A decade on, rapid HPV test-and-treat reaches Mpumalanga — but national rollout remains out of reach
Key milestones in South Africa's cervical cancer prevention programme, 2014–2025
10 March 2014
National HPV vaccination programme launched
Up to 500,000 Grade 4 girls at 17,000 public schools are targeted in the first phase of SA's school-based campaign, using Cervarix (bivalent, two-dose). First-dose coverage reaches 86.6% — among the highest for any new vaccine rollout in the country.
February 2015 – May 2016
Prof. Denny pioneers GeneXpert HPV testing in Khayelitsha
Prof. Lynette Denny's team installs a GeneXpert machine at a primary care facility in Khayelitsha, Cape Town, training a community health worker with no prior lab experience to run the test. The point-of-care study proves one-hour result turnaround and same-day treatment is feasible — establishing the blueprint for mobile "test and treat".
2020
Covid-19 school closures disrupt the vaccination campaign
HPV vaccination is halted when schools close during lockdown. An entire Grade 4 cohort misses scheduled doses. South Africa subsequently pivots the programme to Grade 5 to catch up the unvaccinated group once schools reopen.
17 November 2020
WHO launches global strategy to eliminate cervical cancer
194 countries — including South Africa — formally commit to the 90-70-90 targets by 2030: vaccinate 90% of girls by age 15; screen 70% of women; treat 90% with cervical disease. The WHO defines elimination as fewer than 4 cases per 100,000 women per year. Modelling projects a 42% reduction in cervical cancer rates by 2045 if targets are met.
2022
WHO shifts to single-dose HPV vaccine schedule
Based on evidence of comparable efficacy, WHO updates its recommendation from two doses to one — simplifying delivery logistics and cutting costs for national programmes.
2024
SA adopts single dose; HPV DNA screening replaces pap smears in public health
South Africa implements the WHO single-dose schedule for Grade 5 girls and extends the vaccination programme to private schools for the first time. Simultaneously, the National Department of Health introduces HPV DNA-based screening as the primary screening tool across public facilities — detecting infection before cellular abnormalities develop, allowing earlier intervention. In 2025, 928,811 women are screened; 322,611 test positive for high-risk HPV strains.
1 October 2025
Pfukani Mobile Clinic opens in Bushbuckridge, Mpumalanga
A R2-million public-private partnership between the Mpumalanga Department of Health and Discovery Health / Breast Health Foundation formally opens, equipped with a GeneXpert machine for one-hour HPV testing and same-day thermal ablation or LLETZ treatment. The clinic will serve approximately 20 patients a day, rotating across the district — one of the first operational implementations of Prof. Denny's test-and-treat model outside a research setting, nearly a decade after her Khayelitsha proof-of-concept.
South Africa has maintained above-86% HPV vaccination coverage since 2014 and committed to WHO's elimination targets in 2020. But the rapid test-and-treat technology Prof. Denny proved in Khayelitsha a decade ago still lacks national funding — the Pfukani Mobile Clinic is one of the first real-world implementations of her vision, while budget constraints explicitly block a nationwide rollout despite 322,611 high-risk HPV cases detected in 2025 alone.
Daily Maverick · Source: SA Government News Agency, 2014; UICC — WHO Global Strategy, 2020; ScienceDirect, 2025
