In recent years, tremendous advancements have taken place in the global health systems that have accorded heightened importance to resolving health inequities and building sustainable health solutions. This is evidenced by Target 3.4 of the Sustainable Development Goals (SDGs), which seeks to reduce premature mortality from noncommunicable diseases (NCDs), particularly cancer, which accounts for 22% of the NCD deaths, by a third by 2030 compared to 2015 levels1; as well as improve mental health and well-being. Therefore, a reduced global cancer and NCD burden is a necessity for resolving social and economic injustice, increasing economic growth, and speeding sustainable development, given the immense social and economic burden of cancer in many LMICs.

Amongst the many disease areas contributing to the global health burdens, cancer is one of the key causes of concern. Even during the COVID-19 pandemic that toppled many essential health services, an estimated 19.3 million people were newly diagnosed with cancer, yet its diagnosis and treatment were adversely affected in 55% of countries2. In India, for example, cancer services saw a 54% decrease in new patient registrations in 2020,  a 37% drop in outpatient chemotherapy, and  a 25% reduction in screening activities3. The country is at a critical juncture in its healthcare system, where it can genuinely satisfy the demands of its people by focusing on what its core beneficiaries — patients value. (? Unsure what this means) Given that inequities in cancer care continue to exist both between and within nations themselves, improving cancer outcomes for everyone would require health systems to be reoriented around patients and their needs. Up to 50% of all early deaths from NCDs, including cancer, have been linked to insufficient health systems that fail to respond effectively and equitably to the population’s healthcare requirements. As a result, if action is taken and effective restructuring of health systems is achieved, a considerable fraction of cancer-related fatalities can be averted. It will need training in cancer care organisation and delivery, as well as how to do it effectively and efficiently, given the country’s people and financial resources. It will also necessitate the improvement of health information systems and a political commitment to ensuring prompt patient access to critical cancer services.

As India’s healthcare system evolves, care should be personalised to address known sources of patient heterogeneity (? What does this mean?). These can be used to fine-tune care modalities, such as treatments based on the patient’s health, their response to therapy, the presence of side effects or problems, and life expectancy. Considering India’s current state of healthcare, these value-adding policies and translational activities should be based on re-prioritizing primary care.

RAPID: A Global Cancer Alliance which is an initiative that brings with it a five-pronged approach- comprising awareness amongst the masses, stakeholder collaboration across disciplines and professions, decentralisation and modernisation of the cancer healthcare system, increasing accessibility, the ambit of cancer care and prevention, and finally decreasing the cancer burden in India. Cross-sectoral collaboration and partnerships are essential for alleviating increasing cancer incidence in the society.

With this initiative, the attempt is to build a platform wherein collaborators, influencers and experts across the globe can come together with the primary objective of creating a well-knit and connected network of global oncologists and other experts who believe in bringing an intersectional convergence to strengthen response to the global fight against cancer. Societal changes are necessary, yet they must be sought after rather than left to happenstance. RAPID aims to garner a global alliance against the plague that cancer has become through institutionalising international, national and regional social organisations for infrastructure, policy, patient survivors and palliative care groups that shall work together for RAPID actions.

Therefore, RAPID would strive to bring about changes in cancer control frameworks and policy, from health system design to implementation and governance. Consequently, everyone agrees that the next step for the cancer community is to use the demonstrable public and political momentum behind cancer to drive change. Thus, our vision is to embed societal and policy changes in the fabric of the cancer healthcare system in a manner that encourages- even facilitates- a global stakeholder collaboration.

_{¹.https://www.who.int/data/gho/data/themes/topics/sdg-target-3_4-noncommunicable-diseases-and-mental-health}

².https://www.who.int/publications/i/item/WHO-2019-nCoV-EHS_continuity-survey-2020.

³.Ranganathan, Priya et al. “Impact of COVID-19 on cancer care in India: a cohort study.” The Lancet. Oncology vol. 22,7 (2021): 970-976. doi:10.1016/S1470-2045(21)00240-0

Author

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Dr Ravi Mehrotra, Adjunct Professor, Epidemiology, Rollins School of Public Health, Emory University, Atlanta