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Three years earlier than, Rwanda had determined to make preventing cervical most cancers a health precedence. The government agreed a partnership with pharmaceutical company Merck to offer Rwandan ladies the opportunity to be vaccinated towards human papillomavirus (HPV), which causes cervical most cancers. This was the primary time an African nation had embarked on a nationwide prevention programme for cervical cancer. Could Rwanda develop into the first country in Africa to eliminate it? It was an formidable aim. Cervical cancer is the commonest cancer in Rwandan ladies, and there were considerable cultural limitations to the vaccination programme - HPV is a sexually transmitted infection and talking about intercourse is taboo in Rwanda. Added to this, rumours that the vaccine may cause infertility made some parents reluctant to permit their daughters to be vaccinated. Rwanda's economic system and historical past also made it seem an improbable candidate for achieving excessive HPV vaccination coverage. After the 1994 genocide, it was ranked as one of many poorest countries in the world. High-earnings countries had solely achieved reasonable coverage of the HPV vaccine; if the United States and France could not obtain excessive coverage, how may Rwanda? Worldwide, cervical most cancers is the fourth most common most cancers in girls.