Opening the prestigious journal The Lancet, I was struck by the editorial “Eliminating cervical cancer”. It’s a cancer that is most preventable and yet is woefully prevalent in India. According to recent statistics (WHO Globocan), among the 5,00,000 patients with cervical cancer diagnosed globally each year, most are in developing nations. India is among the countries with high incidence and prevalence.
Almost 97,000 women are diagnosed with this crippling cancer annually in India (20% of global incidence). More alarming, 88% of deaths from cervical cancer are from Sub-Saharan Africa and South Asia. Among the 97,000 diagnosed, 60,000 die — this is way too high, to have two of three women diagnosed die. The prevalence (those living with cancer) is about 2,25,000 and the quality of life of these women is poor. This is a double burden of death from cervical cancer and significant disability in those living with this disease.
Cervical cancer screening and prevention using PAP smear and HPV vaccination are highly effective. The WHO envisions 70% of women between the ages of 35 and 45 to be screened; 90% of girls fully vaccinated by age 15; and 90% of patients with disease to receive evidence-based care. There shall be no choice for the Indian healthcare system but to take up this cause for eliminating cervical cancer. We should meet and exceed WHO targets.
Zero harm treatment
Now, the next target is zero harm in healthcare delivery. Unsafe care in hospitals is a global concern. Deaths from preventable harm are among the top 10 causes of mortality. In keeping with the adage Primum non nocere (First do no harm), we must make our health systems safer. Are our hospitals safe? Not safe enough! The Union and the State governments and the medical profession should ensure healthcare safety — both for patients and the workforce. Zero harm in healthcare implies achieving absolute patient and workforce safety by eliminating preventable harm… in many dimensions: diagnostic safety, medication safety, surgical safety, healthcare-associated infection mitigation, and safe and effective communication culture, to name a few.
The author is President of the All India Institute of Medical Sciences, Mangalagiri.
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