February 4 is observed as world cancer day to generate awareness and creating solutions for alleviating the pain of patients suffering from the dreaded disease. It is also a day to press upon policy-makers to make cancer treatment a priority. Cancer is the second leading cause of death in India as over 10,00,000 new cases are diagnosed and around 7,00,000 succumb to it every year. More than 60% of the cases are diagnosed at an advanced stage and most of them suffer from tremendous pain. Rough estimates suggest that nearly 1.5 to 2 million cancer patients die of excruciating pain every year because they do not have access to oral morphine – an inexpensive, safe and highly effective pain medication. Most corporate hospitals, even in cities, do not have access to oral morphine. And that’s primarily because procuring this medicine is an ordeal. A couple of years ago, around 300 kg of morphine was consumed in India for cancer pain relief, even as the actual annual requirement stood at 36,000 kg. There was a breakthrough at the beginning of 2014 when an Amendment to the Narcotic Drugs and Psychotropic Substances (NDPS) Act was passed by Parliament.
The amendment enabled medical institutes to procure morphine by obtaining a single license from the State Drugs Controller rather than five. And while in theory, this should have made access to morphine easier, it hasn’t been the case. The absence of a palliative care department in most cancer hospitals in India (Kerala being an exception) is also a grave concern. Hospitals involved in delivering cancer care do not give much importance to training and establishing palliative care departments because it is not considered profitable. Lack of awareness among healthcare workers, policy-makers, patients and their relatives are important reasons contributing to poor pain control among cancer patients.
Currently, there are three main obstacles limiting the scope for improving pain management and palliative cancer care in India – insufficient training of doctors, poor integration of palliative cancer care into health services and poor implementation of the amended NDPS Act passed in 2014.Turns out, most doctors in India do not know how to assess or treat severe pain because the government has not included such instructions in the medical curriculum. Further, as the national cancer control programme does not contain meaningful palliative care components, it has been relegated to second-tier status and does not receive adequate public funding. So is there any scope for light at the end of the tunnel. But for that, palliative cancer care has to be urgently introduced throughout India at tertiary, secondary and primary healthcare facilities and the integration of such care in all established cancer centers (both in private and government) has to be made mandatory . Medical students have to be formally taught about cancer pain relief and palliative care, and monitored thereafter so as to ensure that their knowledge translates into clinical practice. Involving the pharma industry , associated with manufacturing of chemotherapy drugs, is also a good idea.
Not-for-profit palliative care services can be developed in hospitals – that have links with the pharma industry – through a partnership between the two. Through a Corporate Social Re sponsibili ty (CSR) initiative, hospitals can provide space for such care centres within their premises while the pharma indus try can take care of the day-to day running costs. Training of man power must be the responsibility of the hospital. This is perhaps one solution that can help make a beginning in the development of an essential cancer care service – something that the country desperately needs at the moment. The `good of the patient’ must be the first priority of the doctor, hospital and the pharma industry involved in cancer care. One may not be able to cure cancer, but it is critical to keep a patient pain free.
PHARMA HUB IN INDIA
Lucknow: Globally, India ranks 3rd in terms of volume and 14th in terms of value. According to pharmaceutical department , Ministry of chemicals and fertilizers. The total pharmaceutical industry between 2008 and sep 2009 us $21.04 Billion .Hyderabad, Mumbai, Bangalore, and Ahmedabad are the major pharmaceuticals hubs of India.While domestic market is worth us$13.8 Billion as of 2013 and expected to reach us$49 Billion by 2020.
The Indian Pharma Industry consists of more than 20,000 Registered Companies which has highly fragmented, In facts how many unregistered companies are operating in 120 crores populated Country. The Indian pharma industry has around 70%of the country’s demand bulk drug and intermediates. pharmaceuticals formulation, chemicals tablets, capsules, oral and injectables, ointments 250 Large units and about 8000 small scale units from the core of pharmaceuticals industry in india. The units produced have the complete range of medicines which are ready for consumption of patients.
Over past 40yrs Indian pharma industry has shown rapid growth and transformation from the mere volume Rs10crores the industry registered sales turnover of about US$5.5 Billion in 2004 annual growth rate was 17%.The flexible policy of Indian patents act of1970 and other supportive policies of Govt. of India played an instrumental role in the growth and development of this industry. Given the importance of public policies in influencing the present structure of the industry.
The evolution of the Indian drug and pharmaceutical industry. This history of Indian pharmaceutical industry has divided into four principal epochs. The first epochs from 1850- 1945. The second epochs 1945 to late 1970. The third epochs for development isfrom the early 1980 to early1990, and the fourth epochs spans early1990 to present time. It was concerned about the lack of domestic manufacturing facilities and unequal pattern of trade, few scientists like Prof Acharya prafulla Chandra Roy T. k Gajjar and A.S kotibhaskar laid the foundation of Bengal chemical and pharmaceutical works in Kolkata 1892 and the Alembic chemicals works by in 1907 in Baroda.
The establishment of Bengal Immunity in 1919 by a group of notable scientists and physicians namely DR NILRATAN SARKAR, KAILASH CHANDRA BOSE, AND BIDHAN CHANDRA ROY was yet another landmark in the history of evolution of the Indian pharmaceutical industry. The company was established with the sole objective of the attaining self suffiency of the production synthetic medicine and of sera and vaccines.