About Author: Manikandan Bala, Senior Vice President, TIMEA & Asia Pacific, Direct Sales Strategies & MD India & SA, Elekta Medical Systems India. In a career spanning 32+ years in the healthcare industry, Manikandan has led and managed cross-cultural teams and engaged actively in mentoring next-gen leaders. Manikandan played an instrumental role in driving business growth for companies including GE, Siemens and Johnson & Johnsons. Hei has also been the Co-chair for Medical Devices Forum at Federation of Indian Chambers of Commerce and Industry (FICCI).
We have multiple positive indicators that are driving the nation’s health in the right direction, the national incidence of Non-Communicable Diseases (NCDs) like Cardiovascular diseases, Cancer, Chronic Respiratory Diseases, Diabetes, etc. are estimated to account for around 60% of all deaths in the country. India reported a rise of nearly 324% in cancer cases from 2017 to 2018, according to the 2019 National Health Profile and has also triggered the government to make it a ‘notifiable’ disease in September 2022.
However, we have an opportunity to shape this. With the adoption of cutting-edge systems and technologies, the healthcare industry in India is evolving quickly. India has been successful in countering cancer through the National Programme for Prevention and Control of Cancer, Diabetes, Cardiovascular diseases and Stroke (NPCDCS) program that was initiated in 2011. Though there are areas of improvement like increasing access, availability and affordability of care in Tier 3 and 4 cities, there is a sincere push by the Government and private bodies to meet the demands of the public.
We all understand that decisions are made based on quantitative evidence that is built over some time. Over the last 40 years, the cancer registries that are set up have only been able to collect just 10% of the Indian cancer incidence. Therefore, this is an area that has to be addressed to get a better view of the disease landscape in the country.
Cancer incidence and data collection
Modern computing and information technology have completely transformed the field of conventional medical and healthcare operations. IT subsystems including networking, website, database and software systems completely alter the situation. The medical and healthcare industries have undergone a significant transformation over the past ten years, as a result, there is a gap between India’s supply and demand for medical and allied products. This gap presents an opportunity for the development of medical gadgets.
“Holistic cancer care is based on a multimodal approach – surgery, chemotherapy, immunotherapy, and radiotherapy.”
In this digital age, procedures and diagnostics associated with cancer care are well documented and traceable over the years. Since cancer care is a long-term treatment, electronic documentation of the patient is of specific importance. In line with the Ayushman Bharat Digital Mission, the growth in Electronic Medical records (EMR) adoption is a healthy sign across the country – both in private and government medical facilities. EMR is the foundation for the healthcare industry to thrive and is the much-needed digital tool doctors in the country can rely on. As the penetration of EMR has increased across the country, the support for cancer care has also improved.
Holistic cancer care is based on a multimodal approach – surgery, chemotherapy, immunotherapy, and radiotherapy. The Lancet Oncology Commission Global Task Force on Radiotherapy for Cancer Control (GTFRCC) report from 2015 did a good job of describing the role of radiotherapy in the management of cancer, showing that roughly half of all oncology patients will need radiotherapy at some point during their treatment. There is a direct link between the prevalence of cancer and the number of machines available per million people (CMI).
Challenges faced by patients who need radiotherapy
According to World Health Organisation (WHO) recommendations for developing nations, one Linear Accelerator (Linac) per million people is advised. India has 135 crore people, hence there is a need for 1,350 Linac. At the moment, India has about 545 teletherapy devices (180 tele-cobalt machines and 365 Linac). Consequently, there is an 800 Linac shortage. This shortage means that in public hospitals the waiting period for radiotherapy could go up to 1 year!
“Modern computing and information technology have completely transformed the field of conventional medical and healthcare operations.”