Heather Cubie

Together we have provided better preventative care for women in the hospital catchment area in relation to cervical cancer. The local communities have better understanding of the potential to reduce the burden of this unpleasant cancer and providers are justly proud of their achievements. The Ministry of Health accepts the appropriateness of the Nkhoma model of same day screen and treat and would like to roll-out further.” [from 2016] As a Clinical Scientist in Virology, my career-long interest has been human papillomavirus (HPV). I retired from my roles as Director of the Scottish HPV Reference Laboratory and in the training of Healthcare Scientists in 2012 and from the HPV Research Group in University of Edinburgh in 2014 but remain involved in HPV-related multi-professional / multi-partnership research. I have an honorary chair in the University of Edinburgh and act as a Senior Advisor to the Global Health Academy. Persistent infection with HPV is the cause of cervical cancer and pre-cancers. Cervical cancer is the second most common cause of cancer in women particularly in relatively young, productive women. Western countries have two effective means of reducing cervical cancer incidence: HPV immunisation of young girls and population-based cervical screening programmes. Scotland has an exceptionally effective school-girl immunisation programme and effective, centrally recorded cervical screening. Our programmes and processes in this area of preventative medicine are envied worldwide. I was involved in developing strategy, service change and implementation in Scotland, and from 2013 became involved in implementing a cervical cancer screening programme in Malawi. Partnerships are key to successful implementation and since our first meeting, I and Scottish colleagues have formed a close team with Nkhoma CCAP Hospital and have successfully delivered cervical screening and treatment to over 20,000 women. Much of the success of Scottish programmes is associated with education and communication, not just of healthcare staff but also of communities and young women themselves. I and my colleagues, Dr Christine Campbell and Dr Liz Grant of University of Edinburgh received funding from the Scottish Government for our programme in Nkhoma from 2013-2016 (MW01). Without this support for which we are most grateful, our aspirations both here and in Malawi would never have been fulfilled. However, there was no external funding between 2016-2018, yet Nhkoma Hospital and its trained team continued to deliver ‘screen and treat’ in such a way that it has become almost routine…a little injection of help and annual visits kept the partnership very much alive and increased the bond between the Malawian providers on the ground and the remote Scottish team through regular email, skype and What’s App messaging. My commitment to Malawi was strengthened by becoming a Board Member of SMP in 2015, a role which has been a privilege and also a revelation of the breadth and

Together we have provided better preventative care for women in the hospital catchment area in relation to cervical cancer. The local communities have better understanding of the potential to reduce the burden of this unpleasant cancer and providers are justly proud of their achievements. The Ministry of Health accepts the appropriateness of the Nkhoma model of same day screen and treat and would like to roll-out further.