Dr Raj Shankar Ghosh and Dr Saurabh Sharma
Every eight minutes, somewhere in India, a woman dies of cervical cancer. By the time most are diagnosed, the disease has already advanced to Stage II or beyond, stealing years of life, household savings and the rhythm of family. And yet, of all the cancers women face, this is the one we know how to prevent. The vaccine exists and is proven to work. The screening tests exist. The treatments exist. What has been missing for many communities is awareness, health systems that provide accessible, equitable, inclusive and affordable healthcare for all and the trust that this cancer can be prevented and treated when caught early.
That is beginning to change and a new coalition is trying to accelerate it. The Cervical Cancer Elimination Consortium – India (CCEC-I), brings together government bodies, academic institutions, non-profits and clinicians around a single goal: to support the Government of India in achieving the World Health Organisation’s 90-70-90 targets by 2030, which means that 90% of girls vaccinated against HPV by age 15, 70% of women screened with a high-performance, by ages 35 and 45, and 90% of those diagnosed receiving adequate treatment. The Consortium’s blueprint goes by a simple acronym: SAVE- Screening, Access to treatment, Vaccination and Empowering communities through education.
Screening: From hesitation to self-sampling
Among the four pillars of the SAVE strategy, screening remains both the weakest link and the greatest opportunity in India’s cervical cancer response. In a small Health and Wellness Centre in rural Madhya Pradesh, an auxiliary nurse-midwife (ANM) might still be asking women about symptoms before referring them for visual inspection with acetic acid (VIA). The trouble is that by the time symptoms appear, the cancer is often advanced. Just 1.9% of eligible Indian women have ever been screened (National Family Health Survey- NFHS-5), a number that lays bare how thinly the current opportunistic model is spread.
The gap between policy intent and on-ground implementation has increasingly drawn attention to three areas that could significantly strengthen cervical cancer screening in India. First, move from VIA to high-performance HPV DNA testing, in line with WHO guidance, since over 80% of Indian cervical cancers are driven by HPV types 16 and 18. Second, embrace self-sampling, which removes the discomfort and embarrassment that keep so many women away. A woman can collect her own sample in the privacy of a curtained corner, drop it at a centre and receive a reliable result without ever placing her feet in stirrups. Third, ensure that every primary health centre has the basics-a private room, trained female staff, working specula, an empathetic ear,so that when women do come, they are met with respect rather than rushed exams or whispered judgments.
For the most marginalised groups such as transgender people, women living with HIV, those in prisons, sex workers, tribal women and women with disabilities, the standard model has been all but invisible. Special drives, mobile units and community-friendly clinics must reach them where they are. A woman in a remote tribal hamlet of Arunachal Pradesh, whose Papumpare district records among the highest cervical cancer incidence rates in Asia (National Cancer Registry Programme), deserves the same chance as a woman in South Delhi.
Access to treatment: Closing the last mile
Screening only saves lives when a positive result leads to timely care. In India, that pathway is often broken. District hospitals frequently lack histopathology labs and colposcopy units. Specialists are few and far apart, clustered in and around the bigger towns and cities. Standard pathways for managing pre-cancerous lesions and invasive cancer are inconsistently followed. And the financial blow of cancer treatment-surgery, chemotherapy, radiotherapy, often pushes families into poverty. India’s five-year survival rate of 51.7%, compared with over 80% in better-resourced systems, tells the story of late diagnosis and uneven care.
Elimination of cervical cancer will require a series of coordinated, step-by-step interventions. First, Integrate visual assessment and thermal ablation into the Centre’s National Programme on Non-Communicable Diseases (NP-NCD) framework so that screen-positive women can be treated at the same visit, dramatically reducing loss to follow-up. Second, Equip district hospitals with colposcopy and biopsy services and the Loop Electrosurgical Excision Procedure (LEEP) for early lesions. Third, build out the Hub and Spoke model that links State Cancer Institutes and Tertiary Care Cancer Centres with district facilities, training local gynaecologists through regional centres of excellence. Fourth, Include cervical cancer diagnostics in the Pradhan Mantri Jan Arogya Yojana so that families do not have to choose between treatment and food. And critically, deploy patient navigators, the real people whose job it is to walk every screen-positive woman from her village to her treatment, holding her hand through a system that can otherwise feel like a maze.
Vaccination: A generation within reach
The most exciting chapter of India’s cervical cancer story is being written now. In 2022, the Serum Institute of India became the first domestic and fifth global manufacturer of an HPV vaccine, opening the door to affordable supply. Punjab’s Bathinda and Mansa districts and the entire state of Sikkim have already shown what is possible, vaccinating thousands of schoolgirls through partnerships between health departments, schools, UNICEF and Jhpiego. On 28 February 2026, Prime Minister Narendra Modi launched the HPV vaccination programme at Ajmer, Rajasthan as part of India’s Universal Immunisation Programme. The vaccine will now be available free of cost to about 1.5 crore (15 million) girls aged 14 across all states and union territories.
However, this rollout must be matched by equally strong systems: state-specific microplans that include out-of-school girls, robust Adverse Events Following Immunisation surveillance to maintain public trust, a strengthened laboratory network to track post-vaccination genotype shifts and use of the new U-Win digital platform to record every dose. The Ministry’s move to a single-dose schedule is in line with WHO’s 2022 position paper, which could improve compliance, particularly among out-of-school girls who may be hard to reach a second time.
Empowering communities: The hardest, most important work
Vaccines and screening tests are only as effective as the awareness and the trust that surrounds them. In a country where the cervix is barely named, where reproductive health is shrouded in shame, where men often make the final decisions about women’s bodies and their health choices and where rumour can travel faster than science, community education is not a soft add-on, it is the foundation on which everything else rests.
It means equipping ASHAs (Accredited Social Health Activists) with job aids and the language to dispel myths about HPV and screening. It means engaging male family members, family decision makers, mothers-in-law, community influencers, religious leaders and traditional medicine practitioners as allies rather than obstacles. It means training teachers to talk to parents about why a vaccine for a nine-year-old protects her from a cancer she might otherwise face at fifty, without ever having to invoke the word “sexuality” in a way that closes the door. It means partnering with self-help groups, youth champions under the Rashtriya Kishor Swasthya Karyakram (RKSK), transgender community leaders, women in prisons and cancer survivors who can speak with the authority of lived experience. And it means using every available channel, may it be social media, community radio, local theatre, jatra performances, even festivals,to reach women where they live, in the languages and idioms they already trust.
A future worth building
India has eliminated diseases before. It eliminated polio against odds many thought insurmountable and it did so through the same ingredients that cervical cancer elimination demands: political will, scientific rigour, last-mile delivery and a deep, unrelenting faith in community workers. With the SAVE strategy, Screening that respects women’s dignity, Access to treatment that does not bankrupt families, Vaccination that protects a generation, and communities Empowered to protect their own – cervical cancer can join that list. The tools are in our hands. What remains is the resolve to use them well, together and without delay. For every Indian woman alive today, and for every daughter not yet born, the time to act is now.
Dr Raj Shankar Ghosh is Lead, Healthcare Consultancy at Nangia & Co LLP and a physician with three decades of experience in infectious disease control and primary healthcare delivery, currently working on climate and health, digital health tools and women’s cancer control.
Dr Saurabh Sharma is Senior Advisor at the Cervical Cancer Elimination Consortium- India, and a public health specialist with 33 years of experience in policy formulation, immunisation and surveillance systems in low-resource settings.
