Healthcare in India has not received the priority it deserves and much more needs to be done in a country as big and diverse as ours—ranging from budget allocation and robust systems to policy implementation and better infrastructure. The existing healthcare system is overworked and overextended. The patient is at the receiving end and suffers the most, because most treatment options either do not to reach her or reach too late.
At the same time, we have made advancements and this must be recognised. Terminally-ill cancer patients can now be effectively cured if they have access to life-changing treatment for skin cancer and lung diseases. Game-changing cardiovascular disease medications allow a much better quality of life to so many young heart patients in the country. AIDS is no longer a death sentence.
Drug innovators are applying innovative sciences to create newer and better medicines and diagnostics. They are using novel techniques to make medicines easier to store, transport, dispense and consume. Scientists and data researchers are building evidence, and doctors are using their skills to save lives and deliver desired patient outcomes. Newer and better treatment options are being discovered every day for treating complex health conditions and emerging diseases, and to improve health and longevity.
A joint study by WIPO, WTO and WHO titled “Promoting Access to Medical Technologies and Innovation” recognises that innovation and access are inevitably intertwined—access without innovation would mean a declining capacity to meet an evolving global disease burden. The recently adopted Sustainable Development Goals (SDGs), including SDG-3, reiterate the commitment to “ensuring healthy lives and promoting well-being for all at all ages.” To meet this goal, all efforts to promote access to new medicines, vaccines, diagnostics and related health technologies must be optimised, while simultaneously incentivising new research and innovation.
The government must focus on how new technologies can reach those most in need, but it must also respect intellectual property rights and ensure an IP environment that encourages research for discovery of new medicines to treat the numerable diseases that still have no cure. Our officials and policymakers have to do a lot more to encourage research, while enabling new technologies to reach the masses as quickly as possible. The government needs to invest more in research, ensure an ecosystem that encourages the private sector to invest in research and then help these investments lead to desired outcomes and benefits for patients. A patient’s right to be able to choose and use the best available treatment options is paramount.
Let us take a look at the dengue situation. The mosquito-borne virus wreaks havoc every year and at present there is no cure. Treatment is symptomatic and patients are advised to rest, drink fluids and take paracetamol to bring down fever and reduce joint pains. Parts of India are endemic, and effective prevention measures are desperately needed. Vector management and clean environment are the most cost-effective methods for large populations and vast geographic areas. In the short-term, vaccines are the best choice for highly endemic areas. Recently, the Mexican regulator accorded marketing authorisation for the first vaccine for prevention of dengue. At the same time, a Pune-based company is working in association with a Thailand-based university and the National Institutes of Health, US, on creating a vaccine against all four serotypes of dengue where a single dose is expected to provide lifelong immunity. These combined efforts will bring down the incidence of dengue and help manage this public health crisis more effectively, all thanks to continued innovation.
Innovation backed by good policy can bring about exemplary results. The war on HIV/AIDS in India is surely not over, but the results to date are very encouraging. Ongoing innovation in combination products, supported by a strong prevention strategy and greater patient empowerment, has led to a decline in new infections. Available data suggests that HIV prevalence in the female sex worker community has declined from 12.7% in 2006 to 9.3% in 2010.
Hepatitis C virus has a much higher disease burden and is several times more virulent than HIV. It is estimated that 150-200 million people, approximately 3% of the world’s population, are living with chronic hepatitis C. In India, an estimated 12 million people are infected with hepatitis C, but today we have a cure even for this deadly disease. Tackling Hepatitis C and keeping its numbers down is an achievable goal, provided we enable companies to introduce new scientific innovations from around the world and adopt a multi-pronged strategy: a robust awareness drive, focus on screening and early diagnosis and access to quality, affordable medicines through a patient-centred healthcare system. Much still needs to be done in this area and we must continue to incentivise companies to invest in new treatments and cures.
The road ahead
Scientists have been trying to find cures for many types of cancer for a long time. Hopefully, the breakthroughs happening worldwide, such as the new model of testing being developed by scientists at Cambridge University and the two new FDA-approved biological drugs used to treat advanced melanoma made by US-based drugmakers, will reach our country soon. Efforts by the Drug Controller General of India to bring them to the country sooner must be lauded. A multi-sectoral and comprehensive approach to create proactive strategies to improve healthcare access and affordability is the way to go, if the patients are to derive the benefits.
Research has to be given a boost, safety needs to be ensured and quality needs to be monitored—all these are essential to keeping our people healthy and safe. Innovative, safe and quality medicines play an indispensable role in the outcome of disease treatment. All patients should have access to the most advanced medicines, developed after years of research and with proven medicinal benefits to treat the most complicated disease conditions. While making decisions with respect to healthcare, all stakeholders must be fully aware and appreciative of the role of medicines in saving lives. Access to safe, efficacious and new/improved medicines cannot be ignored while working towards India’s goal of healthcare for all. This should be backed by development and adoption of guidelines to standardise care and processes across India as well as uniformity and enforcement of quality in long-term patient interests. Collaboration between ongoing innovation and collective implementation is the call of the future.
The author is CEO, Dakshayani & Amaravati Health and Education, and founder, Indian Alliance of Patient Groups. Views are personal