• Agnes Binagwaho, Fidele Ngabo, Claire M Wagner, Cathy Mugeni, Maurice Gatera, Cameron T Nutt, and Sabin Nsanzimana.
• Ministry of Health of Rwanda, Kigali, Rwanda .
• Bull. World Health Organ. 2013 Sep 1;91(9):697-703.

ProblemAlthough it is highly preventable and treatable, cervical cancer is the most common and most deadly cancer among women in Rwanda.ApproachBy mobilizing a diverse coalition of partnerships, Rwanda became the first country in Africa to develop and implement a national strategic plan for cervical cancer prevention, screening and treatment.Local SettingRwanda - a small, landlocked nation in East Africa with a population of 10.4 million - is well positioned to tackle a number of "high-burden" noncommunicable diseases. The country's integrated response to infectious diseases has resulted in steep declines in premature mortality over the past decade.Relevant ChangesIn 2011-2012, Rwanda vaccinated 227,246 girls with all three doses of the human papillomavirus (HPV) vaccine. Among eligible girls, three-dose coverage rates of 93.2% and 96.6% were achieved in 2011 and 2012, respectively. The country has also initiated nationwide screening and treatment programmes that are based on visual inspection of the cervix with acetic acid, testing for HPV DNA, cryotherapy, the loop electrosurgical excision procedure and various advanced treatment options.Lessons LearntLow-income countries should begin to address cervical cancer by integrating prevention, screening and treatment into routine women's health services. This requires political will, cross-sectoral collaboration and planning, innovative partnerships and robust monitoring and evaluation. With external support and adequate planning, high nationwide coverage rates for HPV vaccination and screening for cervical cancer can be achieved within a few years.

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