Understanding the Burden of Cervical Cancer in the Pacific

Cervical cancer remains one of the most pressing health challenges in the Pacific region, where it stands as a leading cause of cancer death among women. Caused primarily by persistent infection with high-risk types of the human papillomavirus (HPV), this preventable disease claims lives due to limited access to vaccination, screening, and treatment. In parts of the Pacific, incidence rates can be up to nine times higher than in Australasia, with age-standardized incidence rates reaching 19.28 per 100,000 women in the Pacific Islands Hub. The World Health Organization's (WHO) Western Pacific Region, which includes many Pacific nations, reported 145,700 new cases and 74,900 deaths in 2020 alone, predominantly in low- and middle-income settings.

In New Zealand, Pasifika women face disproportionate risks, with cervical cancer incidence at 6.1 per 100,000 compared to 5.7 for European/Other women, and mortality at 3.5 versus 1.3 per 100,000. Screening coverage lags, with Pasifika rates as low as 55% at recent lows, despite national efforts. These disparities stem from barriers like limited knowledge, privacy concerns in small communities, time constraints from family and work responsibilities, and cultural stigma around sexual health discussions. For the University of Auckland's researchers, addressing these inequities through targeted, culturally sensitive interventions is paramount, positioning higher education at the forefront of regional health equity.

This context underscores the urgency of initiatives like the one led by the University of Auckland, bridging academic research with practical Pacific-led solutions.

The Launch of the $5.1 Million Pacific-Led Initiative

Announced on March 6, 2026, the Pacific-Led Cervical Cancer Elimination Initiative marks a transformative step toward eradicating the disease in the region. Spearheaded by the University of Auckland's Te Poutoko Ora a Kiwa – Centre for Pacific and Global Health – the programme secures NZ$5,097,210 from the Matariki Fund, a philanthropic effort administered by Rt Hon Dame Jacinda Ardern to support women's health in the Pacific. This funding enables a collaborative rollout of proven prevention strategies, starting in the Cook Islands and Niue before expanding region-wide over 2026–2031.

The initiative builds on existing successes like Australia's EPICC programme and New Zealand's Polynesian Health Corridors, avoiding duplication while amplifying impact. By empowering local leaders, it ensures sustainability beyond the grant period, exemplifying how university-led research translates into actionable policy and health system strengthening.

University of Auckland's Pivotal Leadership Role

The University of Auckland stands at the helm through Te Poutoko Ora a Kiwa, a dedicated centre advancing Pacific and global health research. As co-directors, Professor Judith McCool, Head of the School of Population Health, and Professor Sir Collin Tukuitonga bring decades of expertise. McCool's work focuses on non-communicable diseases in Pacific contexts, including barriers to screening and vaccination uptake. Tukuitonga, a Niuean public health pioneer and former New Zealand Director of Public Health, champions equity for Pacific peoples, drawing from his WHO advisory roles.

This leadership highlights the university's commitment to research jobs that address real-world inequities, fostering interdisciplinary teams in public health, epidemiology, and community engagement. The centre's involvement not only drives the project but also trains emerging Pacific researchers, ensuring knowledge transfer for future generations.

Strategic Alignment with WHO's Global Elimination Targets

Perfectly aligned with the WHO's Global Strategy to Eliminate Cervical Cancer, the initiative targets the "90-70-90" milestones by 2030: 90% of girls fully vaccinated against HPV by age 15, 70% of women screened at ages 35 and 45 with high-performance tests like HPV self-testing, and 90% of those with cervical disease treated effectively. In the Pacific, where progress lags due to geographic isolation and resource constraints, this structured approach provides a roadmap.

• 90% HPV Vaccination: Scale coverage for adolescent girls, leveraging school-based programs and community outreach.
• 70% Screening: Introduce self-collection HPV tests to overcome access barriers, with follow-up diagnostics.
• 90% Treatment: Ensure timely access to cryotherapy, LEEP, or surgery for precancerous lesions and cancers.

University researchers will monitor progress using robust data systems, contributing to evidence-based adaptations.

Key Partnerships Driving Regional Collaboration

Success hinges on a robust network: Te Marae Ora (Cook Islands Ministry of Health) and Niue Department of Health lead local implementation. Broader ties include EPICC (Australian Government and Minderoo Foundation-funded) for technical support and Polynesian Health Corridors (NZ Ministry of Health and MFAT) for vaccination logistics. This Pacific-led model prioritizes local ownership, with University of Auckland providing research backbone.

Such collaborations exemplify higher education's role in international development, opening doors for higher ed career advice in global health for NZ academics.

Focus on Cook Islands and Niue: Initial Implementation

The programme kicks off in Cook Islands and Niue, where cervical cancer burdens are acute due to remoteness. In these nations, self-testing kits will reach remote communities, HPV vaccination campaigns target schools, and training equips local clinicians for treatment. University of Auckland teams will embed monitoring frameworks to track 90-70-90 progress, adapting based on real-time data.

This phased approach allows testing at scale-up, minimizing risks while maximizing early wins. For NZ universities, it showcases applied research's value in small-island contexts.

Core Activities: Vaccination, Self-Testing, and Treatment Expansion

Step-by-step, the initiative operationalizes prevention:

1. HPV Vaccination Drive: Partner with schools and communities to vaccinate 90% of eligible girls, using Gardasil-9 for broad protection against oncogenic HPV types.
2. Self-Testing Rollout: Distribute easy-to-use HPV self-collection kits, mailed to labs for analysis, boosting screening to 70% by overcoming clinic visit barriers.
3. Diagnostics and Treatment: Link positive screens to colposcopy and ablation/LEEP, ensuring 90% treatment access via mobile units if needed.
4. Digital Infrastructure: Develop apps for tracking and reminders, enhancing system efficiency.

Research from University of Auckland validates self-testing's efficacy in Pasifika populations, where privacy concerns deter traditional smears.

Empowering Pacific Women Leaders

A standout feature: forming a coalition of Pacific women leaders to spearhead workforce development. Training nurses, community health workers, and policymakers in digital tools and leadership ensures sustainability. Professor McCool emphasizes: “This grant allows us to move beyond isolated interventions to a truly collaborative, Pacific-led approach.”

This focus aligns with equity goals, inspiring NZ higher education opportunities in leadership roles for Pasifika scholars.

Expected Health Impacts and Research Contributions

By 2031, the initiative could avert thousands of cases, saving lives and reducing healthcare burdens. Modelling suggests meeting 90-70-90 halves incidence long-term. University researchers will publish findings on implementation science, informing global strategies.

Professor Tukuitonga notes: “Cervical cancer is preventable, yet too many Pacific women continue to die from it.” Broader ripple effects include strengthened health systems and empowered communities.

Overcoming Challenges: Barriers and Solutions

Challenges persist: geographic isolation, low awareness, supply chain issues for vaccines/tests. Solutions include culturally tailored education (Pasifika languages), mobile clinics, and data-sharing platforms. Research addresses privacy via anonymous self-tests, proven effective in NZ trials.

• Privacy: Community-led distribution builds trust.
• Access: Drones/partners for remote delivery.
• Sustainability: Train-the-trainer models.

Future Outlook: Scaling to Regional Elimination

Post-2031, the model scales across Pacific, potentially achieving WHO elimination as a rare disease. University of Auckland's role evolves to evaluation and innovation, like AI screening tools. This positions NZ higher ed as Pacific health hub.

Photo by Andrew Yu on Unsplash

Implications for Higher Education and Careers

The initiative exemplifies university impact, attracting higher ed jobs in global health. Aspiring researchers can explore research assistant roles, contributing to equity. Explore openings at university jobs or rate my professor for mentors like McCool and Tukuitonga.

For Pacific students, it opens pathways in public health, aligning with NZ's commitment to regional leadership.