Hitting the Pause Button: The Impact of COVID-19 on Cervical Cancer Prevention, Screening and Treatment Access in Indonesia

As Indonesia grapples with COVID-19, it remains vital that other crucial health interventions continue to be prioritised to minimise the overall health footprint of the epidemic. Cervical cancer is a preventable disease, yet it is the most lethal female cancer in Indonesia, responsible for more than 18,000 deaths each year. Thanks to the efforts of several key groups driving health reforms to step up cervical cancer control in recent years, Indonesia has a national screening program and, up until late 2019, a HPV vaccination pilot program was being rolled out across five provinces. An interdisciplinary four-year study exploring the experiences of and health system responses to cervical cancer in Indonesia was underway when the COVID-19 pandemic emerged. Alarmingly, the widespread restrictions on citizens’ mobility and the redistribution of resources to the COVID-19 response has resulted in key services for cervical cancer prevention and screening being paused indefinitely, without a clear path forward. Treatment seeking, and the availability of support services for women with a cervical cancer diagnosis have also been interrupted. If unaddressed, these pauses will lead to an increase in women presenting with late stage cervical cancer, for which treatment is more invasive and costly, with a lower chance of survival. We are also concerned for the future generation of women in Indonesia, who, without access to affordable HPV vaccination, will face a heightened risk of developing cervical cancer compared with their peers from countries that have prioritised investing in this life saving vaccine