EVERY public health breakthrough carries two promises: that science can prevent disease and that people will trust it enough to embrace it. Scientific progress alone cannot fulfil the second promise.

Pakistan’s introduction of the human papillomavirus (HPV) vaccine into its national immunisation programme is a historic milestone in the fight against cervical cancer. The vaccine offers girls protection from a largely preventable disease. But introduction is only the beginning. Long-term success will depend not only on vaccine delivery but on whether families have confidence in it.

Cervical cancer is one of the few cancers that can largely be prevented. Persistent infection with high-risk HPV causes almost all cases, and decades of evidence show that vaccination substantially reduces HPV infection and precancerous lesions and can prevent cervical cancer. Pakistan now has the opportunity to achieve these gains.

Science answers one question: does the vaccine work? Communities ask another: can I trust it?

Pakistan has the vaccine. Now it must build trust.

Our GLOBE-HPV research among women in urban informal settlements and rural communities across Pakistan offers an important insight. Awareness of HPV and cervical cancer was remarkably limited; many women had never heard of HPV and cervical cancer screening was virtually nonexistent. Yet when information was shared clearly and respectfully, many expressed willingness to embrace preventive measures.

This should encourage us. Communities are not rejecting science. They are asking for information they can understand and sources they can trust.

Public health has often assumed that facts alone change behaviour. Experience tells us otherwise. People make health decisions through relationships of trust with healthcare professionals, teachers, family members, neighbours and, for many Pakistani families, religious scholars. Recognising this does not weaken science; it strengthens public health. Trust is built through dialogue, not instruction.

Community engagement should therefore be a core part of vaccine implementation from the beginning, not an aftertho­­ught. Healthcare workers need confidence to answer questions about vaccine safety, effectiveness and fertility with empathy and clarity. Teachers, schools and community organisations also need accurate information so that reliable information reaches families before misinformation does.

Religious engagement deserves similar attention. For many Pakistani families, faith and healthcare are complementary sources of guidance. Several Muslim-majority countries have incorporated HPV vaccination into national programmes, and Pakistan’s health authorities have affirmed that leading Islamic scholars support HPV vaccination and consider it consistent with Islamic values. The lesson is not that religion validates science but that science and faith can work together to protect future generations.

Implementation science offers another lesson: successful vaccination programmes rely not only on evidence but also on transparent communication, political commitment, strong primary healthcare, community partnerships and public trust. Trust cannot be built during a crisis. It must be cultivated early by listening to concerns, answering difficult questions honestly and ensuring that families feel their voices matter.

Pakistan has taken the historic first step. The next challenge is to make HPV vaccination a lasting public health success rather than simply another campaign. This means moving beyond counting doses towards building confidence, listening to concerns and ensuring that ev­­ery family has access to trusted, understa­ndable information.

Trust cannot be built after misinform­ation has taken hold. It must be cultivated early through honest conversations, respon-sive healthcare providers, informed teachers and meaningful engagement with communities. If we get this right, Pakistan’s HPV programme can become more than a vaccination campaign; it can become a model for how science, communities and public health systems can work together.

Years from now, the success of Pakistan’s HPV vaccination programme should not be measured only by the number of girls who received the vaccine. It should be measured by the women who never develop cervical cancer, the families spared preventable loss and the generations protected because trust allowed science to reach those who needed it most.

Pakistan has the vaccine. Now it must build the trust that allows the vaccine to fulfil its promise. Vaccines prevent cervical cancer. Trust ensures that they can fulfil that promise.

The writer is an epidemiologist and public health researcher at Aga Khan University. Her research focuses on HPV, implementation science, vaccine confidence and health equity in Pakistan.

Published in Dawn, August 18th, 2026