Cytology (pap smear) programs have not decreased mortality from cervical cancer in low and middle-income countries (LMICs). These programs are not feasible in LMICs because they require highly trained staff and sophisticated infrastructure.

In 2012, BHI partnered with the Salvadoran Ministry of Health (MINSAL) to introduce low-cost HPV testing, potentially a more effective screening strategy in these settings. CAPE was a phased demonstration project that screened more than 28,000 women.

To implement this scale-up, the Salvadoran Ministry of Health (MINSAL) has secured one million dollars to integrate the CAPE paradigm into the public health system beginning in 2018. BHI will continue to act as a technical advisor for this countrywide initiative.

Analysis of this project showed that a screen and treat strategy using HPV testing was clinically effective and less costly than conventional programs. The demonstration project was so successful that the Ministry of Health decided to use it to scale-up cervical cancer screening and treatment nationally.

Lastly, in collaboration with MD Anderson Cancer Center, a five-year follow-up will be conducted on the women who were screened in the CAPE project beginning in 2012 to find out how providing HPV testing with immediate treatment impacted the prevalence of the disease in El Salvador. These interventions will help inform other programs on how to achieve an impact on preventing this disease.