Peer-reviewed article
Financing of Human Papillomavirus Vaccination in Africa: A Scoping Review
Kafayat Aminu, Jimoh Amzat, Rita Amarachi Nwebo, Precious Chika Nnannah, Chiamaka Norah Ezeagu et al. ·
Summary
Written by AI, not yet AICS's view · claude-sonnet-5-5This scoping review looked at how HPV vaccination, which helps prevent cervical cancer, is paid for in Africa. It drew on 27 peer-reviewed studies found by searching nine databases. HPV vaccination in most African countries depends heavily on donor funding, mainly from Gavi, and domestic co-financing is limited. Costs vary widely between studies. The authors say countries need to prioritise cost-effective vaccines, increase domestic funding and reduce reliance on external support.
Key points
- 27 peer-reviewed studies were included.
- Funding depends heavily on donors, particularly Gavi, with limited domestic co-financing in most countries.
- Per-dose costs ranged from US$0.27-US$19.76 (financial) and US$1.31-US$45.00 (economic) as reported.
- Main cost drivers were service delivery, personnel and outreach to out-of-school girls. School-based delivery was more cost-effective in several contexts.
- A single-dose schedule consistently showed lower cost with comparable efficacy. Willingness to pay exists among private individuals, but out-of-pocket models remain inequitable.
Limitations
Only the abstract is available, so we cannot see which countries or studies produced each finding. As a scoping review of cost and financing studies, it does not test whether any financing model improves vaccination coverage or health outcomes, and cost figures vary widely across settings and years.
Abstract
Background and Aims: Human papillomavirus (HPV) vaccination is a critical intervention for cervical cancer prevention in Africa; however, program uptake and scale-up remain limited due to financing constraints. This scoping review mapped existing evidence on HPV vaccine financing in Africa, identifying prevailing funding mechanisms, cost estimates, delivery strategies, and challenges and opportunities for sustainable financing. Methods: Guided by the Arksey and O'Malley framework and PRISMA-ScR guidelines, we systematically searched nine electronic databases for peer-reviewed studies. Retrieved records were deduplicated and screened against eligibility criteria. Eligible studies underwent data extraction, followed by collation, summarization, and thematic synthesis. All costs were standardized to United States (US) Dollars and further adjusted to a common reference year (2025US) using the US Consumer Price Index (CPI-U) to enable comparison across study years. Results: Twenty-seven peer-reviewed studies were included. The review found heavy dependence on donor support, particularly from Gavi, with limited domestic co-financing across most countries. Per-dose costs ranged from US$0.27-US$19.76 (financial) and US$1.31-US$45.00 (economic) as reported, or US$0.32-US$26.50 and US$1.63-US$60.36 after adjustment to 2025 US; per fully immunized girl, costs ranged from US$6.68-US$40.03 and US$17.31-US$91.19 as reported, or US$8.31-US$53.69 and US$21.53-US$122.31 adjusted. Primary cost drivers included service delivery, personnel, and outreach to out-of-school girls. School-based delivery was more cost-effective in several contexts, and the single-dose schedule consistently showed lower cost with comparable efficacy, enhancing cost-effectiveness and reducing programmatic burden. Willingness to pay exists among private individuals, but out-of-pocket models remain inequitable. Conclusion: Donor funds, mainly Gavi, still drive HPV vaccination in most of Africa. The single-dose schedule cuts costs and logistics while remaining effective. For equitable, sustainable access, African countries must prioritize cost-effective vaccines, boost domestic funding, strengthen health systems, and adopt models that lessen reliance on external support.