How have you and your organization been impacted by and adapted to COVID-19?

Unplanned program shifts have presented new opportunities to reimagine solutions to emerging problems. For example, PCI has deep experience in cervical cancer detection/treatment in Zambia, having treated over 35,000 rural women over the past decade.   This year, in partnership with PEPFAR and the U.S. DOD HIV/AIDS Prevention Program, we have worked with the Zambian Defense Forces to integrate cervical cancer screening into routine care for HIV+ women. Addressing the joint burdens of cervical cancer and HIV saves women’s lives.

In May, when Zambia recorded the first cases of COVID-19, the Health Ministry introduced measures to reduce HIV+ clients’ exposure to COVID-19 by providing them with a 6-month supply of antiretroviral drugs to limit clinic attendance. However, that resulted in a drastic drop in the number of women accessing cervical cancer screening services. Although this helped prevent COVID-19, it left women vulnerable to the threat of HIV/cervical cancer co-morbidity. 

We rapidly mobilized our CHWs to educate women on the importance of cervical cancer screening and COVID-19 prevention. CHWs now send appointment reminders to HIV+ clients to promote screening services. Spacing out appointments to avoid overcrowded clinics and connecting virtually with clients ensures the safety of those who receive and provide vital services.

What concerns you most about women’s health in low-resource countries during the pandemic? What is your organization doing about it?

Women and girls, especially those most underserved, suffer most during public health emergencies. In places where there is already limited access to safe water, sanitation and health care, COVID-19 has continued to exacerbate existing threats to women’s health.

In addition to facing a heightened risk of domestic violence and exploitation while under lockdown or other restrictions, women are also more likely to bear the responsibility of caring for ill family members. And, as the global health community turns its attention to COVID-19, women’s health interventions such as cervical cancer screenings, maternal, newborn and child health services, and sexual and reproductive health services have been given the backseat or disrupted altogether.

Recognizing this, we are working with a wide range of partners, supporters and stakeholders—from governments to private sector corporations and foundations—to prioritize practical ways to mitigate secondary effects of COVID-19 in women’s health interventions. We have pulled together some creative public-private partnerships to allow us to adapt our programs using digital technology and mobile services so we can continue our support for women and adolescent girls at heightened risk during COVID. And in an era of potential cutbacks, we are prioritizing those programs with greatest likely impact and scale for women health. Safeguarding the health of women in low resource countries remains one of PCI and Global Communities’ top priorities.   

How do you see cervical cancer prevention – the HPV vaccine and screen-and-treat – coming back after the pandemic? What can we do now to prepare for the resumption of services?

We can’t let cervical cancer prevention fall to the wayside as we continue to adapt to evolving COVID-19 challenges. We will continue to shift toward mobile outreach cervical cancer screening programs to minimize crowding at health facilities and prevent infection. If we provide PPEs to screening personnel and women accessing services and maintain strict infection prevention and control measures, we can take these proven low-cost/low-tech lifesaving services to the last mile.  

As facility-based immunization programs have been affected by COVID-19, the strategy should also shift to providing mobile outreach services. Just as we prioritized integrated cervical cancer and HIV services, we need to integrate HPV vaccination programs into expanded mobile immunization programs. And mobile technology is an important strategy to educate and engage communities and build demand for HPV vaccination, cervical cancer screening, family planning, and MNCH services in underserved areas.

Working with global advocacy networks such as TogetHER, we must keep donors engaged and informed about the critical importance of continuing services by sharing compelling stories and statistics that speak to our ability to end cervical cancer. This includes accelerating and implementing global strategies such as the “Global Strategy towards Elimination of Cervical Cancer as a Public Health Problem.”

What is something you have learned during COVID-19 that makes you hopeful?

I’ve been reminded that we are capable of doing extraordinary things when we come together. Despite all the alarming news, it is the people who keep me truly hopeful. I am heartened to see governments, corporations, foundations, NGOs and individuals stepping up and collaborating in new and creative ways, even as they face enormous difficulties. And, as always, I am continually inspired by the resilience and commitment of the health care workers, CHWs and frontline staff who ensure that our HIV/AIDS and cervical cancer screening and treatment services continue without interruption, in the face of extreme hardship. I urge all of us to view COVID-19 as a clarion call to action and an opportunity to choose the kind of defiant optimism that sees the world as it is, with all of its pain and perils, but also all of its progress and potential. We owe that to each other.

For more on PCI’s global cervical cancer programs, click here.

Interested in reading more TogetHER Interviews with leaders in the global cervical cancer response? Click here for the full list.

Carrie Hessler-Radelet is the President & CEO of Project Concern International (PCI), a Global Communities Partner. She also serves as President of Global Communities.

Prior to PCI, Hessler-Radelet served as Director of the Peace Corps (2012-2017) and Deputy Director (2012-2015), leading America’s iconic international volunteer service organization with programs in over 65 countries. At Peace Corps she led historic reforms to modernize and strengthen the agency to meet the challenges and opportunities of the 21st century.

Before being appointed to the Peace Corps by President Obama, Hessler-Radelet worked as the Vice President and Director of the Washington D.C. office of John Snow, Inc. (JSI), overseeing the management of public health programs in 85 countries around the world. Her decades of global health work also included serving as the lead consultant on the first Five-Year Global HIV/AIDS Strategy for the President George W. Bush’s Emergency Plan for AIDS Relief (PEPFAR), working with USAID in Indonesia on maternal and child health and HIV programming, founding the Special Olympics in The Gambia, and serving as a Peace Corps Volunteer with her husband in Western Samoa.

Hessler-Radelet is passionate about empowering communities to discover their own sustainable, innovative solutions to poverty. She holds a Master of Science in Health Policy and Management from Harvard University and a Bachelor of Arts in Political Science and Economics from Boston University.