By In 2011, Maina Modu, an immunization officer in Borno, a northeastern state of Nigeria, experienced a loss that would forever shape his mission in life. His wife, Hauwa, succumbed to cervical cancer, one of 349,000 preventable deaths women face worldwide each year. Her passing left a void that stretched beyond the walls of their home, touching a community already grappling with poverty, conflict, and limited access to healthcare.
Thirteen years later, Modu saw an opportunity to prevent such tragedies from striking his family and neighbours again. In May 2024, he played a key role in launching Borno’s first vaccination programme to protect teenage girls against the human papillomavirus (HPV), the virus responsible for almost all cases of cervical cancer. The campaign was personal: he ensured that two of his daughters, including the youngest child of his late wife, were among the first recipients of the vaccine.
“I was more excited than anyone,” Modu said, reflecting on the moment he could shield his children from the same fate that claimed his wife. “I was so happy they were safe. It made me think of my wife’s lost glory.”
Modu, a father of ten, has since become an advocate for the vaccine in his community, spreading awareness and encouraging families to participate. His story illustrates a broader global effort spearheaded by Gavi, the Vaccine Alliance, a public-private partnership that works with governments in lower-income countries to protect children and adolescents from over 20 infectious diseases. Through this initiative, millions of girls worldwide are gaining access to lifesaving HPV vaccinations.
Global Reach and Achievements
Since its foundation in 2000, Gavi has reached more than 86 million girls with HPV vaccinations, 73 million of them in just the past three years across Asia and Africa. The programme represents a crucial component of the World Health Organization’s (WHO) strategy to eliminate cervical cancer, following the success of global campaigns against measles, polio, and smallpox. Yet, despite the progress, the initiative faces significant hurdles.
In 2023, Gavi announced an ambitious target to expand HPV vaccination coverage dramatically. By early 2025, the organisation reported it had achieved its objectives ahead of schedule, thanks to the coordinated efforts of governments, civil society, and local communities. “This cooperative endeavour is propelling significant worldwide advancements in the eradication of one of the deadliest illnesses affecting women,” said Dr. Sania Nishtar, CEO of Gavi.
However, the celebrations were tempered by a sudden policy reversal from the United States. In June 2024, during a video address to world leaders gathered to pledge financing to Gavi, US Health and Human Services Secretary Robert F. Kennedy Jr. announced the withdrawal of all US funding until the organisation could “re-earn the public’s trust.” Kennedy, a longstanding critic of vaccines, praised Gavi’s commitment to making medicines accessible worldwide but questioned its handling of vaccine safety and communications during the Covid-19 pandemic.
Gavi swiftly defended its record, citing its reliance on independent WHO experts and its continued commitment to evidence-based decisions. “The organisation remains committed to a scientific approach in its work and investment decisions,” a spokesperson said. Talks with US officials to restore funding have been ongoing in the months since.
Funding and the Global Challenge
National governments and private funders—including businesses, philanthropies, and individuals—constitute the bulk of Gavi’s financing. Until recently, the US was among the largest contributors, providing about 13% of Gavi’s total funding. Since its inception, the organisation has immunised over 1.2 billion children in 78 low-income countries, preventing an estimated 20.6 million deaths. No nation had ever revoked a funding commitment before, making the US decision unprecedented.
Without the US contribution, Gavi faces a shortfall of approximately $3 billion, roughly 25% of its projected budget. Experts warn that this financial gap could necessitate scaling back HPV vaccination efforts, jeopardising the fight against cervical cancer.
“Deploying resources to areas with the greatest health impact will require difficult decisions,” a Gavi spokesperson said. “While HPV vaccination remains a priority, funding constraints could limit our ability to expand coverage.”
Dr. Robert Bednarczyk, associate professor of global health at Emory University’s Rollins School of Public Health, emphasises the stakes: “The millions of HPV vaccinations distributed so far will save lives. But each year, new children become eligible. Reducing funding could limit access, particularly in areas with high cervical cancer rates.”
The Science Behind the Vaccine
HPV vaccinations target a family of viruses responsible for around 4% of global cancers, with cervical cancer being the most common and deadly among women. Depending on the vaccine formulation, it prevents between 70% and 90% of cervical cancer cases.
“It’s a remarkable vaccine,” said Dr. Jessica Kahn, senior assistant dean of clinical and translational research at the Albert Einstein College of Medicine. She noted that HPV vaccination also protects against infections that cause vulvar, anal, vaginal, and head-and-neck cancers. “It could have a genuinely revolutionary effect on cancer worldwide.”
First administered in 2006, the HPV vaccine became the second cancer-preventing vaccine globally, following the hepatitis B vaccine, which helps prevent liver cancer. WHO recommends that girls aged 9 to 14 receive the HPV vaccine in two or three doses before becoming sexually active. Its long-term effects are becoming apparent as the first vaccinated cohorts now reach the ages when cervical cancer is most likely to develop.
“The HPV vaccine is probably one of the most effective vaccines we have,” Bednarczyk said. “The research consistently shows it reduces the incidence of cervical cancer and its global burden.”
Yet, for years, access was primarily limited to wealthier nations, including the US and Europe. Vaccinating girls in low- and middle-income countries, particularly in sub-Saharan Africa, requires significant financial investment—an area where Gavi has been crucial.
Gavi’s Strategy and the Single-Dose Breakthrough
Gavi began piloting school-based immunisation programmes in the 2010s, but vaccine shortages soon emerged as demand exceeded supply. Over the years, the organisation negotiated purchase agreements with manufacturers to secure doses for the 57 countries it serves.
A significant breakthrough arrived in late 2022. WHO guidelines confirmed that a single dose could provide effective protection, simplifying delivery and increasing reach. “The single-dose recommendation meant the supply we had could go much further,” said Emily Kobayashi, director of Gavi’s HPV Vaccines Program. Administering one dose rather than two or three allowed health workers to vaccinate more girls efficiently.
Gavi allocated $600 million to revitalise its HPV vaccination programme, helping countries procure vaccines, strengthen health systems, and integrate HPV immunisation into routine schedules. In 2023 alone, 14 million girls were vaccinated—more than in the previous eight years combined.
Nigeria: The Human Face of the Campaign
Nigeria, Africa’s most populous nation, was among the first to introduce a single-dose HPV programme with Gavi’s support. Cervical cancer prevalence in Nigeria is four times higher than in the United States, making the programme urgent.
“When the federal government announced the introduction of HPV vaccination, I was astounded,” Modu said. He mobilised his entire community, ensuring families understood the importance of vaccination.
Since 2023, over 13 million girls in Nigeria have received HPV vaccines, representing the largest share of Gavi’s global efforts. In total, 49 countries have implemented HPV vaccination programmes, with seven more scheduled to launch by mid-2026, some as early as the end of 2025.
Gavi reports that by January 2025, 89% of global cervical cancer cases would be in regions where HPV vaccines are available, up from just 10% a decade ago. “This is a game-changer for HPV vaccination,” Kobayashi said. “One childhood vaccination can almost entirely prevent cervical cancer, a disease that often causes painful and dehumanising deaths.”
Ambitious Goals, Now Under Threat
Gavi plans to vaccinate 120 million girls between 2026 and 2030, potentially saving 1.5 million lives. The organisation has spent the past year soliciting donations to meet this target. However, Kennedy’s announcement threatens the programme’s trajectory.
The United States had pledged $1.58 billion for 2025–2030 under the Biden administration—the largest contribution in its history. While previous administrations, including Trump’s, maintained funding commitments, the current withdrawal marks the first major reversal.
Congress still authorises annual funding, but the administration has paused disbursements. The US State Department has emphasised that global health funding must achieve measurable impact in line with American taxpayer priorities. Other donors, such as Brazil, the Netherlands, and Hungary, have increased contributions, but collectively, these cover less than $200 million of Gavi’s nearly $3 billion budget gap.
“The Board and leadership are exploring ways to adjust programmes with minimal impact on children’s health,” a Gavi spokesperson said. The organisation continues to support countries already implementing HPV vaccination, including Nigeria, where girls remain eligible from age nine.
Modu’s Continuing Mission
At 56, Modu retired last month from his role as an immunization officer, yet his advocacy has not wavered. He shares his family’s story to encourage vaccination, hoping to prevent other families from enduring the pain he experienced.
“I learned from my late wife that cervical cancer is very dangerous and deadly,” he said. “That motivates me to vaccinate my daughters and inspire others to do the same.”
In January, one of his youngest daughters will turn nine. Modu plans to personally take her to the neighbourhood health clinic for her first HPV vaccination. It is a small act, but one that carries the weight of a father’s love, a community’s hope, and a global fight against one of the world’s deadliest preventable cancers.
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