Cervical cancer is one of the most preventable and treatable forms of cancer. Despite this, there are few diseases that reflect as much global inequity.
Low and lower-middle-income countries bear most of the world’s dual burden of cervical cancer and human immunodeficiency virus (HIV). Data from the World Health Organisation (WHO) shows incidence and mortality rates for cervical cancer are, respectively, almost twice and three times higher than in high-income countries like Australia.
Dr Michaela Hall has dedicated her research to addressing these inequities, using mathematical models to optimise cervical cancer interventions, such as human papillomavirus (HPV) vaccination and cervical screening for women living with HIV.
Dr Hall trained as a mathematician and joined her research team, which is now affiliated with the University of Sydney, in 2015. She was so inspired that she undertook a PhD in Applied Mathematics to continue her important work in this area of need.
“The work I do is used to inform local and international health policy on HPV vaccination, cervical screening and HIV control. For me, it is so motivating to see the positive impact of what I am working on,” Dr Hall said.
Dr Hall received a 2024 Early Career Fellowship from the Cancer Institute NSW to support her research assessing strategies for cervical cancer prevention in women living with HIV in low and lower-middle income countries.
Equity at the heart of cervical cancer elimination
About 40 million people are living with HIV worldwide. Like cervical cancer, HIV has a disproportionate burden in lower and lower-middle income countries.
There is a global effort to eliminate cervical cancer around the world within the next century. For Dr Hall, focusing on women living with HIV is critically important for equity in cervical cancer outcomes.
“Strategies we have for eliminating cervical cancer in populations without HIV may not eliminate cervical cancer in women living with HIV,” Dr Hall said.
“To equitably move towards our goal for elimination, we need to make sure that vulnerable populations, including those with HIV, are not left behind.”
Dr Hall and her team are using a mathematical model to simulate a range of hypothetical scenarios to test combinations of cervical screening, HPV vaccination and HIV control measures. This will allow them to compare impacts on cervical cancer outcomes, health-system burden and economic cost.
Research to inform health policy
The goal of Dr Hall’s research is to inform policymakers and health departments of the impact of investments into equitable cervical cancer and HIV interventions.
Dr Hall and her team will work closely with collaborators in Tanzania and Papua New Guinea to ensure this work is of maximum value to the communities it aims to benefit.
“In low and lower-middle income countries there are finite resources and possible limitations in health services capacity. By providing a pragmatic assessment of intervention and investment combinations, this research can help motivate and inform investment in equitable cervical cancer prevention strategies,” Dr Hall said.
“It is my hope this work will shine a spotlight on the need to consider vulnerable communities, including and beyond those living with HIV, when designing programs for cervical cancer prevention.”
Cancer Institute NSW support going beyond borders
Funding from the Career Support Grant, worth $592,932, will support Dr Hall to build on her research capacity as well as take her work to international collaborators and audiences.
“This Fellowship is instrumental as it provides me the freedom and agency to support the communities which rely on research like mine,” Dr Hall said.
“Not only will my career benefit from the opportunity to do the work that I am passionate about, but the Fellowship itself also gives me a mechanism to strengthen and extend my connections with international collaborators and agencies like the WHO and the International Agency for Research on Cancer.”
Immunisation for all is humanly possible
World Immunisation Week is marked annually on 24 – 30 April. It promotes the life-saving power of immunisation to protect people of all ages against vaccine-preventable diseases like HPV.
The 2025 theme, Immunisation for all is humanly possible, is key to Dr Hall’s research efforts and aligned with her own values.
“It emphasises accessibility and inclusivity of vaccination, while being a future-focused call to action,” Dr Hall said.
“We can celebrate the amazing achievements already made globally by individual countries, through efforts of charitable organisations such as the Gavi Vaccine Alliance, while recognising the achievability of our common goal providing immunisation to all.”
Dr Michaela Hall is a Research Fellow affiliated with the University of Sydney.
Find out more about other recipients of the Cancer Institute NSW’s Career Support Grants.