Vaccination alone is not sufficient to eliminate cervical cancer — critically analyse India's multi-pronged approach of vaccination, screening, and treatment.

Cervical cancer is India's second most common cancer among women [2]. WHO's elimination strategy rests on three legs — 90% vaccination, 70% screening, 90% treatment by 2030 [3] — the benchmark against which India's 2026 HPV campaign must be assessed.

Pillar 1: Vaccination — strong start, narrow reach

• Nationwide free, single-dose Gardasil-4 (quadrivalent) drive launched February 2026 from Ajmer for girls aged 14, validated by NTAGI [2].
• Over 52 lakh girls vaccinated by mid-July 2026 across all 36 States/UTs, tracked on the U-WIN platform [1].
• Limit: it protects only a future cohort. Women already exposed to HPV — the bulk of today's disease burden — gain nothing, so incidence will not fall for decades.

Pillar 2: Screening — the weakest link

• Screening and early diagnosis are routed through Ayushman Arogya Mandirs and NP-NCD facilities [1].
• Limit: WHO's 70% target requires high-performance HPV-DNA testing twice by age 45 [3]; India relies largely on visual inspection at the primary level, with uneven trained-manpower availability and low female participation due to stigma.

Pillar 3: Treatment — capacity and continuum gaps

• Day Care Cancer Centres at district level extend chemotherapy closer to patients [1].
• Limit: radiotherapy and oncology specialists remain concentrated in metros and tertiary institutes, so screen-positive rural women often drop out before treatment — breaking the referral chain.

Critical assessment

• Strength: the design is a genuine continuum of care built on existing UIP and Ayushman Bharat architecture, with training completed in all States/UTs [1] — avoiding a standalone vertical scheme.
• Weakness: the three pillars are unevenly resourced; vaccination is centrally driven and measurable, while screening and treatment depend on variable state health capacity.

India's approach is conceptually sound but sequentially unbalanced — prevention has outpaced detection and care. Sustaining momentum needs phased rollout of HPV-DNA screening, district-level oncology strengthening, and community mobilisation of ASHAs to convert coverage into cure. Achieved together, the 90-70-90 pathway can make cervical cancer India's first eliminated cancer, advancing SDG-3's promise of health for all.