Strengths, Weaknesses, Opportunities and Threats (SWOT) in Human Papillomavirus Vaccine Roll-out in India
Year: 2026
Type: article
Abstract: Cervical cancer is the fourth-most commonly diagnosed cancer and also the fourth leading cause of cancer mortality in women globally.[1] As per the Global Cancer Observatory, India accounts for 1/5th of cervical cancer cases detected and 1/4th of cervical cancer deaths globally. Cervical cancer is the second-most common cancer in both incidence (18.3%) and cancer mortality (18.7%) amongst women in India, with a 5-year prevalence of 18.8% as per the 2020 report. Although there is a decline in age-standardised incidence rate and mortality rate, India is still falling short of the target for reducing premature cancer deaths.[2,3] The World Health Organization (WHO) has set a goal for the global elimination of cervical cancer, defined as an incidence of fewer than 4 per 100,000 women per year. A 90-70-90 target has been set: 90% of girls should be fully vaccinated with the human papillomavirus (HPV) vaccine by age 15, 70% of women should be screened with a high-performance test by 35 and again by 45 years of age and 90% of women with cervical disease should receive treatment.[4] However, as per a national study, only 2.2% of women between the ages of 30 and 69 have undergone cervical cancer screening and the cervical cancer vaccine coverage is very low.[5] Cervical cancer is highly preventable and its cause is well understood and there is an efficacious vaccine available. About 80%–90% women develop an HPV infection during their lifetime. While 90% of these infections and associated low-grade lesions clear out by themselves, persistent, unresolved HPV infection causes cervical cancer. It takes 20–40 years for an HPV infection to cause cervical cancer, according to the WHO. Vaccination against HPV is one of the most effective preventive strategies against cervical cancer, along with screening. India now has an indigenous vaccine developed against cervical cancer and the cost of the vaccine is much lower. India has attempted HPV vaccination in certain states in the past and understanding the strengths, weakness, opportunities and threats would strengthen and greatly improve public health outcomes by implementing HPV vaccination, especially through the Universal Immunization Programme (UIP).[6] Keeping this in mind, the following article attempts to assess internal and external factors influencing the successful roll-out of the HPV vaccine in India. The analysis aims to inform strategy formulation, identify areas for policy intervention and support decision-making for national and state-level stakeholders. The SWOT analysis has been carried out by considering lessons learnt from various countries. Peer-reviewed articles, public health journals and policy brief literature available for the HPV vaccine in India, which have focussed on the barriers and facilitators. Lessons learned from roll-out in Indian states, especially to strengthen the SWOT analysis for guiding HPV vaccine implementation across the country, have also been considered [Table 1].[6-10]Table 1: Strengths, weaknesses, opportunities and threats analysis for human papillomavirus vaccination roll-out in IndiaSWOT analysis does have certain limitations. While the SWOT outlines factors, it may not provide a strategy or clear decision-making path. It does require further analysis (e.g. gap analysis, cost–benefit analysis) to translate insights into practical actions. The results from the SWOT analysis can support data-driven strategies for policy formulation, stakeholder engagement and operational improvements. The major factors include prioritising school-based vaccination, sensitisation of parents and teachers, considering WHO-recommended single-dose vaccination schedule, ensuring equitable access, engaging private practitioners and NGOs, promptly addressing misinformation, engaging community influencers and leaders, taking support from role models of the female youth and leveraging technology and they could be helpful for its successful launch and sustainability. It is essential to identify vaccine hesitancy and misinformation early and involve multiple stakeholders in community sensitisation (media, religious and political leaders) in order to prevent more damage from this misinformation.
Authors: Rashmi Agarwalla, Himashree Bhattacharyya
Institution: All India Institute of Medical Sciences Guwahati
Language: English
Subfield: Epidemiology
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W7118197292