Expanding access to cancer care: Public-Private partnerships key to success

Unlike many other diseases, cancer care is uniquely complex, involving prolonged treatment regimens, high costs, and significant emotional distress for patients and their families. The financial burden is especially severe, as out-of-pocket expenses for chemotherapy, radiation, and advanced treatments often push families into debt.

India is facing a rapidly growing cancer burden, with over 14.6 lakhs new cases diagnosed annually, the number is expected to rise to 20 lakhs by 2040. Unlike many other diseases, cancer care is uniquely complex, involving prolonged treatment regimens, high costs, and significant emotional distress for patients and their families. The financial burden is especially severe, as out-of-pocket expenses for chemotherapy, radiation, and advanced treatments often push families into debt.

Additionally, cancer treatment is not a one-time intervention; it requires long-term care, frequent hospital visits, and continuous monitoring, making accessibility a critical issue. The Union Budget 2025-26 has proposed the establishment of day care cancer centres in district hospitals, beginning with 200 centres in the next financial year. The day care cancer centres are designed to provide crucial services such as chemotherapy, targeted therapy, immunotherapy, and palliative care in a setting that does not require hospitalisation.

This initiative, if implemented, holds immense potential to improve cancer care outcomes by addressing critical gaps in accessibility, affordability, and continuity of treatment. By bringing cancer care closer to patients, these centres will reduce travel burdens, lower indirect costs associated with prolonged hospital stays, and decongest tertiary hospitals, allowing them to focus on complex cases that require advanced intervention.

While this initiative marks a significant step forward, the role of the private sector in bridging the existing gaps in cancer care cannot be overlooked. Several private organisations have already been actively working in this space, introducing innovative models to improve access and quality of care. The Tata Memorial Centre, a pioneer in oncology treatment and research, has been expanding its outreach through peripheral chemotherapy models, allowing patients to receive treatment closer to home. Tata Memorial has adopted a four level step down model for enabling access, which are – Level 1: Apex centres that are equipped with an array of oncology services including radiation, medicine, surgery, nuclear medicine and allied facilities; Level 2: Hospitals with comprehensive oncology services and allied facilities, some of which are linked to the government medical college hospitals; Level 3: Diagnostic and daycare radiotherapy and chemotherapy units; and Level 4: Outreach initiatives, including palliative care. In addition, the National Cancer Grid (NCG), also spearheaded by Tata Memorial, has brought together over 140 cancer centres across India to standardise treatment protocols and share expertise. Leading private hospital chains such as Apollo Cancer Centres, HCG, and Max Healthcare have also developed day care.

Chemotherapy models in urban regions, demonstrating the effectiveness of decentralised oncology care. The Indian government has also been progressively strengthening cancer care infrastructure as well. Over 1.6 lakh HWCs have been set up, with plans to integrate oncology services at the primary healthcare level. 19 State Cancer Institutes (SCIs) and 20 Tertiary Care Cancer Centres (TCCCs) have been approved under the National Programme for Prevention and Control of Cancer, Diabetes, Cardiovascular Diseases and Stroke (NPCDCS). Several new AIIMS hospitals have been announced with dedicated oncology wings. Non-governmental organisations (NGOs) like CanKids and the Indian Cancer Society have been instrumental in providing financial assistance, accommodation, and transportation support to cancer patients, easing some of the economic challenges associated with long-term treatment.

Despite these commendable efforts, a vast segment of India’s population lack access to adequate cancer care. This is where public-private partnerships (PPPs) can be pivotal in scaling up efforts to ensure that quality cancer treatment reaches every district.

The private sector can play a significant role in several ways—establishing chemotherapy units within district hospitals, training government doctors and nurses in oncology care, and leveraging telemedicine platforms to provide remote consultations. Best suited PPP models, including co-location, facility management, and service delivery models, among others, can be strategically selected based on the specific factors influencing the location and needs of a district hospital and its catchment area. Successful PPP models already exist in India’s healthcare ecosystem, offering valuable lessons for cancer care expansion. For instance, the Pradhan Mantri National Dialysis Programme has successfully leveraged private healthcare providers to set up dialysis centres in public hospitals, dramatically improving access to treatment for kidney disease patients. A similar approach can be adopted for cancer care by integrating private oncology expertise with government infrastructure. In addition to infrastructure and expertise, PPPs can help address one of the biggest barriers in cancer care—affordability. Pharmaceutical companies, as part of corporate social responsibility (CSR) initiatives, can provide free or subsidised chemotherapy drugs to district-level day care centres, reducing the financial strain on patients. AI-driven teleoncology programs, backed by private players, can enhance early detection efforts, ensuring timely intervention and better survival rates. NGOs can further support these initiatives by providing logistical aid, patient navigation services, and community outreach programs to increase awareness about early screening and treatment options. Through a collaborative approach, all these efforts by the private sector and be weaved together into an ecosystem enabling quality cancer care to patients in need.

However, the success of this ambitious initiative will depend on several factors. Addressing the shortage of trained oncologists and oncology nurses is critical, as India currently has only 2,700 oncologists, whereas it needs more than 5,000 to meet the growing demand. Sustainable funding mechanisms must also be in place to ensure that these day care cancer centres continue to function effectively beyond the initial investment. The integration of community-level screening programs with these centres will be essential to ensure that patients are diagnosed early and directed toward appropriate treatment pathways. A phased rollout, starting with high-burden districts, combined with robust monitoring and evaluation mechanisms, will be key to ensuring successful implementation. The decentralisation of cancer care, coupled with strategic PPP collaborations, has the potential to transform India’s oncology landscape, making treatment more accessible, affordable, and efficient. With strong government commitment, private sector participation, and community engagement, this initiative could set a new benchmark for cancer care in India, if implemented, ultimately saving millions of lives and improving the quality of life for countless patients.

This article first appeared in ET HealthWorld on 12 February 2025.