The rising burden of cancer care in India highlights the need for advanced solutions to improve patient outcomes and accessibility. According to a 2020 Lancet Global Health study, 5.3 million premature deaths globally were attributed to cancer. India ranked third in new yearly cancer cases, after China and the US, as per the World Health Organization. Given the escalating numbers, India faces a significant challenge in providing comprehensive, affordable cancer care to its diverse population.
In an exclusive interaction with BW Healthcare, Malti Sachdev, Senior Vice President and Head, Varian- A Siemens Healthineers company, discussed the role of Public-Private Partnerships (PPP) in building robust cancer care infrastructure across India. She highlighted how these partnerships can improve access to advanced treatment technologies, bring comprehensive cancer care under one roof in hospitals and cancer centres, and leverage innovations like AI to personalise patient care. Sachdev also shed light on advancements in radiation therapy, including same-day treatment options and the diverse applications of radiation therapy for curative treatment and symptom relief. Excerpts from the interaction:
How can successful PPP models improve access to advanced cancer treatment across India?
Successful Public-Private Partnership (PPP) models can significantly improve access to advanced cancer treatment across India by leveraging the strengths of both public and private sectors. The government provides space and infrastructure, while the clinical services and medical equipment are delivered by the private sector. This arrangement allows the government to avoid straining the public budget by utilizing private sector funding and expertise, while the private sector gains access to a new market and potentially higher efficiency through managing these facilities.
The biggest beneficiaries, however, are the cancer patients. They get quicker access to advanced technologies and improved services. In a country like India where roughly 70 per cent of the population resides in rural areas with limited access to cancer care, these models are critical in mobilizing resources.
Varian, for instance, has been actively working with both the Central and State governments to address this issue. We have approached various states, encouraging them to establish radiation therapy centres within government hospitals under the PPP model. This collaborative approach holds great promise for expanding access to advanced cancer treatment across India.
What are the biggest roadblocks to offering comprehensive cancer care in India?
Despite leaping into the cancer care ecosystem, India continues to face numerous challenges in offering its citizens comprehensive cancer care. The primary is the cost of care. Cancer treatment, encompassing surgery, radiation, and medications, is unaffordable for a large section of India. This financial barrier often delays diagnoses and forces patients to discontinue their treatment. Incomplete treatment courses significantly reduce survival rates. Sustainable funding and wider health insurance coverage can help to tackle this issue.
Also, the shortage of trained medical professionals in India puts a lot of pressure on existing practitioners. We need to increase our skilled workforce to build a strong cancer care system. We can also use service delivery models that create a network of connected healthcare facilities, whereby cancer centers can utilise services from one another.
These interlinked challenges need a multi-pronged approach. Initiatives promoting early detection through public awareness campaigns and collaboration between governments, healthcare providers, civil society organisations, and the private sector, are crucial. Encouraging medical professionals to specialise in oncology and incentivising them to practice in rural areas can bridge the workforce gap. By tackling these issues, India can move towards a healthcare system that provides comprehensive and accessible cancer care to all its citizens.
What are the most promising advancements in radiation therapy for Indian cancer patients?
Radiation therapy has come a long way in India, evolving from basic X-rays to highly precise techniques. One of the most promising advancements is the use of linear accelerators, which allow much more targeted radiation delivery compared to older technologies like cobalt-60 machines. While these advancements have significantly improved treatment outcomes, the quest for even greater precision and personalisation continues.
Adaptive radiotherapy is a relatively new technique that can do both these things. Unlike traditional radiation therapy, which follows a fixed treatment plan, adaptive therapy considers daily changes in a patient's body, such as variations in organ size or position. This allows for continuous adjustments to the treatment plan, ensuring that radiation is precisely delivered to the tumor while minimising damage to healthy tissue. This level of personalisation holds immense promise for improving treatment efficacy.
The result is improved outcomes and a higher quality of life for cancer patients. As adaptive radiotherapy continues to evolve, we can anticipate even greater benefits in the years to come.
How can India balance adopting advanced technologies with affordability for patients?
Cancer patients in India should have access to the technologies that meet their specific needs. I don’t think it is a balancing act, it is a process of finding the best way to provide that access. Widening the reach of health insurance, for example, can help patients afford advanced treatments.
The government's focus on universal healthcare access is another critical aspect. Initiatives like the Comprehensive Primary Health Care Programme and Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB-PMJAY) aim to financially support underprivileged patients. AB-PMJAY, in particular, provides coverage for secondary and tertiary care, including radiation therapy, for a significant portion of the population.
Developing scalable healthcare solutions that can be adapted to different regions within India is another possibility. There could also be a shift towards value-based care, where providers are incentivised to deliver better health outcomes rather than just volume-based services.
The government can also play a crucial role by offering subsidies, tax incentives, and public-private partnerships to reduce the cost of advanced medical technologies. Public-Private Partnership (PPP) model also provides access to advanced technology at a mutually agreed-upon price between the private and public entities thus ensuring affordability for the patients. While this arrangement is gaining traction in several states, it has the potential for further expansion.
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