Cancer has the dubious honour of being the emperor of all maladies since the shadow of death is a constant companion.

 

 

 

The financial, emotional, and social impact of cancer is debilitating. Cancer care in India is characterised by high incidence, late detection, and lack of access to quality affordable care and hence, high mortality. The key risk factors for cancer, in India, are the use of alcohol or tobacco, obesity, human papillomavirus infections, radiation exposure, smoky food and fatty diet, as well as environmental pollution.

 

Major global initiatives to address cancer include the “Cancer Moon Shot program 2020”. In January 2016, the US President, Barack Obama, launched this initiative to accelerate progress in cancer research. A Blue Ribbon Panel (BRP) of experts from relevant scientific backgrounds was established as a subcommittee of the National Cancer Advisory Board. Leading experts hailed from diverse scientific areas such as biology, immunology, genomics, bioinformatics, drug development, clinical trials, cancer disparities, epidemiology and public health.

 

The cancer moon shot program brings together targeted therapy and immunotherapy, academic and industry, research projects. The program aims to initiate Quantum Integrative Lifelong Trial (QUILT) comprising of randomised trials in 20,000 cancer patients. QUILT will enrol patients at all stages of the disease of 20 different tumour types with the mandate to develop an effective vaccine-based immunotherapy to combat cancer by 2020. The ultimate objective of the program is to to be able to manage cancer in a manner similar to other chronic diseases. The approved fund for the program is $1.8 billion which is approximately 120 billion rupees.

 

Collaboration and partnerships are essential for achieving the goals of the Cancer Moon shot program. Regional Centers of Research Excellence (RCREs), an international network, was created to support partnerships between high-income countries and low - and middle-income countries One of the six RCREs will establish a country-wide, clinic-based method to prevent and control breast and oral cancers in India.

 

In 2015, cancer incidence in India was reported as 1.1 million — the real incidence of cancer might actually be 1.5 to 2 times higher than reported. India has mortality rates of more than 5.5 lakhs per year for cancer. The baseline treatment costs are higher than the annual household income of 80-85% households. This makes cancer a significant threat to the Indian population.

 

India‘s Own Moon Shot

 

India is a part of the greater collaboration in cancer moon shot program but there are several advantages and challenges towards developing a US-style moon shot program.

 

Advantages: 

 

1. Cancer treatment facilities are at par with International treatment guidelines.
2. Cost-effective because of readily available human resources, low recruitment cost, and a lower rate of compensation.

 

Challenges: 

 

1. Dependent on medical research in the Western countries.
2. Lack of infrastructure and research orientation.

 

While a cancer moon shot program may be beneficial, in a country with less than 1% GDP spent on health, it will require tremendous political will and people initiatives to design and implement such a large-scale program which might need investments of multiples of crores of rupees. The government, academicians, and renowned cancer institutes like Tata Memorial Hospital (Mumbai), AIIMS (New Delhi), and Adyar Cancer Institute (Chennai), as well as private counterparts, have to join hands to plan such a program in India.

 

 

Learn more about this topic at:

 

1. Call for Action: Expanding cancer care in India. 

2. Cancer Moonshot Ribbon Panel