Lok Sabha Question No. 916 (UNSTARRED), answered on 2024-07-26
Subject: Increasing Cancer Cases in North-East Region
Ministry: HEALTH AND FAMILY WELFARE
Asked by: Shri Kamakhya Prasad Tasa

## GOVERNMENTOFINDIA MINISTRYOF HEALTH AND FAMILY WELFARE DEPARTMENTOFHEALTH AND FAMILY WELFARE

## LOK SABHA UNSTARRED QUESTION NO. 916 TO BE ANSWERED ON 26 TH JULY, 2024

## INCREASING CANCER CASES IN NORTH-EAST REGION

## 916. SHRI KAMAKHYA PRASAD TASA

## Will the MINISTER OF HEALTH AND FAMILY WELFARE be pleased to state:

(a) whether the Government plans to address the rising Cancer cases in the North-East and if so, the details thereof;

(b) whether the Government has any plan for collaboration between the Government and private sector to address the rising Cancer cases in the North-East and if so, the details thereof;

(c) the steps taken/proposed to be taken by the Government to address the risk of Arsenic in potable water in each State of the North-East;

(d) whether the Government has any plan for establishing Positron Emission TomographyComputed Tomography (PET-CT) scan facilities in all Government hospitals across the country especially in North-east, if so, the details thereof; and

(e) whether the Government has made any strategy for ensuring affordable Cancer treatment in the country especially for North-East people and if so, the details thereof?

## ANSWER THE MINISTER OF STATE IN THE MINISTRY OF HEALTH AND FAMILY WELFARE (SHRI PRATAPRAO JADHAV)

- (a) & (b) As per the 'National Cancer Registry Programme Report, 2020' by the Indian Council of Medical Research - National Cancer Registry Program (ICMR-NCRP), the higher Age Adjusted Incidence Rates (AAR) are seen in North-eastern zone of Aizawl district from Mizoram, Papumpare district from Arunachal Pradesh, East Khasi Hills district from Meghalaya, and Kamrup Urban from Assam.

The Department of Health & Family Welfare, Government of India, provides technical and financial support to the States/UTs under the National Programme for Prevention and Control of Non-Communicable Diseases (NP-NCD), 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 NP-NCD. The program focuses 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 (NCDs), including Cancer. Under NP-NCD, 753 District NCD Clinics, 356 District Day Care Centres and 6238 Community Health Center (CHC) NCD Clinics has been set up. For activities upto the District level and below, states/UTs are given financial assistance under NHM in the ratio of 60:40 (90:10 in case NE and hilly states).

A population-based initiative for prevention, control and screening for common 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 Aarogya Mandir.

- (c) Government of India, in partnership with States, is implementing Jal Jeevan Mission (JJM) since August, 2019 to provide potable tap water supply in adequate quantity, of prescribed quality and on regular & long-term basis to every rural household in the country. Drinking Water being a state subject, the responsibility of planning, approval, implementation, operation, and maintenance of drinking water supply schemes, including those under the Jal Jeevan Mission, lies with State/UT Governments. Under the Jal Jeevan Mission, as per existing guidelines, Bureau of Indian Standards'BIS:10500 standards are adopted as benchmarks for ensuring quality of water being supplied through the piped water supply schemes. The Government of India supports the States including North-eastern States by providing technical and financial assistance.

Under JJM, while planning water supply schemes to provide tap water supply to households, priority is given to quality-affected habitations. While allocating the funds to States/ UTs in a particular financial year, 10% weightage is given to the population residing in habitations affected by chemical contaminants including Arsenic affected habitations. As reported by States on Jal Jeevan Mission - Integrated Management Information System (JJM-IMIS), as on date, no rural habitations in North-east are affected with Arsenic contamination in drinking water sources.

To enable States/ UTs to test water samples for water quality, and for sample collection, reporting, monitoring, and surveillance of drinking water sources, an online JJM - Water Quality Management Information System (WQMIS) portal has been developed. The State-wise details of water quality test reported through WQMIS are available in public domain and can be accessed at:https://ejalshakti.gov.in/WQMIS/Main/report

As reported by States/UTs on JJM-WQMIS portal, as on date, 2,163 drinking water quality testing laboratories at different levels viz. State, regional, district, sub-division and/or block level, have been set up in the country. To encourage water quality testing to ensure potable drinking water supply, States/ UTs have opened water quality testing laboratories to general public for testing of their water samples at a nominal rate.

In order to empower citizens, States/ UTs have been advised to identify and train 5 persons, preferably women, in every village to conduct water quality testing using Field Testing Kits (FTKs)/ bacteriological vials at village level and report the same on the Water Quality Monitoring Information System (WQMIS) portal.

- (d) & (e) The Central Government implements the Strengthening of Tertiary Cancer Care Centres Facilities Scheme in order to enhance the facilities for tertiary care of cancer. Under this scheme, there is a provision for the procurement of PET-CT scan equipment.19 State Cancer Institutes (SCIs) and 20 Tertiary Cancer Care Centres (TCCCs) have been approved under the said scheme. Out of which, five institutes in North-East are approved:-
- a. Guwahati Medical College & Hospital, Assam (SCI)
- b.State Cancer Institute, Aizawl, Mizoram (TCCC)
- c. District Hospital, Kohima, Nagaland (TCCC)
- d.Multispecialty Hospital at Sochakgang, Sikkim (TCCC)
- e. Cancer Hospital, Agartala, Tripura (SCI)

There is also focus on Oncology in its various aspects in case of AIIMS in Guwahati, Assam under Pradhan Mantri Swasthya Suraksha Yojna (PMSSY).Govt of Assam has collaborated with Tata Trusts and established Assam Cancer Care Foundation (ACCF)and developed an equitable and affordable cancer care model called the Distributed Cancer Care Model with a vision to deliver standardized and affordable care closer to the patients' homes.

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. Cancer related Treatment is also available under Ayushman Bharat-Pradhan Mantri Jan Arogya Yojana (AB PMJAY) under three heads Oncology-Medical, Surgical and Radiation. The number of treatment packages and procedures for treatment of Cancer in the national Health Benefit Package (HBP) is as follows:

|   Sr. No. | Specialty           |   No. of packages |   No. of procedures |
|-----------|---------------------|-------------------|---------------------|
|         1 | Medical Oncology    |                76 |                 288 |
|         2 | Radiation Oncology  |                20 |                  53 |
|         3 | Surgical Oncology   |                81 |                 166 |
|         4 | Palliative Medicine |                42 |                  42 |

AB PMJAY provides health cover of Rs. 5 lakhs per family per year for secondary and tertiary care hospitalization to approximately 55 Cr beneficiaries corresponding to 12.34 Crore families constituting the bottom 40% of India's population.

As of 15th July 2024, approximately 72.16 Lakh hospital admissions worth Rs. 13,778 Crores have been authorized under AB PMJAY for cancer-related treatment. In North-East, approximately 1.79 Lakh cancer-related treatments amounting to Rs. 336.79 Crore under AB PMJAY have been provided as on date. Further, a total number of 957 hospitals are empaneled under the scheme for the North-East region.

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.