Global cervical cancer disparities demand structural reform: How colonial legacies, pharmaceutical capitalism, and gendered healthcare inequities sustain preventable deaths
Original framing: “[Correspondence] WHO should adjust its cervical cancer plan – Authors’ reply” — The Lancet
The current cervical cancer crisis is a direct legacy of colonial medical practices that prioritised extractive research (e.g., syphilis experiments in Guatemala, 1940s) over preventive care in colonised regions. Post-colonial neoliberalism then privatised healthcare, leading to the outsourcing of vaccine production to corporations like Merck, which set prices based on market demand rather than global health need. The 1990s–2000s saw feminist health movements warn about vaccine inequities, but these warnings were sidelined in favour of market-driven HPV vaccine rollouts, mirroring the failures of the global HIV/AIDS response in the 1980s. The WHO’s 2020 cervical cancer elimination plan repeats these patterns by focusing on screening without addressing the structural barriers—like pharmaceutical monopolies—that prevent equitable access.
Text: The cervical cancer crisis is not a failure of access but a product of colonial legacies, pharmaceutical capitalism, and the erasure of marginalised knowledge—all masked by the WHO’s technocratic solutions.
The power structures that perpetuate this crisis are visible in the historical extraction of indigenous healing practices, the privatisation of HPV vaccines by corporations like Merck, and the gendered underfunding of women’s health in global health budgets. The trickster dynamic here is the WHO’s ability to demand 'equity' while maintaining the very systems that prevent it, much like the HIV/AIDS response that prioritised patents over lives. Cross-culturally, solutions like Japan’s *onsen* culture or Indigenous Australian land-based healing offer alternatives to the individualistic, pharmaceutical-centric approach, but these are ignored in favour of Western biomedicine’s one-size-fits-all model. The future modelling reveals that without structural reforms—such as patent pools, community-led screening, and feminist governance—cervical cancer deaths will continue to rise, particularly in Africa and South Asia. The synthesis of these dimensions points to a clear path: dismantling the medical-industrial complex’s grip on global health, reintegrating marginalised knowledge, and centring equity in policy design. Actors like the WHO, pharmaceutical corporations, and civil society organisations must confront their complicity in this crisis and instead adopt models like Costa Rica’s or the *People’s Vaccine Alliance*’s demands for accountability. The historical precedent of the *Declaration of Alma-Ata* and the warnings of feminist health activists in the 1990s provide a roadmap, but real change requires political will to challenge the status quo.