Cervical cancer is South Africa’s leading cause of cancer-related death among women, with disproportionate impact on women living with HIV, who experience higher rates of persistent HPV infection and treatment failure. Although school-based prophylactic HPV vaccination and screening programmes exist, current interventions are insufficient to achieve WHO cervical cancer elimination targets, particularly in high-burden settings.
Therapeutic HPV vaccines, which aim to clear HPV infections and regress precancerous lesions, are in late-phase development and may complement existing prevention strategies. However, their potential utility in South Africa is unknown, and no modelling studies have evaluated how product characteristics and delivery strategies would influence health impact or cost-effectiveness in this setting.
This project will extend MicroCOSM-HPV, a locally calibrated individual-based model, to explore a range of therapeutic vaccine Preferred Product Characteristics and implementation approaches. Scenarios will account for real-world constraints in efficacy, coverage, and health system delivery, with outputs including projected reductions in cervical cancer incidence and disability-adjusted life years, stratified by HIV and antiretroviral therapy status.
The model will estimate the product characteristics and delivery strategies most likely to yield public health benefit and define threshold prices per dose for cost-effective use.
This is the first study to evaluate therapeutic HPV vaccine Preferred Product Characteristics for the South African epidemiological and health system context, and will provide the necessary evidence showing the conditions under which therapeutic HPV vaccines would be a game-changer for cervical cancer elimination in South Africa.
Findings will support evidence-informed planning, guide potential vaccine or trial design, and provide critical input to South Africa’s National Cervical Cancer Elimination Strategy. The project will also build local modelling capacity through early career research training and technical engagement with national stakeholders.
