Lok Sabha Question No. 330 (STARRED), answered on 2022-03-25
Subject: Impact of COVID-19 on Reporting of Cancer and HIV Cases
Ministry: HEALTH AND FAMILY WELFARE
Asked by: Thomas Chazhikadan

## GOVERNMENT OF INDIA MINISTRY OF HEALTH AND FAMILY WELFARE DEPARTMENT OF HEALTH AND FAMILY WELFARE

## LOK SABHA STARRED QUESTION NO.330 TO BE ANSWERED ON THE 25 TH  MARCH, 2022

## IMPACT OF COVID-19 ON REPORTING OF CANCER AND HIV CASES

## *330. SHRI THOMAS CHAZHIKADAN:

Will the Minister of HEALTH AND FAMILY WELFARE be pleased to state:

- (a)  the  details  of  the  impact  of  COVID-19  on  reporting  of  cancer  cases  and detection of HIV cases;
- (b) whether the Government anticipates an increase in the reporting of incidence of cancer and HIV during the post pandemic phase; and
- (c) if so, the details of the measures being taken by the Government to address the situation?

## ANSWER THE MINISTER OF HEALTH AND FAMILY WELFARE

## (DR MANSUKH MANDAVIYA)

- (a) to (c) A Statement is laid on the Table of the House.

## STATEMENT REFERRED TO IN REPLY TO LOK SABHA STARRED QUESTION NO. 330* FOR 25 TH  MARCH, 2022

(a) to (c): As per the Indian Council of Medical Research's Cancer Registry Data Report  on  'National  Cancer  Registry  Programme  Report,  2020',  the  estimated number of incidence and mortality of cancer cases in the country are 13.92 lakhs and  7.70  lakhs  respectively.  Patients  of  cancer  with  COVID19  are  getting treatment at various health facilities in the health care delivery system including Districts  Hospitals,  Medical  Colleges,  Central  Institutes  like  AIIMS  and  private sector  hospitals.  Relevant  data  related  to  patients  registered  for  treatment,  is maintained by the Institutions and Hospitals concerned at their own level.

Health  is  a  state  subject.  The  Department  of  Health  &  Family  Welfare, Government  of  India  however,  provides  technical  and  financial  support  to  the States/UTs under the National Programme for Prevention and Control of Cancer, Diabetes,  Cardiovascular  Diseases  and  Stroke  (NPCDCS),  as  part  of  National Health Mission (NHM), based on the proposals received from the States/UTs and subject  to  the  resource  envelope.  Cancer  is  an  integral  part  of  NPCDCS.  The programme focusses on strengthening infrastructure, human resource development, health promotion & awareness generation for Cancer prevention, early diagnosis, management and referral to an appropriate level of healthcare facility for treatment of the Non-Communicable Diseases, including Cancer.

Cancer is diagnosed and treated at various levels in the health care facilities. The treatment in Government Hospitals is either free or highly subsidized for the poor  and  needy.  Under  NPCDCS,  682  District  NCD  Clinics,  191  Cardiac  Care Units, 264 District Day Care Centres and 5408 CHC NCD Clinics have been set up.

A  population-based  initiative  for  prevention,  control  and  screening  for common  Non-Communicable  Diseases  (NCDs)  i.e.  diabetes,  hypertension  and common cancers has been rolled out in the country under NHM and also as a part of Comprehensive Primary Health Care. Under the initiative, persons more than 30 years of age are targeted for their screening for the three common cancers i.e oral, breast  and  cervical.  Screening  of  these  common  cancers  is  an  integral  part  of service  delivery  under  Ayushman  Bharat  -  Health  and  Wellness  Centres  (ABHWC).

The  Central  Government  is  also  implementing  Strengthening  of  Tertiary Care of Cancer Scheme in order to enhance the facilities for tertiary care of cancer. 19 State  Cancer  Institutes  (SCIs)  and  20  Tertiary  Care  Cancer  Centres  (TCCCs) have been approved so far under the said scheme. There is also focus on Oncology in its various aspects in case of new AIIMS and many upgraded institutions under Pradhan  Mantri  Swasthya  Suraksha  Yojna  (PMSSY).  Setting  up  of  National Cancer Institute at Jhajjar (Haryana) and second campus of Chittaranjan National Cancer  Institute,  Kolkata  are  also  steps  in  this  direction.  All  these  enhance  the capacity for treatment of cancer in the country.

Treatment of Cancers is also available under Ayushman Bharat  - Pradhan Mantri Jan Arogya Yojana (PMJAY). Besides, quality generic medicines are made available  at  affordable  prices  to  all,  under  Pradhan  Mantri  Bhartiya  Janaushadhi Pariyojana  (PMBJP)  in  collaboration  with  the  State  Governments.  Affordable Medicines and Reliable  Implants  for  Treatment  (AMRIT)  Pharmacy  stores  have been  set  up  in  some  hospitals/institutions,  with  an  objective  to  make  available Cancer drugs at a substantial discount vis-à-vis the Maximum Retail Price. Under the  umbrella  scheme  of  Rashtrya  Arogya  Nidhi  (RAN),  financial  assistance  is provided  to  families  living  below  threshold  poverty  line  for  their  treatment, including treatment of Cancer in Government hospitals.

During the COVID -19 pandemic in order to ensure continuity of health care services  Mobile  Medical  Units  were  utilized  for  delivery  of  services,  especially follow  up  care  for  NCDs.  The  screening  services  were  reorganized  during  the period  of  lockdown  and  beyond.  Primary  healthcare  team  at  Sub-Health  Centre (SHC),  including  HWCs  were  encouraged  to  follow  up  with  the  specific  subpopulation  groups  such  as  patients  undergoing  planned  procedures  like  cancer treatment.

States were instructed to ensure uninterrupted availability of cancer treatment services. State Health Department was advised to issue directives to the district administration allowing easy movement of these patients to access care. In case  of  patients,  who  could  not  afford  private  vehicles,  Rashtriya  Bal  Swasthya Karyakram (RBSK) vehicles could be used for facilitating transport of patients.

The HIV disease in India is under control. The prevalence continues to be low with an adult prevalence rate of 0.22% as per the latest HIV Estimations 2020 report of the Government of India.

The Government took necessary steps through NACP at the beginning of the COVID-19 pandemic in February-March 2020 for the uninterrupted supply of free, life-saving,  high-quality  anti-retroviral  (ARVs)  medicines  ensuring  that  people living  with  HIV/AIDS get their  ARVs without any difficulty.  Community-based service delivery, like the provisioning of anti-retroviral medicines, was facilitated to  avoid  travel  by  target  beneficiaries  and  thus  facilitating  the  prevention  of COVID-19 infections.  Regular  review  and  appropriate  reiteration  of  instructions and advisories were undertaken during the COVID-19 pandemic as a key activity to ensure continuity of services.

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