Prior to the World Health Assembly in 2018, the Director-General of the WHO, Dr Tedros Adhanom Ghebreyesus made a global call for action regarding a disease that has the potential to be eliminated - cervical cancer. He expressed the need for a global coordinated initiative of multilateral agencies and the private sector, who are the manufacturers of vaccines, diagnostics, and treatments.
Cervical cancer has long been one of the most preventable and treatable forms of cancer if detected and managed early. Yet in 2018 one woman died of cervical cancer every two minutes and of those that died, 9 in 10 lived in poor countries (1). The Human Papilloma Virus (HPV) vaccine is very effective and has the ability to save millions of lives (as nearly all cases of cervical cancer are caused by HPV), but access is problematic. In 2018, Dr Tedros called for all girls globally to be vaccinated against HPV and that every woman over 30 years old is screened and treated for precancerous lesions.
Cervical cancer is a disease of poverty. It is largely preventable through public health interventions such as screening and the HPV vaccination. However, where a woman lives (her country, rural or urban), her socioeconomic status, her status within the family, and the culture she is exposed to will determine whether she develops cervical cancer. The Gender Inequality Index (which includes the status of reproductive health, women’s empowerment, and economic status) has shown to be correlated with cervical cancer incidence and mortality. The higher the inequality, the higher the risk of developing and dying from cervical cancer. Thus, in addition to vaccination against HPV, access to reliable, accurate, and dependable screening procedures are incredibly important.
Although time has passed since Dr Tedros’s call to action, in hopes of moving towards a world where cervical cancer is eliminated, the current numbers to not reflect completely positive progress. As of 2022, there were 604,000 new cases of cervical cancer worldwide and there were 342,000 cervical cancer deaths in 2020 alone. While HPV vaccination does help reduce cervical cancer levels, frequent screening to accurately detect and treat cervical cancer as early as possible is crucial. The most common means for conducting a cervical exam is to use a two-bladed or duck-billed speculum. While these have been the standard of care for decades, one major downside of this traditional speculum is that it does not provide for full visibility of the cervix, meaning that indications of cervical cancer could go unnoticed. The new and innovative Bouquet SpeculumTMmay offer a solution to revolutionize future cervical exam access worldwide. The speculum is a low-cost, plastic single-use speculum which highlights a forward-thinking design allowing for advanced healthcare provision via cervical exams that allow for maximum visibility to quickly identify irregularities and initiate any precancer or cancer treatment. The 5-petal shaped speculum also has several other benefits, such as offering increased patient comfort, and its suitability for women of any BMI via radial dilation for an even distribution of pressure exerted from the vaginal walls, and can be used for a variety of other procedures that require a speculum.
While the Bouquet Speculum is currently available to the U.S market, its features make it a product that shows a high amount of promise for future use worldwide to allow for increased access to cervical cancer screenings worldwide. This would be a great step forward in the effort to eliminate the loss of life due to cervical cancer.
The BiliDx is a novel system for diagnosing jaundice. The device uniquely meets the Target Product Profile (TPP) developed as part of the NEST 360 initiative in that it allows blood-based testing at the bedside. This initiative is part of an emerging global consensus in the Every Newborn Action Plan that countries need functional WHO level-2 inpatient units to care for "small and sick newborns."
Now as a next step, we ask what could be done to lower the costs of the implementation of the E-MOTIVE bundle? The most obvious answer is to consider displacing the tens of thousands of disposable plastic drapes with a purpose-built reusable device.
Fortunately one of the obstetricians involved in the E-MOTIVE study, Dr. Justus Hofmeyr, had been innovating around this very issue, designing a tray with wells that could fit under a woman’s buttocks, collect and accurately measure the. blood. This tray, theMaternaWellTraywas conceived as a device that could be sterilized and reused, and is manufactured in South Africa by Umoya.