HPV Vaccination Across the Life Course: Protecting More People from Preventable Cancer

Human papillomavirus (HPV) is one of the world’s most common infections. WHO estimates that up to 80% of sexually active people will acquire HPV during their lifetime. Most infections clear naturally, but persistent infection with high-risk types can cause cancer.

The list is broader than many people realize. HPV can cause cervical, anal, penile, vulvar, vaginal, and oropharyngeal cancers. In 2019, HPV was estimated to cause around 620,000 cancer cases in women and 70,000 in men worldwide.

That is why the conversation around HPV vaccination needs to evolve. HPV prevention has long been associated primarily with adolescent girls and cervical cancer. Those programs remain essential, but they do not represent the full HPV disease burden or the full population that may benefit from prevention.

HPV-related cancer is not a women’s health issue alone

Cervical cancer remains the most significant HPV-related cancer globally and is a major health equity challenge. Yet HPV affects people of all genders.

Among men, HPV can cause anal, penile, and oropharyngeal cancers. Oropharyngeal cancer has become one of the most common HPV-associated cancers in men in several high-income countries, illustrating how an approach focused exclusively on cervical cancer can leave important gaps in public understanding. 

The way HPV is discussed is critical. When the virus is presented only in relation to women’s health, men may not recognize their own risk or understand why vaccination is relevant to them.

HPV prevention should therefore be communicated as what it is: cancer prevention for people of all genders.

Why consider HPV vaccination beyond adolescence?

Routine vaccination before exposure to HPV remains the foundation of prevention. 

However, a large number of adults were never offered HPV vaccination when they were younger.

The reasons differ. Some were already beyond the age groups targeted when national programs were introduced. Others faced eligibility, access, or cost barriers. HPV vaccines were introduced at different times across countries, creating significant differences between generations.

Adults can continue to encounter new HPV exposure risks throughout life. Previous infection does not necessarily mean previous exposure to every HPV type covered by a vaccine. Vaccination does not treat an existing infection, but it can provide protection against HPV types a person has not encountered. 

National recommendations for adult HPV vaccination vary. A life-course approach is therefore not a single global vaccination schedule. It is a public health framework that asks whether current programs are reaching the populations they are designed to protect and what happens to those who were missed.

What is a life-course approach to HPV immunization?

A life-course approach recognizes that prevention does not happen at one point in time.

For HPV, it begins with strong vaccination programs for adolescents and continues by creating opportunities for catch-up and adult vaccination where national policies, evidence, and health systems support them.

A comprehensive approach can include:

• Routine vaccination for adolescents
• Catch-up vaccination for eligible populations
• Consideration of adult vaccination
• Inclusive policies covering people of different genders
• Convenient access through appropriate healthcare and community settings
• Clear communication from trusted health professionals

The principle is simple: a person’s age should not be the only lens through which prevention opportunities are considered.

The vaccination access gap

Having an effective vaccine is only one part of a successful immunization program.

People need to know that vaccination is available, understand why it matters, and be able to access it without unnecessary barriers.

For adults, this may mean offering vaccination through services they already use. Primary care, pharmacies, sexual health services, specialist clinics, workplaces and community programs can all provide potential access points depending on the national context.

Healthcare professionals are equally important. A recommendation from a trusted clinician can help people make informed decisions, particularly where misinformation has created uncertainty about vaccines.

Access strategies must also reflect local realities. A program designed for a large urban health system may not work in a rural community. Cost, distance, language, and trust can all determine whether prevention reaches the people it is intended to serve.

A global conversation that includes LMICs

Low- and middle-income countries carry a disproportionate burden of HPV-related disease. According to WHO, around 94% of the approximately 350,000 cervical cancer deaths recorded in 2022 occurred in low- and middle-income countries.

This imbalance should shape the global conversation about HPV prevention.

Countries facing the greatest burden must be represented in decisions about vaccine access, financing, delivery, and policy. A global life-course approach cannot simply export models developed elsewhere. It needs to account for different health systems, disease burdens and access challenges.

The goal is shared, but implementation will look different from one country to another.

From evidence to action

The World Federation of Public Health Associations (WFPHA), together with more than 60 supporting organizations, is calling for greater attention to adult HPV vaccination through its Advancing Adult HPV Vaccination: From Evidence to Action initiative.

The Call to Action focuses on strengthening prevention across the life course and addressing populations that earlier vaccination programs may have missed. It calls for:

• Greater consideration of adult HPV vaccination
• Broader and more inclusive prevention strategies
• Better integration of vaccination into healthcare systems
• Stronger public and professional awareness
• Policies that address gaps in access
• Meaningful participation from low- and middle-income countries in shaping global approaches

It’s not shifting attention or resources away from adolescent vaccination; it examines the gaps that remain once those programs are in place.

The public health opportunity is clear: protect adolescents early, close gaps where they exist, and avoid treating previous missed opportunities as permanent.

Protecting people across the life course

HPV vaccination has already changed what is possible in cancer prevention. The next challenge is ensuring that prevention strategies reflect the full reality of HPV-related disease.

That means recognizing cancers affecting women and men. It means strengthening routine programs while considering those who were never reached. It means designing access around people rather than expecting people to navigate complex systems.

Most importantly, it means changing the question.

Instead of asking only: Who is the vaccine traditionally offered to?

Public health leaders should also ask: Who remains unprotected, and what can be done about it?

The WFPHA’s Advancing Adult HPV Vaccination: From Evidence to Action Call to Action brings this question to the forefront.

HPV-related cancers are preventable. The evidence is there. The tools are available.

The next step is to expand prevention.

Watch the video here

Preventing death and disease from Respiratory Syncytial Virus (RSV) and Pneumococcal Disease in all our children

RSV and pneumococcal disease are longstanding threats to child health, but we are at a turning point: after decades of research, we now have safe and effective tools that can greatly reduce severe disease and hospitalization in young children.

With this Call to Action, the World Federation of Public Health Associations (WFPHA) and supporting leaders and organizations aim to catalyze urgent, equitable, and sustained investment in protecting every child against preventable respiratory disease.

By doing so, we take a decisive first step in a broader, lifelong commitment: a life-course approach to immunization that safeguards health not just in the first months of life, but at every stage.

Preventing RSV and Pneumococcal Disease in Every Child

Pneumonia is preventable

Pneumonia is the leading infectious killer of children under five. It is not inevitable; it is preventable.

RSV is the single most important cause of severe pneumonia in infants globally. Pneumococcal disease is the second. Together they account for the majority of childhood pneumonia deaths. Both are preventable.

RSV also causes bronchiolitis and other RSV-attributable respiratory illnesses.

Yet the children who bear the greatest burden have the least access to prevention.

We have the tools to prevent severe respiratory disease

We have the tools. We need the political will. We need to act urgently.

Two WHO SAGE-endorsed approaches can prevent severe RSV disease in infants:

• RSV prevention: RSV long-acting monoclonal antibody interventions or RSV maternal vaccination must be introduced and expanded.
• Pneumococcal disease prevention: The pneumococcal conjugate vaccine (PCV), already widely available, must be maintained and expanded.

Particular emphasis is needed on RSV because PCV is already included in many national immunization programs, while an advocacy gap remains for RSV.

The burden of RSV in children

More than 3.6 million children under five are hospitalized each year because of RSV, creating recurring strain on pediatric wards and ICU capacity, especially during seasonal peaks.

Approximately 100,000 children under five die from RSV-attributable respiratory illness annually, and 97% of RSV deaths occur in low- and middle-income countries.

Pneumonia also claims the lives of approximately 700,000 children under five each year.

Countries should make evidence-based immunization policy decisions based on local epidemiology, disease burden, health system readiness, and national public health goals.

Immunization is an investment

Prevention is one of the most cost-effective government investments.

Immunization programs overall are estimated to return $20–$52 for every $1 invested.

Evidence from different settings demonstrates the potential economic value of RSV prevention. In Chile, nirsevimab was cost-saving. In Spain, a universal long-acting monoclonal antibody program averted 215,878 RSV events and saved approximately €48 million in direct costs. In Canada, approximately 47,609 RSV health-related events were averted, with around CAD$45 million in healthcare savings.

The key takeaway is clear: prevention is an investment, not a cost. A major barrier is budget silos, where vaccine and drug budgets may sit in separate ministries or funding streams.

Results can be visible within one year

Act today.

In one year:

• Pediatric RSV hospitalizations can fall by up to 88%.
• ICU admissions can drop by up to 90%.

Results are visible, measurable, and politically rewarding.

Every country needs an approach suited to its context

There is no one-size-fits-all approach. Every country must select the approach best suited to its context, products, and system.

WHO recommends long-acting monoclonal antibody or maternal vaccination for universal implementation. The choice depends on infrastructure and delivery capacity, and some countries may use both.

RSV seasonality varies by region and climate. Local epidemiology and timing should guide strategy.

Alongside PCV, RSV immunization provides a synergistic shield against two leading infectious causes of severe childhood pneumonia.

A Call to Action for RSV Immunization and PCV

Governments and policymakers

WFPHA calls on all stakeholders, including government ministers, politicians and policymakers, health professionals, funders, industry, community leaders and civil society, to act urgently and decisively to make RSV immunization a national priority in every country, for every child, while maintaining, simplifying and strengthening PCV immunization.

Politicians and policymakers should:

• Prioritize RSV prevention alongside PCV.
• Allocate funding and bridge vaccine and drug budget silos.
• Set a national target for RSV coverage for every infant by next season.
• Enhance surveillance.
• Enhance real-world evidence.

Health professionals

Health professionals have a critical role in integrating RSV and PCV prevention into care pathways and advocating for national action.

They should:

• Integrate RSV and PCV into antenatal, neonatal and pediatric pathways as appropriate.
• Advocate for NITAG and HTA consideration.
• Engage professional societies and trusted voices.
• Monitor hesitancy toward long-acting monoclonal antibodies.
• Strengthen training.
• Combine RSV and PCV advocacy in every vaccination engagement.

Experience from Murcia, Stanford and Zurich demonstrates how health-system integration, continuous training, parent education, eligibility checks and opportunities for discussion can support high uptake and reduce equity gaps.

Funders, industry and interest groups

Funders, industry and interest groups should:

• Fund country-level economic analyses and budget impact models.
• Invest in production capacity when appropriate.
• Finance surveillance and real-world data.
• Close access gaps through tiered pricing, expanded LMIC regulatory filings, and manufacturing and supply commitments.
• Ensure RSV and PCV financing fit coherent investment strategies.

Access depends on functioning markets and predictable supply. Clear demand forecasting, healthy markets, multiple products, appropriate manufacturing capacity, and market-shaping mechanisms are important to ensuring that children can benefit from available prevention tools.

Civil society and community leaders

Civil society, community leaders, and community health workers can translate evidence into accessible language, build awareness and acceptability, and elevate the prioritization of infant pneumonia prevention.

They should:

• Amplify demand for infant pneumonia prevention.
• Counter misinformation with accessible and culturally appropriate narratives.
• Advocate to elected representatives through patient associations.
• Engage faith and community leaders.
• Champion equity so no child is unprotected by geography, income, or ethnicity.

Measure the burden. Measure the impact. Make success visible.

Surveillance is not universal, making robust RSV and PCV surveillance an immediate priority.

Countries should:

• Build baseline burden estimates.
• Establish standardized reporting, case detection, and laboratory confirmation.
• Monitor serotypes where appropriate.
• Conduct post-introduction monitoring.
• Collect first-season impact data.
• Maintain pharmacovigilance.
• Share national data globally.
• Communicate results publicly.
• Advocate for RSV to be included on notifiable disease lists where appropriate.
• Maintain virological surveillance, including monitoring of mutations.

A practical eight-step framework can support implementation:

1. Know your burden.
2. Assess your system.
3. Check product access.
4. Run the numbers.
5. Gauge community readiness.
6. Engage your NITAG.
7. Integrate and launch.
8. Measure and adapt.

Equity must remain at the center

Science alone does not drive policy. Advocacy requires clear, emotionally resonant narratives.

Every child, wherever born, deserves a first birthday free from vaccine-preventable disease.

RSV and PCV prevention together are a statement of equity. The burden falls hardest on families vulnerable to structural disadvantage, including differences related to ancestry, economic status, and other social factors.

Long-acting monoclonal antibodies are a new therapeutic class that parents and caregivers may not understand. For some hesitant families, this can also become a communication asset when the approach is explained clearly.

The data are strong. The tools exist.

Every day without action means preventable deaths.

This is a rare, urgent, and timely opportunity to protect countless children from severe respiratory disease.

The WFPHA and those who recognize the importance of this opportunity call on all organizations, professionals and citizens who seek fairer, healthier and more equitable societies to join us by signing this document and committing to drive the changes outlined in the Call to Action.

Learn more: WHO: Respiratory syncytial virus (RSV) | UNICEF: Pneumonia in children

Read the original call to action

Watch the call to action video with Michael Moore, Chair of the Global Taskforce on Immunization Policy

The 2025-2026 World Federation of Public Health Associations (WFPHA) Annual Report

Our 2025-2026 Annual Report is now available. This yearly report showcases the WFPHA’s key initiatives and activities aimed at protecting people, preventing diseases, and promoting global health and well-being. As always, we thank our members, sponsors, partners, colleagues, and friends for promoting public health.

Previous Annual Reports from the WFPHA

Global One Health Index Report, One Health for All

Geneva Principles for One Health Implementation

Adopted on the occasion of the World Health Assembly Side Event “One Health for All to Improve Global Public Health” on May 19, 2026, Geneva, Switzerland.

Preamble

We, the participants of the 79th World Health Assembly side event convened by the World Federation of Public Health Associations (WFPHA) and the Chinese Preventive Medicine Association (CPMA), reaffirm that human, animal, and environmental health are inextricably linked, forming a single, indivisible system.

Recognizing the persistent gaps between One Health policies and their effective implementation, and acknowledging the urgent need for coordinated action against emerging infectious diseases, antimicrobial resistance, climate-sensitive health threats, zoonotic pandemics, biodiversity loss, and food insecurity, as well as recognizing the essential role of civil society, faith communities, and Indigenous peoples as partners in One Health delivery, we hereby adopt and commit to the following Geneva Principles for One Health Implementation.

Principle 1: Shared Responsibility and Inclusive Governance

One Health implementation requires mandatory, institutionalized collaboration across health, agriculture, environment, water, food systems, and infant sectors at local, national, and global levels. Decision-making must include representatives of human, animal, and ecosystem health, civil society organizations, Indigenous peoples, and faith communities throughout design, implementation, and evaluation.

Principle 2: Bridging Policy-Practice Gaps

All One Health commitments shall be accompanied by gender-responsive, actionable roadmaps, clear budgetary allocations, and time-bound milestones. Policies must be co-designed with field implementers, community health workers, civil society organizations, Indigenous knowledge holders, and veterinary and wildlife services.

Principle 3: Monitoring, Evaluation, and Accountability

Each signatory institution commits to establishing measurable One Health performance indicators, including joint outbreak-response metrics, zoonotic disease transmission rates, antimicrobial-use surveillance, and ecosystem health outcomes. Regular independent peer review and public reporting on implementation progress shall be conducted, with findings made publicly accessible through open platforms.

Principle 4: Science-Based and Locally Informed Decision-Making

While global indices can serve as valuable tools, implementation decisions must be guided by local epidemiological, ecological, and social data, as well as traditional and Indigenous knowledge systems. We encourage the systematic adoption of integrated One Health assessment frameworks, including city-level One Health assessments, to identify capacity gaps and track improvements.

Principle 5: Capacity Building and Equitable Access

Sustainable One Health requires investment in cross-sectoral workforce training, laboratory networks, and digital surveillance systems, with priority given to low- and middle-income countries, small island developing states, and vulnerable communities. Knowledge exchange, open science, technology transfer, and expanded joint financing mechanisms should be prioritized.

Principle 6: Emergency Preparedness and Adaptive Management

One Health implementation must function as a dynamic, real-time system for early warning and rapid response. Mechanisms for adaptive management, including regular simulation exercises, community-based surveillance networks, and after-action reviews, shall be integrated into national and global health security and planetary resilience architectures.

Advancing One Health Through Global Cooperation

The COVID-19 pandemic highlighted the deep connections between health, animals, ecosystems, food systems, and the environment. A One Health approach is critical not only to prevent outbreaks of zoonotic diseases but also to address antimicrobial resistance, food safety, biodiversity loss, and climate-related health threats.

One Health is an integrated, unifying approach that aims to sustainably balance and optimize the health of people, animals, and ecosystems. It recognizes that the health of humans, domestic and wild animals, plants, and the wider environment is closely linked and interdependent. Through collaboration across sectors, disciplines, and communities, the approach supports prevention, preparedness, detection, and response to current and emerging global health challenges.

International cooperation has become central to advancing One Health implementation. The collaborative work of the World Health Organization, the Food and Agriculture Organization of the United Nations, the World Organization for Animal Health, and the United Nations Environment Program has strengthened global recognition of the need for coordinated action at the human-animal-environment interface. Their continued efforts support countries in improving prevention, prediction, detection, and response to global health threats while contributing to sustainable development.

The Geneva Principles for One Health Implementation reinforce the importance of measurable action, inclusive governance, and accountability. By bridging knowledge and implementation, these principles aim to support stronger national and global systems that protect public health, strengthen resilience, and promote equitable and sustainable futures for all.

Bridging knowledge and action through measurement done by the Global One Health Index Research Team

A Vision for Our Federation: Two Years, Four Priorities, One Purpose

It is a thought I carry with me as I begin this presidency. We live in a turbulent world. Conflicts, climate crises, emerging pandemics, and deepening inequalities do not wait politely for our strategic plans to catch up. Events will challenge our priorities. They will test our resolve and demand our flexibility.

But what events cannot change — what I am determined they will not change — is the DNA of this Federation. The reason each of us gives so much of our time, energy, and passion to this agenda is a shared and unshakeable belief: that global public health matters, that the health of our societies and our planet is a collective responsibility, and that our greatest obligation is to those who are most vulnerable. That conviction is our compass, however turbulent the waters.

With that compass firmly in hand, I want to set out four work streams that will shape my two-year mandate.

First: strengthening our member organizations. WFPHA is only as strong as the national public health associations that make up its family. I am committed to ensuring the center serves the membership by sharing regular updates, a bi-monthly newsletter that keeps every association informed of major events and opportunities, and by introducing travel grants to enable young public health professionals to attend key international gatherings. The next generation of leaders must have a seat at the table.

Second: supporting our World Congresses on Public Health. These congresses are among the most important convening spaces in global public health. I want to ensure they are exceptionally well planned, properly resourced, and financially sustainable — events that our members are proud to attend and that leave a lasting legacy in their host cities.

Third: the creation of a WFPHA academic journal. Knowledge must be a public good. I envision an open-access journal available free of charge to all our members, and one in which up to 20 percent of published articles incur no publication costs for authors from the Global South. If we are serious about equity, we must begin with how we share knowledge.

Fourth: building a true Global Public Health Alliance. We are not alone. The Global Network of Academic Schools of Public Health and the International Network of Institutes of Public Health share our values and our ambitions. Working more closely together — creating something genuinely greater than the sum of our parts — is both a strategic opportunity and a moral imperative.

None of this will be achieved alone. It will take all of us, working in the same direction, with generosity and determination. I am fortunate to have the support of our outstanding CEO, Professor Bettina Borisch, and COO, Dr. Marta Lomazzi. With a team of this caliber — and a membership of this commitment — I am confident we can deliver.

The journey begins now. I am honored to take it with you.