From today, vaccinators across Khyber Pakhtunkhwa will offer about 2.93 million girls aged nine to 14 a single, free injection. It protects against the virus behind almost every case of cervical cancer, a disease that kills more than 3,000 Pakistani women a year. Parents should say yes. The provincial government, which has spent two months preparing for this fortnight, should treat it as the start of a long job. The campaign itself is only the first step.
A death that need not happen
The numbers are stark. The World Health Organization estimates that more than 5,000 women in Pakistan develop cervical cancer each year and that about 3,200 of them die, close to two in every three. The International Agency for Research on Cancer, the WHO’s cancer research body, put the figure at 4,762 new cases and 3,069 deaths in 2023. The head of the WHO’s office in Pakistan has said the disease kills eight Pakistani women every day. Those are only the cases that are counted.
Cervical cancer in Pakistan, every year
Source: World Health Organization, Pakistan office, January 2026.
Cervical cancer is unusual among cancers because its cause is known and its prevention is cheap. More than 95 per cent of the 660,000 cases recorded worldwide each year are caused by HPVHuman papillomavirus, a very common group of viruses. Most infections clear on their own, but a few high-risk types can persist and, over many years, cause cancer., a virus that most people meet at some point in their lives and clear without ever knowing. In some women, though, certain high-risk types persist and, over a decade or two, turn healthy cells cancerous. A vaccine given before any exposure stops that from happening.
That is why the jab is offered to girls of nine to 14. It is not a comment on their lives today. It is given early because protection works best long before it is needed, in the same way that no one waits for an outbreak to give a child the measles vaccine. Cervical cancer usually appears decades after infection, which is why a decision taken for a ten-year-old this month may decide whether she lives to see her grandchildren.
“Protection works best long before it is needed.”
What the rest of the country has shown
Khyber Pakhtunkhwa is not starting from scratch. In September 2025 Pakistan ran its first HPV campaign across Punjab, Sindh, Islamabad and Azad Jammu and Kashmir, aiming at 13 million girls with the support of the WHO, UNICEF and Gavi, the Vaccine Alliance. About 49,000 health workers were trained for it. By the WHO’s count, more than 9.6 million girls were vaccinated.
It was not easy. In the first days, refusals outnumbered acceptances as social media filled with claims that the vaccine caused infertility or was a foreign plot. Some school administrations hesitated. Teams in Islamabad found school coverage so low that they changed plan and went door to door, into neighbourhoods and nomadic settlements. Federal Health Minister Mustafa Kamal had his own daughter vaccinated on live television to make the point. He later said refusals began to fall from the fifth day and that acceptance climbed to between 70 and 80 per cent in some districts.
Pakistan’s HPV drives, girls aged 9 to 14
The 2025 campaign covered Punjab, Sindh, Islamabad and Azad Jammu and Kashmir. Sources: World Health Organization; Khyber Pakhtunkhwa Health Department.
The lesson of last year is not that misinformation wins. It is that misinformation can be beaten, but only by people whom parents already trust, speaking early and plainly, and by a programme flexible enough to change course when its first plan fails. Roughly three in every four girls targeted were reached. That is a strong start for a first attempt in a country where vaccines are regularly the subject of rumour, and it shows the ceiling is higher still.
Why this province is harder
Khyber Pakhtunkhwa carries a heavier burden of suspicion than any other province. Its vaccinators have spent years facing refusals in polio campaigns, a distrust fed partly by the memory of the fake vaccination exercise that the CIA used in Abbottabad in 2011 in its hunt for Osama bin Laden. Terrorists have attacked and killed polio workers in the province. Even this month, families in Kurram have raised questions about the safety of the HPV drive, and some have delayed routine childhood vaccines because of rumours linking them to infertility.
The campaign is also aimed at two very different groups. Of the 2.93 million girls, about 1.6 million are in school and 1.3 million are not. The second group is harder to find and harder to reach in remote valleys and the merged districts. They are also more likely to live in households where such decisions are made by fathers and elders, and least likely, as adults, to be screened or treated. A campaign that reaches only the classroom will protect the girls who already have the most.
Who the KP drive must reach
The drive runs from November 11 to 24. Source: Khyber Pakhtunkhwa Health Department.
What will make it work
The health department has done serious groundwork. It held awareness sessions at universities, colleges and schools, and gynaecologists, an oncologist and a paediatrician briefed residents in Parachinar and Sadda. Parents with questions can call the Sehat Tahaffuz helpline on 1166. Five things will decide whether that preparation turns into coverage.
The first is who knocks on the door. Female vaccinators and Lady Health WorkersPakistan’s community health workers, almost all women, who visit homes in their own neighbourhoods to provide basic health and family care., known in their neighbourhoods for years, will persuade mothers in a way that no poster can. They need to be paid on time, kept safe, and given straight answers to the questions they will be asked at every gate.
The second is the mosque and the hujra. Pakistan’s experience with polio shows that a word from a respected local scholar can achieve more than any minister’s press conference. As the federal health minister has pointed out, the vaccine has been used in some 150 countries, including almost all Muslim-majority states. Religious scholars who are willing to say so in their own districts should be invited in early and thanked publicly.
The third is honesty about side effects. Sore arms and brief fevers do happen, and parents should be told so before the injection, not after. The WHO’s Global Advisory Committee on Vaccine SafetyAn independent panel of experts that advises the WHO on vaccine safety and reviews safety data from around the world. has reviewed the evidence and found no causal link between HPV vaccination and infertility or premature ovarian insufficiency, a form of early menopause. That message is far stronger when it comes with a visible system behind it: a number to call, a doctor who will see any girl who feels unwell, and prompt public reports on any serious case, investigated and explained. Silence is where rumours grow.
“Silence is where rumours grow.”
The fourth is a catch-up plan. A two-week window will miss girls who are ill, away visiting relatives, or whose parents simply need more time to decide. The province should say now where and how those girls can be vaccinated after November 24, whether at health facilities or in a mop-up round, rather than leave it to chance and goodwill.
The fifth is what happens after the campaign ends. A one-off drive protects one group of girls, but every year a new group turns nine. The vaccine needs a permanent place in the routine immunisation schedule, delivered through schools and health centres year after year, with its own budget line. Otherwise Khyber Pakhtunkhwa will have to repeat this whole exercise, with all its cost and all its arguments, every few years.
The objections
It will harm a girl’s fertility
Why give it to a child of nine?
One dose cannot be enough
A target within reach
The WHO has set out a strategy to eliminate cervical cancer as a public health problem. It asks countries to meet three targets by 2030, known as 90-70-90The WHO’s 2030 targets for eliminating cervical cancer: 90% of girls vaccinated by 15, 70% of women screened by 35 and 45, and 90% of women with disease treated..
The WHO’s targets for 2030
Source: World Health Organization, Global Strategy to Accelerate the Elimination of Cervical Cancer.
Pakistan is a long way from the second and third targets. Screening and treatment are where the next fight will be, and they will need money, trained staff and equipment that most districts do not yet have. But the first target is within reach, and the girls of Khyber Pakhtunkhwa are a large part of meeting it. Getting there would be one of the most valuable public health achievements this province has managed.
The mothers who open their doors over the next two weeks have every right to ask questions. They deserve answers from people they know, a vaccine that has been checked and checked again, and a government that keeps its word on safety. Their daughters deserve the chance of a life without this disease. A single injection is a small thing to ask in return.
