Ration health resources to save more statistical lives from cervical cancer death in Africa: Why are we allowing them to die?

Public health interventions, particularly in low- and middle-income countries (LMICs), are implemented with the never-ending challenge of limited resources and the ever-present challenge of choosing between interventions. While necessary, the application of ethical analysis is absent in most of such decision-making, resulting in fewer favourable consequences. In applying ethical principles to the saving of women from the burden of cervical cancer, I argue in favour of saving statistical lives (investing in prevention) in LMICs, by mapping the principles of justice in resource allocation to the prevailing circumstance. The key facts in this circumstance are that providing treatment (which is saving identified lives), involves mostly providing palliative treatment, which is associated with a high likelihood of death among the identified lives while undergoing treatment or shortly thereafter. I focus on the dilemma of having a national cancer prevention program versus the expansion of cancer treatment facilities.

Automated summary

Public health interventions in low- and middle-income countries face the challenge of limited resources and the difficulty of making ethical decisions. This article argues in favor of saving statistical lives by investing in prevention programs for cervical cancer in LMICs, considering the principles of justice in resource allocation. The dilemma of choosing between a national cancer prevention program or expanding cancer treatment facilities is discussed.