Fatoumata Tioye Coulibaly
AI4CC
Improving cervical cancer screening through the combined action of a PCR test and Artificial Intelligence
In brief
Cervical cancer is a global public health emergency, disproportionately affecting low- and middle-income countries (LMICs), where over 90% of deaths occur. Yet, it is a preventable disease through effective prevention measures: vaccination against human papillomavirus (HPV), early screening, and treatment of precancerous lesions. However, in many of the settings where MSF operates, these tools remain largely inaccessible.
To address this inequality in access to care, the MSF Foundation, in partnership with MSF and Epicentre, has launched a project to transform cervical cancer screening by joining the international PAVE (Papillomavirus and Automated Visual Evaluation) study, coordinated by the U.S. National Cancer Institute (NCI).
This project is based on a dual innovation:
- A simplified, more accessible and less expensive HPV test,
- and an artificial intelligence (AI) tool capable of analysing images of the cervix and automatically detecting precancerous lesions.
Between 2021 and 2025, the PAVE study enrolled more than 50,000 women across nine countries. In Malawi, the MSF Foundation coordinated the implementation of the study and oversaw the enrolment of more than 6,100 women in the first phase, which focused on HPV testing, followed by 1,300 women in the second phase, designed to assess the use of artificial intelligence in real-world clinical settings.
The results, which will soon be published in The Lancet, demonstrate the feasibility of a strategy combining HPV testing and artificial intelligence in resource-limited settings.
Beyond research, the AI4CC project aims to bridge the gap between knowledge generation and operational implementation. MSF is therefore supporting the gradual integration of the tools evaluated by PAVE into MSF’s healthcare programmes so that promising innovations can become practical solutions for patients where the need is greatest.
Status of the project
News
In detail
A Solvable but Forgotten Epidemic
Cervical cancer is caused in 95% of cases by a persistent infection with certain strains of the human papillomavirus (HPV). In high-income countries, widespread vaccination and regular screening have significantly reduced the incidence of the disease. But in low- and middle-income countries (LMICs), access to prevention remains extremely limited.
In Malawi, cervical cancer is the leading cause of cancer-related death among women. According to 2020 data (WCRF), the country recorded 4,145 new cases and 2,905 deaths.
Since 2018, MSF has established a structured program in Blantyre, based at Queen Elizabeth Central Hospital, to provide:
- VIA-based cervical screening
- Treatment of precancerous lesions (thermal ablation)
- Specialized surgery for early-stage cancers
- Palliative care for advanced cases
Diego Menjibar
THE PAVE STUDY: A UNIQUE INTERNATIONAL COLLABORATION
The PAVE study consortium, originally coordinated by the NCI, brings together medical and research institutions from around the world operating in nine countries: Brazil, Nigeria, El Salvador, Tanzania, Malawi, Eswatini, Cambodia, Honduras, and the Dominican Republic. The study involves a total of 50,000 women and aims to test a new cervical cancer screening approach on cohorts representative of the diverse LMIC contexts.
The objectives are to:
- Validate the performance of a next-generation HPV test;
- Evaluate an AI algorithm capable of assisting healthcare providers in interpreting VIA images by automating a task currently prone to human error;
- Pave the way for open-source integration of this technology into local health systems.
En janvier 2021, des groupes de soutien ont été créés, un espace où les femmes peuvent partager leurs expériences personnelles de la maladie.
Diego Menjibar
THE CENTRAL ROLE OF THE MSF FOUNDATION
Within the PAVE consortium, the MSF Foundation was responsible for the operational coordination of the study in Malawi from 2021 to 2015, alongside MSF and Epicentre.
In 2025, whilst the final analyses of the study were still to be carried out, the consortium faced the withdrawal of funding from the National Cancer Institute (NCI). To enable the completion of the PAVE study, the MSF Foundation mobilised exceptional funding to support this crucial phase of the project. This support enabled the data analysis to be finalised, the study’s scientific findings to be consolidated, and their dissemination to the international scientific community to continue. By ensuring the continuity of this essential stage, the MSF Foundation helped to transform five years of research into actionable knowledge to advance cervical cancer screening strategies in resource-limited settings.
But producing scientific evidence is only one step. The challenge now is to adapt these innovations to the realities of healthcare systems, the constraints faced by healthcare teams and the needs of patients.
IN PICTURES
Rafaël Catelli D’Agostino, MSF Histopathologist, and Kingsley Makwakwa, MSF Histology Lab Manager, preparing biopsy slides.
ELISHA KAZONDE / La Fondation MSF
Prosper Joyce Suwedi - MSF Screening Nurse, holding the device that will be used to visualize, interpret with AI and treat pre-cancerous cervix lesions if any.
ELISHA KAZONDE / La Fondation MSF
Rafaël Catelli D’Agostino, MSF Histopathologist, and Kingsley Makwakwa, MSF Histology Lab Manager, preparing biopsy slides.
ELISHA KAZONDE / La Fondation MSF
Prosper Joyce Suwedi - MSF Screening Nurse, holding the device that will be used to visualize, interpret with AI and treat pre-cancerous cervix lesions if any.
ELISHA KAZONDE / La Fondation MSF
Our partners
The Team
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