Evidence-based guidance for transitioning to the HPV nonavalent vaccine in South Africa
At SACEMA, a core part of our mission is ensuring that science serves society—that research does not remain locked in academic journals but is translated into evidence that informs national policy and saves lives. As South Africa prepares for its next HPV vaccine procurement cycle, SACEMA and partners present evidence-based guidance for transitioning to the nonavalent vaccine — setting the stage for 2026’s elimination targets.
Research led by Dr Cari van Schalkwyk
The underlying research was led by Dr Cari van Schalkwyk, Senior Researcher at SACEMA, whose work focuses on infection-attributable cancers and the use of epidemiological modelling to guide public health decisions.
Dr van Schalkwyk and collaborators used national HPV prevalence and cost-effectiveness data to compare vaccine strategies for South Africa. Their modelling shows that the nonavalent vaccine—covering seven high-risk HPV types (16, 18, 31, 33, 45, 52, 58)—could prevent up to 85% of cervical cancer cases and remains cost-saving at current UNICEF Supply Division prices (USD 13.5–33.25 per dose).
The nonavalent vaccine is the shot that will give South Africa a real opportunity to reach WHO elimination thresholds. Now is the time for us to rethink our cervical cancer elimination strategy – not just in terms of vaccination, but also scaling up screening and linkage to treatment, to protect the next generation from preventable cancers.
Dr Cari van Schalkwyk, Senior Researcher, SACEMA
Why the nonavalent vaccine matters now
- Broader protection: Prevents ~85% of cervical cancers compared with ~65% for the bivalent vaccine.
- Cost-effective investment: Within South Africa’s public-sector affordability threshold and cost-saving at UNICEF pricing.
- Equity and prevention: Offers enhanced protection for women living with HIV and reduces the burden of other HPV-related cancers.
- Policy timing: Current vaccine procurement reviews provide a short-term opportunity for long-term population health gains.
Even with expanded vaccination, South Africa will need to scale up screening and early treatment to reach elimination targets. The policy brief calls for an integrated national strategy linking vaccination, screening, and treatment within the National Cancer Control Plan.
Collaboration that connects research and policy
This cross-sector collaboration combined modelling, health economics, and social science expertise —turning evidence into guidance that policymakers can act on.
- Policy Brief: Evidence-based guidance for transitioning to the HPV nonavalent vaccine in South Africa
- Data and cost-effectiveness modelling from the VaxCEA study (van Schalkwyk et al., 2025)
- Cancer Alliance website
Issued by the Cancer Alliance in collaboration with the South African Centre for Epidemiological Modelling and Analysis (SACEMA), Stellenbosch University, University of KwaZulu-Natal, and Columbia University.
