By Michael Gwarisa
Following disruptions caused by the COVID-19 pandemic, HPV vaccine coverage declined across Southern Africa, setting back efforts to prevent cervical cancer. New data, however, point to a gradual recovery. The 2024 WHO and UNICEF National Immunisation Coverage report shows that Mozambique leads the region with 89 percent coverage, while Malawi trails at 21 percent, highlighting persistent inequalities in vaccine uptake.
The HPV vaccine protects against the virus responsible for more than 95 percent of the 660 000 cervical cancer cases recorded globally each year, according to the World Health Organisation. The vaccine provides long-lasting immunity for at least 10 years and is routinely administered to girls aged 9–14 years, with catch-up vaccination recommended up to age 45 for at-risk individuals. To improve access, several African countries, including Zimbabwe, Mozambique, Cameroon and Cape Verde, have adopted single-dose schedules in line with WHO’s recommendation.
Despite these gains, HPV vaccination in Africa continues to face major challenges, driven by health system constraints and sociocultural misconceptions that fuel hesitancy. Fears that the vaccine promotes promiscuity or causes infertility remain widespread, undermining public confidence and slowing progress.
To address this challenge, Gavi, the Vaccine Alliance, working in partnership with CAF and UEFA, has launched the Goal Getters programme, which uses football to challenge myths and build confidence in the HPV vaccine.
In an exclusive interview with HealthTimes, Olly Cann, Director of Communications at Gavi, the Vaccine Alliance, explains how the initiative is changing perceptions and strengthening trust across Africa.
Addressing HPV Vaccine Hesitancy
HealthTimes: Vaccine hesitancy remains one of the biggest barriers to HPV vaccine uptake in many African countries. How does the Goal Getters programme directly address misinformation and negative perceptions?
Olly Cann:
The Goal Getters programme confronts vaccine hesitancy head-on by creating safe, open, and youth-friendly environments where adolescent girls are encouraged to speak honestly about what they have heard, what they fear, and what they believe. This approach reflects Gavi’s core belief that trust and confidence are built through dialogue, not one-way messaging.
Each workshop begins with health professionals from national Ministries of Health asking girls what they already know about cancer, HPV and vaccines. This intentionally brings myths and misinformation to the surface early. From there, trusted experts respond clearly and transparently using science-based facts aligned with guidance from our alliance partners including WHO and UNICEF.
By addressing misconceptions openly rather than dismissing them, the programme helps girls replace fear with understanding.
Goal Getters also uses an edutainment model to reinforce learning. MCs, performers, and facilitators are fully briefed on vaccine messaging and weave accurate information into football-themed activities, analogies and interactive discussions. This makes complex health information accessible, relatable, and memorable.
Why Football Works
HealthTimes: Why is football an effective platform for engaging adolescent girls on vaccines, particularly those often missed by conventional health messaging?
Olly Cann:
From Gavi’s perspective, sport and football in particular, is a uniquely powerful gateway to engage adolescents who are often missed by traditional health communication channels. Football creates an environment of trust, aspiration, and belonging, which is essential when discussing sensitive topics such as vaccines and adolescent health.
Goal Getters workshops take place alongside CAF youth football events such as the CAF Girls U-17 Tournament and National Schools Championships. These settings bring together motivated, ambitious girls in spaces where they already feel confident and supported. As a result, health messages delivered in this context are received not as instructions, but as opportunities to realize their aspirations.
Sport also provides a natural platform to communicate the power of prevention. Vaccinating girls at the recommended age can prevent up to 90 percent of HPV-related cervical cancers, making it one of the most impactful public health interventions available. Football allows this message to be framed positively around strength, teamwork and long-term success.
Importantly, football environments also enable the involvement of trusted adults such as coaches, teachers, and community leaders. Their presence reinforces credibility and helps ensure that messages resonate beyond the event, particularly in Gavi-supported countries where community advocacy plays a vital role in reaching girls, including those who are out of school.
Building Trust Through Communities
HealthTimes: Trust is central to vaccine confidence. How does Gavi ensure that accurate information is delivered by trusted voices?
Olly Cann:
Trust underpins every aspect of Goal Getters. All vaccine information shared through the programme is drawn from authoritative sources, including Gavi, the World Health Organization, and national Ministries of Health, ensuring accuracy and consistency at all times.
Before each activation, structured briefings are conducted with coaches, teachers, MCs, performers, and influencers. These sessions ensure that everyone involved understands the science, the messaging and how to respond confidently to questions. Health professionals are present throughout workshops to provide credible, real-time answers reinforcing transparency and trust.
Equally important is the peer-to-peer element. Adolescents are more likely to trust and engage with messages delivered by people they relate to. By empowering youth champions and influencers to communicate accurate information in accessible language, Goal Getters creates a layered trust model that combines institutional authority, community credibility and peer relatability.
Early Results and Evidence
HealthTimes: Has Gavi observed any shifts in attitudes or willingness to accept the HPV vaccine following recent activations?
Olly Cann:
While it is still too early to measure long-term changes in national vaccination coverage, early monitoring and evaluation data from Goal Getters activations in Eswatini and Tanzania demonstrate significant and encouraging shifts in attitudes and confidence.
In Eswatini, at the beginning of the workshops, participants were asked whether they knew what the HPV or MMR vaccine was and whether they believed it was safe. Fewer than 10 out of approximately 440 participants responded positively, indicating awareness and confidence levels of just 2.3 percent. By the end of the same sessions, more than 500 participants actively raised their hands or shouted “me” when asked if they believed the vaccines were safe. This represents a 94 percent positive response rate and a behavioural shift of nearly 92 percentage points.
Beyond improved attitudes, there were tangible outcomes. Thirty-two girls received vaccinations on-site and boys also requested vaccines, demonstrating spillover demand. The programme also created safe spaces for open dialogue, strengthened male engagement in immunisation conversations, and fostered local ownership. Notably, Ministries of Health committed to continuing collaboration with football associations and exploring expansion into other sports.
These findings are supported by robust data collection methods, including live survey questions asked by the MC, social listening teams counting responses across the field, qualitative conversations with participants, and visual documentation through photography and video.
Busting Myths and Misconceptions
HealthTimes: How does Goal Getters equip girls with the knowledge and confidence to challenge myths and act as ambassadors for accurate health information?
Olly Cann:
Goal Getters equips girls with both knowledge and confidence by ensuring they fully understand the facts about HPV, vaccines, and cancer prevention, and by encouraging them to ask questions in a supportive environment. This foundation enables girls to challenge myths not with confrontation, but with confidence and evidence.
The programme strengthens this further through a coordinated influencer strategy. Prominent local influencers are engaged to share an approved, science-based social media toolkit starting one day before each workshop, live-posting during the event, and continuing engagement afterwards. Influencers are encouraged to combine curated content with their own authentic reflections and stories from the workshops.
This approach creates a strong, credible digital presence that extends the reach of accurate vaccine information well beyond the event itself. By seeing peers and role models speak openly and positively about vaccination, girls are empowered to do the same in their schools, teams, and communities.
From Awareness to Uptake
HealthTimes: How does Gavi ensure that increased confidence translates into real access to vaccination?
Olly Cann:
Goal Getters is designed to work hand-in-hand with national health systems rather than operating in isolation. Workshops are delivered in partnership with Ministries of Health, ensuring that all information shared aligns with national immunisation plans and referral pathways.
Where feasible, vaccination services are offered on-site during events, immediately translating confidence into action. At the event, coaches and teachers were informed on how to follow up, ensuring girls know where and how to access vaccines. This systems-based approach reflects Gavi’s commitment to sustainable, country-led immunisation delivery.
Building Local Ownership
HealthTimes: How are Ministries of Health, football associations and community structures being integrated to ensure sustainability beyond tournaments?
Olly Cann:
Local ownership is central to the Goal Getters model. Ministries of Health are involved from the outset in designing and delivering content, while football associations provide trusted platforms and long-term engagement opportunities with young people.
Community structures, including schools and coaches, reinforce messages after the tournaments, and influencer engagement continues well beyond the event itself. Importantly, Ministries of Health have already committed to expanding collaboration with football associations and exploring delivery through other sports, ensuring the programme evolves into a locally driven, sustainable platform rather than a one-off intervention.
Scaling Across Africa
HealthTimes: As the programme expands, how will Gavi measure its long-term impact and determine where to scale next?
Olly Cann:
Gavi takes a comprehensive approach to impact measurement. Social and behavioural change is tracked through pre- and post-workshop survey questions that assess knowledge, attitudes, and confidence. Digital monitoring captures influencer reach, engagement, and audience interaction, helping to understand how messages travel online.
Vaccination data from local health facilities, combined with records of on-site vaccinations delivered during events, provides insight into changes in uptake. Qualitative feedback from participants and community stakeholders adds further depth, allowing Gavi to assess shifts in trust, norms, and adolescent decision-making over time.
Looking Ahead
HealthTimes: How many countries does Gavi aim to reach through the Goal Getters programme, and what determines where it expands next?
Olly Cann:
Goal Getters aims to deliver between two and four events each year. Expansion is strategically aligned with the locations of CAF Girls U-17 and African National Schools football tournaments, ensuring efficient access to large numbers of adolescent girls.
