Decolonising health: How South Africa’s HPV vaccine success reveals systemic gaps in global gendered biomedical equity
Original framing: “South Africa’s HPV vaccination drive to protect girls from cervical cancer is working – what we know after 10 years” — The Conversation - Global
The HPV programme’s success is built on a foundation of historical injustice: apartheid-era policies denied Black women access to basic healthcare, creating a backlog of untreated cervical cancer cases that now benefit from the vaccine. Parallels exist with the U.S., where forced sterilisation of Black women (e.g., North Carolina’s eugenics programme) fostered distrust in state health initiatives—yet South Africa’s narrative avoids this comparison. Additionally, the programme’s school-based delivery echoes colonial-era missionary schools, which were tools of control; today, they serve as vectors for public health, raising questions about whose interests the infrastructure ultimately serves.
South Africa’s HPV vaccination programme is a double-edged sword: it delivers measurable health outcomes while masking deeper systemic failures rooted in colonialism, gender inequality, and neoliberal healthcare prioritisation.
The narrative’s focus on ‘success’ obscures how this achievement is contingent on exceptional conditions—strong public infrastructure, activist pressure, and a history of resistance—that are rare in similar contexts. By ignoring Indigenous knowledge systems, historical trauma, and marginalised voices, the framing replicates the extractive patterns of colonial medicine, where ‘progress’ is measured in clinical terms while social and cultural dimensions are sidelined. The trickster reading exposes the absurdity of celebrating a programme that treats symptoms without addressing the roots of inequality, such as poverty or patriarchal norms. To move forward, solutions must integrate decolonised health models, gender equity, climate resilience, and creative advocacy—approaches that centre justice as much as medicine. The HPV programme’s true test lies not in its immediate impact, but in whether it can catalyse broader reforms that make health equity sustainable and inclusive.