Approximately 1.1 million new cancer cases are detected every year in India. Of the total number of 0.7 million deaths due to cancer, the 30-59 age group accounts for 71 per cent which has a significant impact on the GDP due to direct loss of productivity. There are two major problems faced by patients in India, with regards to cancer, i.e. access to expertise in cancer care and cost-effective care. Tata Trusts are a major enabler for a range of innovations to be tried out for various issues affecting Cancer Care in India, across the spectrum from prevention to cure and further to palliative care. Our work ranges from infrastructure development, setting up large institutions to enabling clinical and technological research. The Trusts are working to introduce genome based technological innovations, precision oncology and clinical expert systems to assist current care delivery systems. The overarching aim is to reach out and impact a large percentage of the affected population, by making investments aimed at catalyzing change in the ecosystem to create affordable access to the right kind of care.
The Tata Trusts have been the first movers in cancer care in India, establishing a world class, super-specialty institute, Tata Memorial Hospital (TMH), Mumbai in 1941, established with a mission to serve those in need. The Tata Memorial Hospital later came under the umbrella of the Tata Memorial Centre (TMC), after the Cancer Research Institute (CRI) merged with TMH. Apart from state-of-the-art medical care, this Center of Excellence is known for its commitment to education, research and playing a pioneering role in guiding national policy for cancer care. In consideration of the high prevalence of cancer and lack of facilities in the east and the north eastern parts of India, in the year 2012, the Trusts subsequently set up the Tata Medical Center, Kolkata, a 167-bedded hospital focused on cancer-care, treatment and research.
The Trusts are working to leverage public and private partnerships to establish satellite-centers in order to reach out to a larger population such as with other not-for-profit organizations/corporate foundations/state governments - Tirupathi Devasthanam, General Electric, and governments of Madhya Pradesh, Tripura, Assam, UP, Maharashtra among them, to establish well equipped facilities which will serve cancer patients at affordable costs. The Trusts are in the process of roping in young clinician entrepreneurs to set up day care oncology centers as social enterprises in tier 3 and tier 4 towns.
The Tata Trusts have been extending support to augment radiology equipment at the Homi Bhabha Cancer Hospital – Sangrur, Punjab. Technology Interventions and Process-reengineering are also being taken up at various levels in the public health systems to improve access and service delivery.
Cancer screening and awareness campaigns have been deployed through various Trust partners across geographies and have demonstrated early detection as a strong tool to combat cancer in the community. This is likely to have the added benefit of sensitizing and educating the general public about preventive measures for cancer and dispelling myths that are associated with a diagnosis of cancer.
Tata Trusts, through the hospitals and other NGO partners, is addressing the need to expand these programs to cover more geographies in an effort to have a more profound impact on cancer outcomes in the future. Screening programs for breast, oral and colo-rectal cancers, conducted by the Tata cancer hospitals and supported by the Trusts from time-to-time have been globally recognized.
As a next step, the Tata Trusts are also implementing a pilot community-based health insurance program in Vijaywada, Andhra Pradesh. The learnings from this pilot will eventually be used to scale the program to cover more individuals and communities.
Palliative care is often equated with end-of-life care and the Trusts through its partners are creating infrastructure to back its awareness campaigns to ensure better acceptability of such centers in India. Tata Memorial Hospital is now testing the replicability of ‘Respite & Rehabilitation’ care model, which is a step down from the hospices model. Tata Trusts have spent considerable efforts in conceiving and developing a comprehensive strategy on Palliative Care in the country with partner organizations.
Considering the shortage of specialized manpower to address the huge need of Palliative care in the country, efforts have been made to develop specialized human resources through training of health care personnel by partner organizations like Pain & Palliative Care Society, Pallium India, Tata Memorial Hospital, Karunashraya Trust, Sir Aurobindo Society etc.
Various studies are being carried out through partner organizations like Bharatiya Sanskriti Darshan Trust (BSDT) for testing Effectiveness of Ayurvedic medicines in reducing adverse effects of chemotherapy & radiotherapy, improving disease free survival and quality of life in cancer patients.
Voluntary Stem Cell Donation across Maharashtra:in collaboration with the Government of Maharashtra
Individual Medical Grants : Poor patients who cannot afford treatment are supported by the Trusts’ medical relief programme
Formed in August 2012 and funded by the Government of India through the Department of Atomic Energy, the National Cancer Grid (NCG) convened by Tata Memorial Centre, will connect Oncology care providers across the country and redefine cancer care the way we know it today. It started out with 14 cancer centres across India, which have steadily grown to 93, covering the length and breadth of India. The primary mandate of the NCG is to link cancer centres across India, establishing uniform standards of patient care for prevention, diagnosis and treatment of cancer, providing specialized training and education in oncology and facilitating collaborative basic, translational and clinical research in cancer. The NCG is working closely with the Tata Trusts on the following initiatives:
A Virtual Tumor Board is being set up - it will consist of teams of specialists in Oncology, across geographies and using state of the art broadband technology, and will enable doctors to meet and share their ideas virtually on specific treatment plans. The Virtual Tumor Board will be launched using the ECHO (Extension for Community Health Outcome) platform, with the NCG member centers as participants. Project ECHO trains care providers to provide special care needs virtually and patients get excellent care at their own place and at reduced costs.
The Digital Nerve Centre is a platform that deploys software applications to provide “Virtual Enablement Services” connecting the seekers of cancer care to the right health care provider, at the right time. Tata Trusts intends to deploy and operate the Digital Nerve Centre for the NCG hospitals, thereby improve accessibility and enhance usability.
As part of its Platinum Jubilee celebrations, the Tata Memorial Hospital conducted a 4-day live surgical workshop from November 24-27, 2016 at the Tata Memorial Hospital, Mumbai. The Tata Trusts facilitated participation of surgeons from North East India thereby increasing their exposure to high quality cancer surgery.
The International Collaboration for Research methods Development in Oncology (CReDO) workshop is an intensive cancer research protocol development workshop modelled on similar workshops held in the United States, Europe and Australia. The objective of this workshop is to train researchers in oncology in various aspects of clinical trial design and help them to develop a research idea into structured protocols that will be “adopted” and shortlisted for funding as NCG trials. The next CReDO workshop is scheduled to be held from February 5 – 10, 2017 Mumbai and has been supported extensively by the Tata Trusts.
The Tata Trusts are funding the Travelling School of Pathology, which is a series of surgical pathology workshops aimed at bringing education and training in standard pathology grossing and reporting to North East India. The team consisting of pathologists, surgeons and other specialists visit several cities and provide high quality training to pathologists and surgeons in cancer centres in remote areas, beginning with the North East.
Summer school in Oncology is a two-week introduction to the fundamentals of oncology to undergraduate and postgraduate medical students. This is a collaborative initiative between King's College London and Tata Memorial Centre, which is funded by the Tata Trusts. Several students across India have participated in this initiative and benefitted from an all-round exposure to oncology. Five of the best students were also funded for a month-long introduction to oncology at the King’s College London.
Partnerships for Future Cancer Care: Tata Trusts is evaluating associating with various research organizations across the world that work on cutting edge Technologies in Cancer Care. These will be technologies that empower physicians, patients, payers and researchers to transcend genomics, proteomics and transcriptomics and provide precision medicine for patients, immunotherapeutic treatment using Chimeric Antigen Receptor (CAR) T cells for hematolymphoid cancers, etc. Tata Memorial Hospital, Mumbai, will pilot these IT platforms/ new technologies beginning 2017, in order to enable data-driven decision making, and enhanced patient outcomes at reduced costs. The long term intention is to implement these solutions across multiple centres in India in a phased manner.