PPPs Can Augment India’s Cancer Care Infrastructure: Manikandan Bala

How do you think the Indian cancer infrastructure has evolved? What are the current gaps and how do you think Elekta is planning to address these gaps? 

For decades, India’s rising cancer burden has continued to be a major public health challenge. If we compare today’s cancer care infrastructure with that of the last two decades, there has been significant improvement. However, the challenge of supply and demand has outpaced the growth in the infrastructure of cancer care systems and facilities. The role of linear accelerators (Linacs) remains the focal point in radiation therapy treatment. 20 years ago, there were hardly 160 Linacs in the country, now we have more than 600 Linacs. Looking at the present demand, as per conservative estimates, the requirement is for around 1,400 Linacs in India. That’s one Linac per million population. Developed nations have four per million. At the current pace, we will require another 20 years to match this.

On the other hand, the rising number of cancer cases can also be attributed to advancements in screening and reporting, enabling early detection and management. Equitable access to cancer care, affordability, forced migration to urban cities for treatment, and challenges of skilled manpower are some of the prominent concerns around India’s cancer care scenario.

Elekta has been addressing these problems in multiple ways. If we are to break down the addressable problems for Elekta, we would put those under four strategic buckets: Access, Quality of Care, Consistency in Care and Data Integration.  Elekta is enabling access to care through innovative public-private partnership (PPP) models. We are currently the largest partner with the public sector with AIIMS putting their faith in Elekta technology. We have also partnered with private care leaders for therapy centres. Our systems deliver high quality precision radiotherapy. 

What is precision radiotherapy technology? Why do you think it is revolutionary technology? 

Although radiation oncology as a discipline has existed for decades, ‘precision’ is an outcome of the advancements achieved through cutting-edge technology.  It is one of the most critical treatment avenues available in cancer care management alongside surgery and chemotherapy. By harnessing precision radiotherapy, it is possible to accurately deliver a radiation dose to the targeted cancer region with sub-millimetre accuracy. This allows for safeguarding and limiting the risk of radiation spillage over surrounding vital organs in close proximity of the tumour, reducing the chances of secondary complications. 

Access to advanced cancer care seems to be a challenge. How does Elekta look at improving cancer care accessibility in India?  

When it comes to accessibility in cancer care, there’s a noticeable disconnect between various geographies of India. This is largely owing to the concentration of cancer care facilities and specialist clinicians in urban and tier-1 cities. What makes things challenging is that around 95 per cent of cancer centres are based in urban cities while around 70 per cent of the India population lives in rural India. Forcing cancer patients to travel to tier-1 cities for treatment adds to the overall economic and social hardships.

We at Elekta believe that access in the form of treatment availability is absolutely critical to combat cancer. Improving Awareness, Affordability, and Accessibility in cancer care are some of the key focus areas for us. In line with the challenges associated with accessibility, Elekta launched its ACCESS 2025 strategy with the vision of a world where everyone has access to the best cancer care.

Further, the strategy is built over four overarching pillars – accelerate innovation with customer utilisation in mind, drive partner integration across the cancer care ecosystem, be a lifelong companion to its end users, and drive technology adoption across the globe. We are also working closely with multiple stakeholders to maximise the adoption of precision radiotherapy technology and linear accelerators across India.   

With the government’s rising focus towards cancer care, do you believe PPP models can boost patient centricity?  

Steps taken by the government to strengthen India’s cancer care infrastructure are commendable. At Elekta, we endeavour to collaborate with the government to boost access, quality, consistency, and adoption of cutting-edge precision radiotherapy technology in cancer care. With rising cancer burden in India, public and private synergy through PPPs can augment India’s cancer care infrastructure, ensuring last-mile care delivery.

We are consistently collaborating with the Indian government as well as engaging with multi-level stakeholders from the private sector to identify and streamline the prevalent gaps within cancer care infrastructure. Undoubtedly, collective efforts towards optimising India’s cancer care are much needed rather than an isolated approach. By scaling PPPs, it is possible to effectively streamline awareness, accessibility, and affordability in cancer care ensuring patient centricity.  

As one of the key industry leaders in the precision radiotherapy space, how do you envision the future of cancer care in India?  

The number of Indians suffering from cancer is projected to rise to 29.8 million in 2025 from 26.7 million in 2021, according to a recent report by the Indian Council for Medical Research (ICMR). In coming years, it will be critical to build models that are patient-centric and cost effective that can ensure thousands of patients aren’t pushed towards poverty. Expanding the scope of digitisation towards cancer care can further bridge Bharat and India enabling last-mile care delivery as well overcoming challenges linked to accessibility. Undoubtedly, to address the future needs of cancer care, collective and targeted efforts synergising government, policy makers, private players, and civil society is essential to ensure prevention, early-stage detection, and equitable access for cancer care in the country.