A visionary initiative for cancer care in Northeast

The inauguration of seven cancer centres and laying of the foundation stone of seven other new cancer centres in Assam by Prime Minister Narendra Modi and industrialist Ratan Tata marks a huge milestone and a visionary initiative for cancer care in the northeastern region. The most important message, that Prime Minister Modi harped in his speeches at Dibrugarh and Diphu, which must not be missed is the return of peace in most areas of the Northeast and accelerated the pace of development has created a new investment climate in the region. Dubbed as the single largest cancer network in entire South Asia, these hospitals are expected to play a crucial role in reducing out-of-pocket expenses in cancer treatment in the region making the treatment affordable and easily accessible for cancer patients in the region. This network of hospitals built under the aegis of the Assam Cancer Care Foundation, a collaboration between the Assam Government and Tata Trusts, also demonstrates the importance of the public-private partnership model in the health sector for providing easy and affordable care. Intensified screening for early detection of cancer and awareness driven by these hospitals will be crucial to reducing the high cancer burden of the region. The Prime Minister's assurance that his government is committed to improving cancer care facilities in the Northeast and has made significant budgetary allocations will give a boost to cancer care delivery. Chief Minister Himanta Biswa Sarma took the initiative during his tenure as the then Health Minister in the previous Sarbananda Sonowal government which led to the signing of the Memorandum of Understanding between the Assam Government and the Tata Trusts in 2017 for jointly setting up the network of cancer hospitals for an estimated expenditure of about Rs 2,000 crore for a comprehensive cancer care delivery. This network of hospitals is going to make cancer care available at the district level which will significantly cut down travel as well as accommodation expenses of cancer patients and their caregivers. The quantum of expenses can be easily gauged if compared to the prevailing scenario of a large number of cancer patients requiring to travel out of the state to avail of treatment. The Prime Minister also pointed out in his speech that the exorbitant cost of cancer treatment was a big barrier in the mind of people and women particularly, avoid treatment as it has the potential of pushing families into debt and penury. The initiatives of the Central Government in this regard, highlighted by the Prime Minister is making cancer drugs affordable by reducing the cost of many medicines to almost half, saving at least 1,000 crore rupees for the patients and more than 900 medicines are now available at affordable rates in Jan Aushadhi Kendras. Spreading information on these is critical to the needy patients availing of the benefits. An estimated 50,000 cancer patients will be able to get treatment when all 17 hospitals become fully operational. Besides, the PPP model will provide a shield to the poor and middle-class patients from expensive treatment in private hospitals. The Fifteenth Finance Commission recommended that the health spending by States should be increased to more than 8 per cent of their budget by 2022 and the commission also underscored the need for the PPP model to address infrastructure deficits in the health sector. It also urged the Central and State Governments to gradually increase health expenditure to 2.5% of the GDP by 2025. A recent report on Cancer Risk Factors and Health System Response in the Northeast released by the National Centre for Disease Informatics and Research (NCDIR) reveals that close to a third (29.9%) of the cancer patients had sought healthcare outside of their state, the majority (63.6%) were availing of treatment at a government health facility. The report titled "Monitoring Survey of Cancer Risk Factors and Health System Response in North East Region of India" states that over a quarter (26%) of the cancer patients were self-financing their treatment and only 5.8% were covered by health insurance. The report states that incidence, mortality, and cumulative risk of developing cancer have been consistently high in the Northeast which amplifies the role of the unique network of cancer hospitals in changing the cancer profile of the region. A robust healthcare system is crucial for the successful outcome of cancer control interventions, it says and recommends that capacity building of healthcare resources locally at all levels of healthcare, ranging from primary care to palliation for improving survivorship, is essential to maintain a continuum of care. It is hoped that the network of cancer centres will help improve cancer research in the region that will contribute to evolving region-specific approaches to cancer care and prevention. While better health infrastructures are critical assets, the adage -that prevention is always better than cure continues to be the bedrock of modern healthcare.