{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T05:03:00Z","timestamp":1789448580407,"version":"build-2803163510"},"reference-count":31,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T00:00:00Z","timestamp":1789430400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Oncol."],"abstract":"<jats:p>Cervical cancer is the first cancer for which the World Health Organization has adopted a global elimination strategy with explicit incidence and coverage targets, and that strategy rests on three pillars: vaccinate 90% of girls, screen 70% of women, and treat 90% of those found to have disease. Only the first is backed by a global pooled-procurement and co-financing mechanism. Screening, triage, treatment of precancer, and the management of invasive disease are financed nationally where they are financed at all, through general budgets, benefit packages, and time-limited donor projects, and where those fall short, they are paid for at the point of use. This Perspective argues that this gap is structural rather than incidental and that it produces a particular kind of unfairness. Vaccination protects a cohort that will not meet the disease for decades. The women dying of cervical cancer now were born too early to be vaccinated, and every remaining step of care carries a price. Recent changes moving vaccine financing into national budgets sharpen this problem rather than resolving it. Four remedies are proposed, each concerning what governments agree to buy and how they pay for it rather than how much external money arrives.<\/jats:p>","DOI":"10.3389\/fonc.2026.1941545","type":"journal-article","created":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T04:27:30Z","timestamp":1789446450000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Vaccinating girls, abandoning women: the financing asymmetry between HPV immunization and the cervical cancer treatment cascade in low- and middle-income countries"],"prefix":"10.3389","volume":"16","author":[{"given":"Shyamkumar","family":"Sriram","sequence":"first","affiliation":[{"name":"Department of Rehabilitation and Health Services, College of Public Affairs and Health Sciences, University of North Texas","place":["Denton, TX, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,9,15]]},"reference":[{"key":"B1","volume-title":"Global strategy to accelerate the elimination of cervical cancer as a public health problem","year":"2020"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(20)30068-4","article-title":"Impact of HPV vaccination and cervical screening on cervical cancer elimination: a comparative modelling analysis in 78 low-income and lower-middle-income countries","volume":"395","author":"Brisson","year":"2020","journal-title":"Lancet"},{"key":"B3","doi-asserted-by":"publisher","first-page":"591","DOI":"10.1016\/S0140-6736(20)30157-4","article-title":"Mortality impact of achieving WHO cervical cancer elimination targets: a comparative modelling analysis in 78 low-income and lower-middle-income countries","volume":"395","author":"Canfell","year":"2020","journal-title":"Lancet"},{"key":"B4","volume-title":"Human papillomavirus vaccine support","year":"2025"},{"key":"B5","article-title":"Human papillomavirus vaccines: WHO position paper (2022 update)","volume":"97","year":"2022","journal-title":"Wkly Epidemiol Rec"},{"key":"B6","volume-title":"Cervical cancer vaccines save over 1 million lives in lower-income countries","year":"2025"},{"key":"B7","doi-asserted-by":"publisher","first-page":"413","DOI":"10.1016\/S1470-2045(26)00128-2","article-title":"India introduces human papillomavirus vaccination","volume":"27","author":"Sharma","year":"2026","journal-title":"Lancet Oncol"},{"key":"B8","volume-title":"Against the odds: Pakistan's health heroes protecting girls from cervical cancer","year":"2026"},{"key":"B9","doi-asserted-by":"publisher","DOI":"10.1016\/S2214-109X(22)00241-8","article-title":"Cervical cancer screening programmes and age-specific coverage estimates for 202 countries and territories worldwide: a review and synthetic analysis","volume":"10","author":"Bruni","year":"2022","journal-title":"Lancet Glob Health"},{"key":"B10","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2020.16244","article-title":"Lifetime prevalence of cervical cancer screening in 55 low- and middle-income countries","volume":"324","author":"Lemp","year":"2020","journal-title":"JAMA"},{"key":"B11","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(19)30308-0","article-title":"Scale-up of radiotherapy for cervical cancer in the era of human papillomavirus vaccination in low-income and middle-income countries: a model-based analysis of need and economic impact","volume":"20","author":"Rodin","year":"2019","journal-title":"Lancet Oncol"},{"key":"B12","doi-asserted-by":"publisher","DOI":"10.1136\/ijgc-2021-003001","article-title":"Global challenges of radiotherapy for the treatment of locally advanced cervical cancer","volume":"32","author":"Mayadev","year":"2022","journal-title":"Int J Gynecol Cancer"},{"key":"B13","volume-title":"Human papillomavirus (HPV) vaccine market shaping roadmap. 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