV testing and the risk of cervical cancer. The Centralized Laboratory Model of Screening project is expanding coverage of cervical cancer screening with introduction of the WHO elimination strategy-recommended high performance HPV testing, and thermal ablation treatment for precancers, in five highly urbanized Local Government Units of the Philippines – with strengthened referral pathways to ensure a pathway to treatment.
Illumina is committed to supporting the development and adoption of genomic diagnostic tests to fulfill the promise of precision medicine in the Indo-Pacific Region. The objective of this initiative is to ensure that advanced-stage (>50%) and non-HPV driven (~5%) cervical cancer patients receive correct diagnoses and possible suitable therapies such as Poly (ADP-ribose) polymerase (PARP) inhibitors and immune checkpoint inhibitors (ICI). Similar initiatives are being explored with gynecological oncology organizations in Australia and Japan.
Roche Diagnostics is expanding its cervical cancer screening and diagnosis initiatives in the Indo-Pacific region. Roche Diagnostics will expand efforts in the Indo-Pacific to increasing access to screening and raising awareness building on the experience gained in partnership with Japan including on providing education to women, training healthcare workers, and developing digital solutions for efficient follow-up care; and in partnership with Australia on promoting cervical cancer screening among under-screened and never-screened groups, including Aboriginal, Torres Strait Islander, and culturally diverse communities.
Becton Dickinson & Co. (BD) is making comprehensive investments in cervical cancer screening in the Indo-Pacific. BD is working with Obstetric and Gynecological Societies to deliver education for clinicians on cervical cancer screening best practices, with an aim of reaching over 1,200 clinicians and support staff by early 2025. BD is also investing in pilots to inform the design of large-scale HPV screening rollout and programs to reach under-served communities. Through their longstanding partnership with Direct Relief, BD is working with the Self-Employed Women’s Association (SEWA) to facilitate screening for over 20,000 women. Under the program, 400 screening camps will offer screening, diagnosis and mental health support.
Improving Cancer Care Delivery
Project ECHO will accelerate cervical cancer elimination in the Indo-Pacific region through 10 new learning networks that facilitate effective and accessible prevention and care. More than 180 public health organizations in 33 countries leverage the ECHO Model, an evidence-based training and mentorship framework for community-based health care professionals, to improve cancer care delivery. By 2028, Project ECHO will launch at least 10 new communities of practice, with local partners and ministries of health in Indonesia, Vietnam, Malaysia, and other Indo-Pacific countries to accelerate cervical cancer elimination, including programs for HPV vaccine implementation, treatment of precancerous lesions, and use of essential curative therapies.
The American Cancer Society is committed to reduce the global burden of HPV-related cancers by increasing support of civil society organizations globally, including in the Indo-Pacific Region. Support for these organizations, initially focused on cancer civil society organizations and medical societies, includes catalytic grants and technical assistance for implementing evidence-based, low-cost behavioral interventions aimed at optimizing the demand and uptake of life-saving prevention services through widespread healthcare provider trainings.
The American Society of Clinical Oncology (ASCO) will update its global guidelines on the Management and Care of Women with Invasive Cervical Cancer to incorporate new recommendation-changing scientific evidence on optimal approaches to the treatment of cervical cancer. Once completed, ASCO will work with its members, including their Asia Pacific Regional Council, and partner oncology societies in the Indo-Pacific to support the usage of these guidelines, along with companion guidelines on primary and secondary prevention of cervical cancer, by cancer clinicians for improved patient outcomes in the region.
The International Atomic Energy Agency (IAEA) is expanding its Rays of Hope initiative to strengthen radiotherapy and medical imaging capacities in the Indo-Pacific region. Through this initiative, 13 countries and territories have requested support, and efforts are already underway to raise awareness and increase cervical cancer screening rates. The IAEA has designated cancer institutes in Japan, and India as Rays of Hope Anchor Centres, serving as hubs for capacity building in education, training, research, innovation, and quality assurance.
The Union for International Cancer Control is committed to working with its 1150 members across 172 countries to address inequities and drive global action in cervical cancer elimination, including in the Indo-Pacific region over the next three years as part of the ‘Elimination Partnership in the Indo-Pacific for Cervical Cancer’. Leveraging flagship convening platforms, established learning opportunities, alongside its rich network and proven ability to collaborate across sectors, UICC will support national partners to improve access to care, sustain progress and ultimately, reduce the burden of cancer for populations around the world.
Increasing Capacity for Cancer Research, Infrastructure, and Training
Memorial Sloan Kettering Cancer Center and Australia’s Royal North Shore Hospital in Sydney launch a $40 million public-private partnership that will advance international clinical trials of precision oncology and liquid biopsy technologies, including for the detection and elimination of cervical cancer. A generous donation of $20 million to each institution from Australian philanthropists Mr. Gregory John Poche and the late Mrs. Kay Van Norton Poche, will support this public-private partnership, accelerating the development of cutting-edge diagnostic and treatment tools for the Indo-Pacific region and beyond.
Amazon Web Services, Inc. (AWS) will support organizations in the Indo-Pacific region in their ability to prevent, detect, and treat cervical cancer, will provide cloud computing credits and enable access to AWS and datasets via the Registry of Open Data on AWS. Researchers are using AWS to identify patterns and variances from datasets secured from the Cancer Genome Atlas and others through AWS.
Pfizer will expand the INDovation initiative to build oncology capacity at the primary care level in the Indo-Pacific. INDovation was launched by Pfizer two years ago to support local startups. Under the program, Pfizer has awarded nearly $1 million in grants to startups, including those related to cervical cancer, and worked in partnership with the government and universities. Pfizer is now expanding the program to focus on oncology with the goal of strengthening primary care health centers. Under this phase, Pfizer will award grants to up to 10 startups that can deploy solutions to help enhance early diagnosis and patient services at the primary care setting with potential deployment across primary health centers in the region.
Elekta will expand radiotherapy capacity in the Indo-Pacific, closing an important treatment gap in the region to contribute to eliminating cervical cancer. Initiatives include establishing radiotherapy training centers in Southeast Asia, conducting treatment courses with regional medical centers and implementing cloud-based platforms to improve quality of care in radiotherapy through knowledge sharing, and peer review sessions among the member centers of the Asia-Pacific radiation oncology network.
MD Anderson commits to expanding their cervical cancer research, training and education programs to the Indo-Pacific region. MD Anderson currently collaborates with the Ministry of Health of Indonesia on the implementation and evaluation of cervical cancer screening, diagnosis and treatment programs and helps train medical providers in-country to perform colposcopy, ablation, loop electrosurgical excision procedure (LEEP), and surgery. MD Anderson commits to expanding these programs to ministries of health in the Indo-Pacific interested in partnerships to eliminate cervical cancer.
Increasing Cancer Awareness and Education to Empower People
Hologic, a global leader in diagnostic and medical imaging solutions for cervical and breast cancer, is working with government agencies and health care providers in the Indo-Pacific region to educate and raise awareness on cervical cancer. Hologic is currently expanding access to innovative technologies such as artificial intelligence in cervical cancer screening to scale population-based programs to overcome provider shortages in the Indo-Pacific region. In addition, Hologic commits to the continued publication of the Global Women’s Health Index, a comprehensive global survey about women’s health, filling a critical gap in what the world knows about the health and well-being of the world’s women and girls.
The Global Initiative Against HPV and Cervical Cancer will promote HPV vaccination, cervical screening and early treatment projects with partners and collaborators in the Indo-Pacific Region. These efforts will include organizing the Asia-Pacific Workshop in Bangkok to share knowledge and best practices within the region and expanding awareness efforts to further enhance awareness initiatives throughout the Indo-Pacific.
India fully supports this initiative. Let’s collectively work to strengthen the fight against cancer! https://t.co/54oxFoPSl9
— Narendra Modi (@narendramodi) September 22, 2024