Govt should take cancer seriously, says Dinesh C Sharma

Celebrity cancer survivors like Yuvraj Singh help create awareness on cancer but government must crack down on tobacco sales to make a difference.

This is a battle that India will have to fight at various levels - at the level of the individual, the society and the government. At stake are several thousands of lives, most of them in productive age groups. Yet there is very little that we are doing currently. The enemy is cancer, which according to latest research is emerging a major killer in India. Nearly ten lakh new cases of cancer are diagnosed in India every year. At any given time, the number of cancer patients is about 25 lakh. The disease claims 6-7 lakh lives every year and most of these deaths are of people in their prime, according to analysis published in journal The Lancet Oncology this past week.If the problem is so massive, you would expect policy makers and the government to respond with alacrity. But, unfortunately, this has not been the case. Yes, the number of regional cancer centres has gone up substantially in the past few years and some medical colleges have been equipped to deal with cancers as well. Still the gap between demand and supply is huge-and this, in fact, is a major challenge. Just imagine, in a country of 1.2 billion people, we have just 2000 cancer specialists: radiation and medical oncologists. This translates into one specialist for every 5000 newly diagnosed cancer cases. The treatment facilities in cities and metros - both private and public - are overcrowded because there are practically no facilities in rural areas and towns. This adds to the woes of already overburdened patients since cancer being a chronic disease requiring frequent hospital visits and admissions.
The treatment costs are so high that mere diagnosis can land a poor patient into debt trap. There is no reason why treatment costs can't be brought down through right policy interventions. Take, for instance drugs, which make up for a large proportion of treatment costs. Top 15 to 20 essential drugs may be identified through consultation with specialists and targeted for price reduction. The health ministry has tried to do this for a couple of drugs by recommending measures like compulsory licensing, but other government departments are opposed to it. One wonders why can't patient right to access affordable care drive such government departments? While expanding treatment facilities in rural areas and bringing drugs prices down may take time, we can surely move to prevent cancers. This can be achieved through screening programmes so that cases can be detected at a stage where they can be treated. A bulk of cases in India is diagnosed at a stage where survival rates are low. Cervical cancer screening or screening for oral cancers in rural areas can save lakhs of lives and also save treatment costs. Low cost screening techniques are available and need to be deployed, as demonstrated by Tamil Nadu for cervical cancers. Tobacco accounts for 40 per cent of cancer cases, yet tobacco control is not taken seriously by states because tobacco is a ' politically sensitive' commodity. It's high time people's lives take precedence over political and business interests.
Restrictions on antibiotic sales
Overuse and misuse of antibiotics is rendering them ineffective as different infectious bugs become resistant to them. The problem was highlighted by the dramatic episode of superbug NDM- 1 a few years ago.

For representation purposes only

The government has finally woken up to the problem and included 24 antibiotics in the list of drugs whose 'over the counter' sale would be restricted. Still, many powerful antibiotics can be bought without any restrictions, sometimes without even a prescription.Professional medical bodies have suggested that within five years, nearly 90 per cent antibiotics should be included in the restricted category so that their use can be monitored and misuse prevented. This should be implemented with other measures such as antibiotic resistance monitoring in hospitals and regulation of antibiotic use for animals.
" We need to implement this action plan to tackle the ever increasing menace of antibiotic resistance. We have been very realistic and not overambitious while making these recommendations", pointed out Dr Abdul Ghafur, Coordinator of Chennai Declaration on Antibiotic Resistance.
GM crops figure in electoral discourse
The issue of genetically modified (GM) food crops is going to haunt the next government irrespective of the combination that comes to power.

Activists and farmers at a protest against BT Brinjal

For the first time, several political parties - except the Congress - have explicitly mentioned GM crops in their manifestoes. The Congress party's silence on the issue is being attributed to conflicting positions the UPA government has been taking on GM foods. As environment minister, Jairam Ramesh stalled commercial release of GM brinjal - some believe at the behest of UPA Chairperson Sonia Gandhi - but Veerapapa Moily sought to reverse the decision. NCP leader and agriculture minister Sharad Pawar too is a staunch supporter of GM crops. By saying that GM foods " will not be allowed without full scientific evaluation on its long- term effects on soil, production and biological impact on consumers," BJP has left all the options open. The condition of " full scientific evaluation" can be conveniently used to allow or disallow GM crops, depending on which side the party wants to be.After all, Gujarat under the party's prime ministerial candidate has been a promoter of GM crops. Aam Aadmi Party has favoured a precautionary approach towards this new food technology.
Only AIADMK has committed to work towards a complete ban. The position of regional parties matters because the decision to allow open field trials rests with state governments.