Background
Cervical cancer remains a leading cause of preventable mortality among women in sub-Saharan Africa, driven by national screening and prevention policies and persistent health system constraints. Women living with HIV (WLWH) are six times more likely to develop cervical cancer, while female sex workers (FSWs) face compounded barriers due to stigma, social marginalisation, and limited healthcare access. The SUCCESS program implements heterogeneous strategies for secondary prevention: some countries prioritise WLWH through vertical integration within HIV services, while others adopt broader, population-based approaches.
 Objectives
This study evaluates the contribution of the SUCCESS program’s Community of Practice and Knowledge (CoSav) . The CoSav is a South–South cooperation mechanism involving eight Francophone African countries (Cameroon, Côte d’Ivoire, Benin, Burundi, Guinea, Madagascar, Democratic Republic of the Congo, and Togo)—to strengthening regional capacities for secondary prevention of cervical cancer and reducing inequalities in access to screening and care among women from the general population, WLWH, and FSWs.
Methods
The study adopts a qualitative, participatory and comparative design, combining:
Semi-structured interviews with institutional, healthcare and community stakeholders in Togo (September 2025; n = 11), Benin (October 2025; n = 11) and Guinea (October 2025; n = 13). Other countries are currently under data collection.
Direct observations of care pathways, particularly the integration of the prevention of mother-to-child transmission of HIV (PMTCT) and cervical cancer screening within healthcare facilities.
Hybrid collaborative regional workshops promoting co-analysis, experience sharing, and the pooling of practices between countries.This approach analyses how differing strategies—targeted prioritisation of WLWH in Togo versus inclusive population-based approaches in Benin and Guinea—shape service organisation and equitable access.
Results
Preliminary findings indicate that South-South cooperation driven by CoSav fosters collective learning at both national and regional level. Organisational innovations, including shared resources management, the rotation of thermoablation devices, and the progressive introduction of HPV self-sampling have enhanced the effectiveness of screening systems across all countries.
The analysis highlights reveals significant differences between target populations: In Togo, prioritising HIV-positive women has facilitated the integration of CC screening into HIV services, strengthening continuity of care. In Benin and Guinea, more inclusive strategies enable wider population coverage.  In Guinea, specifically, the mobilisation of HIV services and a health centre specialising in the care of sex workers has improve access for these high-risk population, who are particularly exposed to social and self-stigma, as well as breaks in the testing cascade. Community mobilisation through mediators, health workers and peer educators emerges as a key lever for reducing these barriers and improving equitable access to services.
Conclusions
The CoSav experience demonstrates that combining targeted strategies with population-based approaches, supported by regional South-South cooperation is essential to addressing inequalities in cervical cancer screening and treatment in LMICs.  The SUCCESS program emphasises tailoring interventions to national contexts and priority populations without reinforcing divisions between groups. This cooperative, collective learning model offers strong transferability to other comorbidities (e.g., diabetes, hepatitis, hypertension) and supports global efforts to eliminate cervical cancer through enhanced implementation research, capacity-building, and equity-focused action in resource-limited settings.