Wednesday, May 9, 2007

Cancer Patients: dying a thousand deaths

In spite of the advance of medical sciences in many fields , cancer is an area where in spite of a lot of progress , things haven't changed much on the ground. The patient still usually has to go through a prolonged treatment and at the end of which there is nothing called a cure in most instances. What you get is a stage of remission usually and even when you are in remission you are always looking over your shoulder to check for recurrences and in the many cases I have known , sooner or later cancer seems to catch up with you and more often than not , the prognosis progressively deteriorates.

Added to that is the burden of cost. Cancer treatment has always tended to bes expensive for several reasons – the treatment is prolonged for one , the treatment is also not available every where – typically the cheapest treatment available would be in the handful of regional cancer centers run by the government and the travel itself is fraught with costs and logistical expenses.
In spite of the fact that cancer strikes all sections of society and only perhaps lung cancer is associated with a clearly defined high risk behavior , which means that not much preventive measures can be really taken, the disease suffers from neglect. Conditions like HIV and AIDS which have got vocal activist groups taking up the cause of treatment care are able to garner funds from both the government and international philanthropic donors but cancer patients are not so lucky.

Apart from the fact that the very diagnosis of this disease spells worries for a cancer patient’s family, what hits even harder is the exorbitant amount of money charged by the pharma companies for the drugs that are crucial for a cancer patient’s survival at an advanced stage. Till recently the fact that Indian pharmaceutical companies reverse engineered many of the drugs and made them available at comparatively cheaper prices made them some what accessible.

This climate is slowly changing. The newer and more effective drugs which a patient would reach for tom try and prolong life or alleviate symptoms are also the most expensive and the changing patent laws in India more or less make them inaccessible. To cite an example , the multi national Novartis had filed a case in the Madras High Court, challenging the clause of the Indian Patent (Amendment) Act, which does not grant patents to medicines that are new forms of an existing drug or are “ever-greened” rather than being innovations. The patents office in Chennai refused to give patents to Novartis’ leukemia drug Gleevec on the grounds that it was “ever greened”, in February 2006.

Till the litigation in the Chennai patent office, many well known Indian forms were manufacturing the generic product end selling it for a fraction of the multi national's own product. However with Gleevec now having gone into litigation and the patent laws changing their color in conformity with trade laws , many firms have quietly stopped producing the drug. They do not want to invest in a contentious product without the law having been settled. This means that leukemia patients , who could have befitted from the generic versions of Gleevec, now have to purchase the hugely expensive product from Novartis or go without it..... or take the potentially explosive route of purchasing he drug by selling off home and hearth and eventually becoming bankrupt- a scenario by no means uncommon in India and in situations far less prohibitive than cancer.

Even the modified and much harsher patent laws of today which protect the interests of the producer than the consumer provide for the government to suspend the laws of patent and produce drugs generically if in the instance of a public health emergency. But in spite of the fact that cancer is one of the three top causes of death in the country , the government has so far looked the other way and not acknowledged it to be so. Although HIV and AIDS has received the attention it deserves and more there are other pressing public health needs which have not received their due attention. And mean while cancer patients and their families suffer a thousand miseries in their life time facing the burden of expenses and disease that they do.

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