Cervical cancer survivor Yuli’s determination to get daughters vaccinated against HPV
“This is how we can protect the next generation.”
In a small community on the outskirts of the city of Makassar on the Indonesian island Sulawesi, 47-year-old Yuli Yanti sits with her daughter and nieces, reflecting on the diagnosis that changed her life and sent shockwaves through her family.
She recalls the early symptoms of illness – heavy bleeding and pain – accompanied by months of uncertainty. In 2021, Yuli was diagnosed with cervical cancer. Since then, her days have been filled with a grueling series of hospital visits and treatment sessions.
“I had to undergo 35 rounds of radiation and chemotherapy. It was exhausting. But I keep fighting, not for myself, but for my daughters.” Yuli is now determined that the next generation of girls in her family – and in her community – will not endure the same suffering. "I don’t want my daughters or nieces to experience this. The chemo, the hospital visits – it’s a nightmare."
“I’m protecting them from what I went through”
Claiming over 20,000 lives every year in Indonesia, cervical cancer is the second leading cause of cancer deaths among women in the country. The primary cause of cervical cancer is HPV infection, responsible for 95 per cent of cases.
After three years of battling cancer, Yuli understands the importance of prevention all too well. When the Government introduced the human papillomavirus (HPV) vaccination programme for adolescent girls in 2023, Yuli personally brought not only her daughters, but also her nieces and the daughter of a friend for their shots. "Prevention is always better than cure. I’m protecting them from what I went through," she says.
Overcoming misconceptions
The Indonesia HPV vaccination programme offers free immunization to girls aged 11 and 12 years, and has overcome significant obstacles. Cultural barriers, misinformation and supply chain challenges – especially in rural and underserved communities – have threatened to slow progress. Many parents fear that vaccinating girls before puberty might encourage early sexual activity, a misconception that has led to resistance in some areas.
In response, UNICEF and the Ministry of Health have joined forces to provide capacity building and resources to health workers, teachers and religious leaders, aiming to educate communities about the importance of HPV vaccination. And these efforts have started to change attitudes.
“We learned how to explain the benefits of the HPV vaccine in a way that isn’t frightening,” says Sarwina, a teacher at the SD Negeri Sudirman IV school. “At first, parents were scared. They thought the vaccine might cause infertility. But after our educational sessions, they began to see how vital it is to protect their daughters from cervical cancer. Now, they’re asking for the vaccine.”
Religious leaders have also played a crucial role in shifting perceptions. Professor Mustari Mustafa, Chair of International Relations at the Majelis Ulama Indonesia for South Sulawesi, has been a vocal advocate for the HPV vaccine. "This vaccine is about prevention, it’s about protecting our daughters’ health, which aligns with Islamic values," says Professor Mustafa.
Reaching girls in and out-of-school
In urban centers such as Jakarta, Makassar and Surabaya, schools are essential in ensuring that girls receive the vaccination as part of immunization drives every August and November. However, reaching girls in urban slums and remote rural areas, and girls who do not go to school is far more complex.
Both health workers and local NGOs play a vital role, reaching deep into underserved communities to identify unvaccinated girls and to building trust for the vaccine.
Vast potential
By reaching girls both in and out of formal education, HPV immunization has vast potential to propel Indonesia to achieve its goal of eliminating cervical cancer by 2030. The HPV vaccine was administered to nearly 90 per cent of the girls targeted for their first dose in 2023. In addition, a catch-up immunization for 15-year-old girls is planned for 2025, and HPV vaccination for boys is scheduled for 2028.
Globally, cervical cancer is the fourth most common cancer in women. In 2022 alone, around 350,000 women died from cervical cancer, a woman’s life lost every two minutes. Cervical cancer has an overwhelmingly disproportionate impact on the health and well-being of women and girls in low- and middle-income countries, reflecting deep global inequities. Of the estimated cervical cancer deaths in 2022, over 90 per cent took place in low- and middle-income countries.
Since 2013, UNICEF has procured and delivered over 130 million doses of HPV vaccines to more than 70 countries. In 2024 alone, UNICEF delivered 37 million doses of HPV vaccines to 50 countries. For Indonesia, UNICEF procured and delivered HPV vaccines on behalf of the Government of Indonesia for the HPV vaccination pilot phase in 2017 and 2018. In 2019, Indonesia progressed to procuring HPV independently.
As Yuli Yanti reflects on her journey, she feels hopeful. “I wish I had known about this vaccine when I was younger. But now, at least I know my daughters and nieces are safe. This is how we can protect the next generation.”
Based on a story originally published on UNICEF Indonesia.
