Right to live

A top radiation oncologist from government medical college in Chandigarh has appealed to the Supreme Court to ensure the Allahabad High Court decision which directs all the government officials, politicians, bureaucrats and judges including their family members to visit only government-run hospitals in case of any medical requirement without any preferential treatment to make these people realise the challenges that the common people have to go through every day.

Unbearable cost of cancer treatment has forced many people to either stand in the queue at the government hospitals’ door due to long waiting list or sell all they may have saved in form of land or jewellery to get some breather in private hospitals. Millions of people have been fighting the scary battle across the country with everything they have <g data-gr-id="228">putting</g> every day at stake.

Mohammed Ali, a cloth merchant from Aurangabad, lost his 12 years old son, who was suffering from renal cell carcinoma, <g data-gr-id="268">rarest</g> form of kidney cancer, after fighting cancer for almost eight months. “I spent more than Rs 7 lakhs in just a matter of few months. I did everything I could still I had no luck. I lost my son,” recalled Mohammed Ali. Speaking on the cost of the cancer drugs and its treatment he said: “It is difficult to tell you how I managed this much of amount for my son’s treatment. It was a huge amount and that too when it was a government hospital. Had it been a private one, I would have to sell all my properties because the same treatment could have cost me around Rs 30 lakhs to 40 lakhs.”

Explaining about the treatment in AIIMS a senior oncologist told Millennium Post that it has experienced even the basic form of cancer namely lounge cancer, cervical cancer, head and neck cancer and breast cancer after its early stage-1 detection which could cost a person between Rs 2 lakhs to 3 lakhs for its drugs and treatment. However, the reality is beyond the imagination as in India due to lack of early screening programmes to detect cancer at the very first stage 80 <g data-gr-id="209">per cent</g> of total cases get detected in a fairly advanced stage costing more than what a person could even think of possibly well beyond anyone’s reach.  

What is more striking in all is the fact that rural India, as per recently released Socio Economic and Caste Census 2011 report, accounted for 73 <g data-gr-id="206">per cent</g> households and 74 <g data-gr-id="207">per cent</g> of these survived on a monthly income of less than Rs 5,000 of its highest earner. Looking at the numbers of these rural households and their income senior oncologist said: “India will have to devise a path to cope with such life-threatening diseases for those who cannot afford the treatment in any given circumstances”.

Manav (name changed), suffering from Osteosarcoma a type of bone cancer with lung metastasis, after his year-long fight against cancer wants to share his experience by writing a letter to Prime Minister Narendra Modi and wants to explain him the hardships and challenges one has to face while seeking medical treatment for any devastating disease in the government hospitals.

Manav, in last almost two years, had spent well over Rs 40 lakhs in his fight against cancer in Tata Memorial Hospital in Mumbai. Doing all that his family could when they were told by the doctors that Manav’s disease had reached a condition where any recovery could easily be termed a miracle, the family has gone into a deep shock. It’s important to understand that these are not just the only two heart-wrenching stories of Ali or Manav but there exists, in reality, millions of people for whom the cancer diagnosis is one of the leading causes of financial bankruptcy. 

Grappling with the high cost of cancer drugs, people of our country are feeling completely left out of the system due to lack of any universal healthcare scheme. In the absence of any such schemes cancer patients have to be as wealthy as possible to get the treatment done. Should the state be worried about this deadly disease and the health of its citizens? So far, it remains an unanswered question.

Indian Council of Medical Research data reveals that currently India is facing 1.2 million new cancer cases every year which are expected to rise up to 1.7 million a year by 2035. With more than 1,300 persons succumbing to cancer every day, it has become one of the major causes of death in the country. Total of 4,91,598 people died in 2014 out of 28,20,179 cases, while in 2013 it was 4,78,180 deaths out of 29,34,314 cases reported in 2012. At a time when cancer is gradually turning into an epidemic in India the country is facing an acute shortage of oncologists too and it is certainly going to make things even more glaring as the killer cancer is changing the equation every passing minute. India has only 1,500 qualified oncologists for more than millions of existing and fresh cases.

“There are two healthcare schemes that India at this stage could think of. First, the National Health Service (NHS) and the second option for the country is to follow the footprint of Obama Care,” said a senior oncologist from AIIMS Delhi requesting anonymity.

The National Health Service (NHS), which is a publicly funded healthcare system for England, is the largest and the oldest single-payer healthcare system in the world. It is primarily funded through the general taxation system, the system provides healthcare to every legal resident in the United Kingdom, with most services free at the point of use.

United States has one healthcare scheme in the name of Patient Protection and Affordable Care Act (PP-ACA) commonly known as Obama Care. This act was enacted to increase the quality and affordability of health insurance, lower the uninsured rate by expanding public and private insurance coverage, and reduce the costs of healthcare for individuals and the government. It introduced mechanisms like mandates, subsidies and insurance exchanges to address serious medical concerns of the people.

Rahul Yadav, a Blood Cancer fighter and also running UNESCO award-winning Cancer support network calledYoddhas, explained Millennium Post about the huge inter-brand price variations of the same drugs from different companies, which also inflicts the common and uneducated people.

“Bortrac injection, which is used to treat certain cancers of the blood and bone marrow cancers such as <g data-gr-id="211">multiplemyeloma</g> and is being manufactured by Glenmark Pharmaceutical, is available in the market at Rs 3,773.75 whereas some other substitutes like Bortecad from Cadila are available at Rs 15,201.52 and Veltip from Pfizer at Rs 14,097.0,” said Yoddhas, founder, questioning the authenticity of the price norms attached.             

Dr Suresh Advani, senior consultant, Oncology at Jaslok hospital in Mumbai, said: “It’s a huge problem as sometimes we cannot figure out the effects of these medicines on patients. We see the patients’ affordability and prescribe assuming the expensive drugs will have good effects”.

Exposing the priority of the successive governments on <g data-gr-id="203">healthcare</g>, the World Health Organisation Global Health Expenditure data reveals that the United States on healthcare spends 17.1 <g data-gr-id="204">per cent</g> of its GDP, United Kingdom spends 9.1 per of its GDP whereas India spends merely four <g data-gr-id="205">per cent</g> of its total GDP, that too when as per the United Nations India constitutes <g data-gr-id="202">one third</g> of the world’s 1.2 billion poorest people.

India’ spending in healthcare is far less than some of its some neighbouring countries. For example, Afghanistan spends 8.1 <g data-gr-id="212">per cent</g>, Nepal spends six per cent, South Africa spends 8.9 <g data-gr-id="213">per cent</g> and even Maldives spends 10.8 <g data-gr-id="214">per cent</g>, which is more than double the number of India. The amount of public fund that our country invests in healthcare is very small compared to some other emerging economies. The ailing cancer healthcare problem in India comes under two headings – prevention and treatment. Prevention is health education regarding cancers and their etiological factors like tobacco, betel nut and alcohol. We have made very little or no progress so far to prevent this devastating disease in our country.

“Almost 80 per cent cases come to us in a fairly advanced stage. There are three main reasons for this. Firstly, people are ignorant about the aggressive nature of cancers and seek healthcare advice only when the disease is causing significant physical disability to them. Secondly, ignorance about the knowledge of proper <g data-gr-id="208">healthcare</g> provider makes cancer patients visit nearest centres not having enough trained personnel and equipment to treat cancer leading to loss of valuable time. And finally, the financial constraints of affording cancer treatment,” says Dr Pankaj Chaturvedi, Professor, Head and Neck Surgeon, Tata Memorial Hospital.

Speaking on the WHO findings that said tobacco use is the single greatest avoidable risk factor for cancer mortality worldwide, causing an estimated 22 <g data-gr-id="201">per cent</g> of cancer deaths per year, 

Dr Chaturvedi said: “Tobacco is the major cause of cancer and that too in India where tobacco businesses running in full swing. Banning tobacco in all forms will cut down the prevalence of cancer significantly though it will take a few decades.”

Cancer at the killing cost comes with both its drowning effects and its unaffordable character. We don’t really need case studies to analyse it. It is apparent that most of the cancer patients can’t afford the forbiddingly expensive treatment. The question is not about the nature of cancer but about the percentage of the people who can afford the amenities prerequisite for its treatment.