Since independence several measures have been undertaken by the National Government to improve the health of the people. Several National Health Programs have been launched by the Government including programs on Non-communicable diseases (NCD) along with the communicable diseases which are prevalent in India. Now India is experiencing a rapid health transition with rising burden of chronic NCDs especially CVD, Diabetes, Cancer, Stroke and lung diseases. In 2005 NCDs accounted for 53 % of deaths and NCDs are surpassing the burden of communicable diseases in India.
In 2010 the Cancer program was integrated with the then existing program and the new program is NPCDCS (National Program for Prevention and Control of Cancer, Diabetes, Cardiovascular Diseases and Stroke). There are two programs under NPCDCS:
- DCS – Diabetes, Cardiovascular Disease and Stroke – under NPCDCS
- Cancer component under NPCDCS
The objectives of the new cancer program under NPCDCS are:
- Primary prevention: Health education
- Secondary prevention: early detection and diagnosis of cervix, mouth, breast and tobacco related cancers.
- Tertiary prevention: comprehensive therapy including palliative care
There are several schemes under this revised program:
- Regional Cancer Centre Scheme – to deal with complicated and tertiary level cancer cases.
- Oncology Wind Development Scheme – to fill the gap between the centers across the country.
- Decentralized NGO scheme – it is meant for IEC activities and early detection activities.
- Information, Education and Communication (IEC) activities – to give publicity about the anti-tobacco legislation for discouraging consumption of cigarettes and related products.
- Research and Training – for training, monitoring and research activities.
- November 7th is observed as National Cancer Awareness Day in the Country
What I strongly believe at this point of time and space is that one should focus on the following:
In India we have a 20 point program in addition to the above mentioned Five Year Plans and Programs. This program is described as an agenda for national action to promote social justice and economic growth.
Objectives of the program are:
- Eradication of poverty
- Raising productivity
- Reducing inequalities
- Removing social and economic disparities
- Improving the quality of life
Following are the Points related to health:
- Attack on rural poverty
- Clean drinking water
- Health for all
- Expansion of education
- Housing for the people
- Improvement of slums – one should plan to completely remove ‘slum’ concept and replace it with permanent housing. Therefore, point 5 should be the prime agenda to remove point 6 permanently.
- Protection of the environment
This program has been described as “the cutting edge of the plan for the poor”, but it can otherwise be called as “Common Minimum Program” to maintain minimum standards in life and of life. These programs are, in my view, are very well executed and maintained throughout almost in every developed country in the world. “I believe, this is what the Vedas are also telling in a sense that maintaining good hygiene, public and personal health, agriculture and fine-arts are the bare minimum to the economic growth, both internal and external.”
Regarding Cancer Disease in India:
In India, ICMR (Indian Council of Medical Research) under National Cancer Registry Programme provides data on incidence, mortality and distribution of cancer from available registries*. Cancer became an important public health problem in India
- Nearly 1 million new cases occurring every year
- About 2.8 million cases are estimated at any given time
- Five most frequent cancers are: cervix uteri, breast, lip. oral cavity, lung, oesophagus.
- Cancer in males are mostly related to tobacco
- Cancer in females are mostly related to hygiene, marriage traditions, exposure to tobacco etc.
- Breast cancer is on the rise in urban areas.
- Screening and management facilities are limited – available mainly in metropolitan cities and the facilities at many of the corporate hospitals are almost comparable to the facilities available in developed countries. It is mainly about the affordability and accessibility to most of the population.
Thanks to some of the schemes introduced by the respective governments. But still lot more to be done. It is just a beginning as far Cancer diagnosis, treatment and prevention are concerned.
*more integration of registries is required which is an ongoing process to get the more realistic data. However, the trend seems to be towards more NCDs in the future.