Rising number of cancer cases in India has also come with the challenge of affordability of cancer care. The Indian Council of Medical Research (ICMR) -National Centre for Disease Informatics & Research (NCDIR) has projected that number of new cancer cases in the northeast region is projected to increase to 57,131 in 2025 against 50,317 in 2020. With low income of affected household, the affordability of cancer treatment is poised to snowball into a larger crisis if accessibility to public funded cancer care is not prioritized. The Parliamentary Standing Committee on Health and Family Welfare has drawn the attention of the central government that public tertiary level hospitals that provide cancer treatment is only 50 against 200 such private facilities across the country. The Committee’s observation that despite the launch of Ayushman Bharat– Pradhan Mantri Jan Arogya Yojana (AB-PMJAY) to increase universal health coverage, healthcare in India is largely financed through out-of-pocket payments and remains unaffordable for a large part of the population highlight a key that needs to be addressed urgently. It points out that though initiatives like Ayushman Bharat and National Digital Health Blueprint have created a foundation for health integration, the delivery of cancer care in the country remains largely fragmented leading to patient leakages within the health system and resulting in poor treatment outcomes. Official data shows that till December last year, about 21.4 lakh hospital admissions worth Rs 3,916 crores have been authorized exclusively for the treatment of cancer under AB PM-JAY. The parliamentary panel recommended that improving the diagnostic infrastructure in medical colleges and hospitals so that prevention and screening scenario in cancer care bear results and patients get better access the treatment facilities in the nearest hospital and not required to travel long distances for access to quality diagnostics. The Ministry of Health and Family Welfare has requested the National Medical Commission to make compulsory oncology department for every medical college in the country in order to increase the manpower, states the report of the Committee. Allocation of adequate fund will be crucial to translate the recommendation into a reality in a time-bound manner. The Committee’s recommendation that there is a strong need to make cancer care affordable is based on its findings that average out-of-pocket spending on cancer care is too high. Besides, the out-of-pocket spending for cancer care in private facilities is about three times that of public facilities. It also highlighted the wide gap in affordability in quality cancer care and points out that about 40% of cancer hospitalization cases are financed mainly through borrowings, sale of assets and contributions from friends and relatives. Other key recommendations made by the parliamentary panel that will make cancer care affordable to patients are: upgrading government hospitals with oncology departments and 25% reservation on cancer services provided in private hospitals for patients treated on government schemes, increasing funding for cancer research that evaluates low-cost technology, repurposed drugs and indigenization of equipment to reduce costs in the long run; linking adherence to the National Cancer Grid (NCG) resource stratified guidelines to reimbursement under government schemes and passing on to the patients the savings from group negotiation conducted by the NCG which has resulted in procuring high quality cancer drugs at 20 to 90% discount. Action taken by the government is still in the policy formulation stage. Information provided by the Ministry to the committee brings to the light that the National Health Authority has constituted an Expert Advisory Committee (EAC) on strategic purchasing which is drafting operational framework for group negotiations to obtain chemotherapy drugs and implants at lower prices and an extensive stakeholder consultation will also be undertaken to develop the final model. The committee’s recommendation with respect to the northeast region focuses on preventing cancer incidence by taking effective measures to prevent alcohol and tobacco consumption. It notes that the reason for high incidence of tobacco-related cancer in the region is the high consumption of tobacco which is as high as 60% in some North-eastern States against the national tobacco prevalence of 28% while alcohol consumption in the region is 28% which is more than double that of the national prevalence of about 12%. It also notes that nearly 50 % of all cancer cases in India are attributed to tobacco use and therefore, these cancer cases are preventable. Effective reduction of tobacco and alcohol use by building awareness, therefore, can significantly reduce cancer burden in the country, more in the northeast region, and resources available with the central and state governments can be optimally utilized to provide affordable treatment and care to other cancer patients. Interventions made by government and the society to prevent tobacco and alcohol use take time to take effect depending on consistency and reach of campaigns. Until then there is no alternative to affordability of cancer care.