LM: Govt prepares to provide more thrust to cancer control strategy: March 19, 2008

The new scheme-expected to be launched by the end of this year-will revamp and extend the scope of the existing National Cancer Control Programme, started in 1975-76.

With more than 800,000 new cases detected and 300,000 deaths every year, cancer has already become one of the 10 leading causes of death in India, according to information on the website of the ministry of health and family welfare.

The number of new cases is projected to jump to 1.4 million by 2026.

Around 1.5 million patients require facilities for diagnosis, treatment and follow up at a given time, states the health ministry-the nodal ministry for administering and designing all public health programmes in the country.

While the ministry is counting this as a significant initiative, a patients group has called these efforts half-baked and deficient, since the strategy glosses over the most critical component in cancer care-unaffordable treatment.

Advocacy will be a big focus area as part of this new national programme with campaigns against smoking, which is a big source of oral cancers, said Naresh Dayal, secretary in the health ministry. “This will be followed by early detection and finally treatment.”

Treatment under the programme could only be provided based on the availability of resources and even then, it will be targeted on the below poverty line patients since the “government can’t foot the bill for all”, he added.

The programme will be linked to the National Rural Health Mission, the flagship project of the ministry. The ministry has already received Rs2,400 crore to fund this initiative under the 11th Plan, scheduled to go on till 2012.

The focus will be oral, breast and cervical cancers to begin with, says Dayal, as these are the most prevalent variants.

Y.K. Sapru, president of the Cancer Patient Aid Association, is unenthused. “The government is once again missing out on the essentials and un less we attack the essentials, which is affordability and availability of cancer drugs, any programme will not give effective results,” he says. Cancer treatments, coupled with the newer patented drugs, are prohibitively expensive for 98% of the patients, he says. A year’s breast cancer treatment, for example, costs Rs5-6 lakh.

India currently has 23 regional cancer care centres and plans are now afoot to add 30 more in the next four years.

“Many of the public sector units have multi-speciality hospitals in their townships, some as big as 1,000-bed too.

We want to develop their oncology wing into regional cancer centres,” said a senior health ministry official who did not wish to be named.

Trust hospitals, charitable hospitals and even private hospitals will be given one-time grants for putting up facilities required of a cancer centre.

A special fund called Cancer Kosh will be created for the for the poor patients. “We also want to stipulate compulsory cancer registry. Estimates are very sketchy and there is a need to discern cancer disease patterns across geographies that could be used to fine tune cancer policy,” said the official, citing examples that stomach cancer cases were more prevalent in the northeastern states, breast cancer in bigger cities and cervix cancer in rural areas.

Sapru says the awareness drive can only dent “lifestyle cancers” such as those occurring in the oral cavity, lung, breast and cervix. The “nonlifestyle cancers” such as those in stomach, pancreas or leukaemia will be unaffected by advocacy efforts and the thrust here had to be cheaper treatment, he says. “Unless all three things (awareness, early detection and treatment) go together, any cancer control programme will be an eyewash.”

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