Why in News ?
- Union Budget 2026–27 announces customs duty exemption on 17 cancer-related drugs, addition of 7 rare diseases to concessional import list, and training of 1.5 lakh caregivers, signalling targeted health-sector relief.
Relevance
GS-2 – Social Justice / Health
- Public health policy
- Access to medicines
- Welfare schemes
- Right to health dimension
GS-3 – Economy (Health Sector)
- Pharma industry
- Health workforce economics
- Social sector expenditure
Context & Basics
Cancer & Rare Diseases in India
- India witnesses rising cancer burden and significant rare disease treatment gaps, driven by high drug costs, import dependence, limited domestic R&D, and shortage of trained caregiving and allied health workforce.
Caregiver Role
- Caregivers provide long-term physical, emotional, and rehabilitative support, especially critical for oncology, geriatrics, and chronic diseases, reducing hospital load and improving treatment adherence and outcomes.
Budget Announcements – Key Features
Cheaper Cancer Drugs
- Full customs duty exemption on 17 cancer-related drugs and medicines lowers import costs, improving affordability for patients undergoing long-term, high-cost oncology treatment.
Rare Diseases Support
- Seven additional rare diseases included in duty-free import list for drugs, medicines, and special foods for personal use, expanding coverage under India’s evolving rare disease policy ecosystem.
Caregiver Training
- 1.5 lakh caregivers to be trained under National Skills Qualifications Framework (NSQF), integrating skills like wellness, yoga, basic medical operations, assistive devices, strengthening community-level healthcare support.
Health Expenditure Snapshot
- Health Ministry allocation ≈ ₹1.05 lakh crore for FY 2026–27, reflecting modest growth (~6–9%), with prioritisation of targeted relief over large headline expansion.
Rationale Behind the Measures
Affordability & Access
- High out-of-pocket expenditure (OOPE) in cancer care pushes families into poverty; tax exemptions directly reduce treatment costs where domestic alternatives are unavailable.
Demographic & Epidemiological Transition
- Ageing population and rising NCD prevalence increase demand for long-term care and palliative services, necessitating trained caregiver workforce beyond doctors and nurses.
Health System Efficiency
- Trained caregivers enable task shifting, reduce doctor overload, shorten hospital stays, and strengthen continuum of care from hospitals to homes.
Constitutional / Legal Dimension
- Advances Article 21 (Right to Life) through improved access to essential medicines and care, and aligns with Article 47 directing the State to improve public health and nutrition.
Governance / Administrative Dimension
- Requires coordination among MoHFW, MSDE, Customs authorities, state health departments, and standardised certification under NSQF to ensure quality, safety, and portability of caregiver skills.
Economic Dimension
- Reduced drug costs ease catastrophic health expenditure, while caregiver skilling creates health-sector employment, especially for women, supporting inclusive growth and service-sector expansion.
Social / Ethical Dimension
- Improves equity in access to life-saving drugs for cancer and rare diseases; ethical imperative to support vulnerable patients with limited treatment alternatives.
- Formal recognition of caregivers enhances dignity of care work, often undervalued and informal.
Health System / Technology Dimension
- Complements expansion of clinical trial sites, drug regulatory strengthening, and allied health professional scaling, moving toward team-based, technology-supported care models.
Data & Evidence
- Cancer treatment can cost several lakhs per year, with medicines forming a major share of OOPE; duty exemptions can meaningfully reduce end prices for imported therapies.
- India faces a shortage of allied health professionals relative to demand, particularly in geriatrics, oncology support, and home-based care.
Challenges / Gaps
- Modest overall health budget growth limits systemic expansion of public healthcare infrastructure.
- Duty exemptions help only imported drugs; absence of domestic manufacturing keeps long-term costs vulnerable to exchange-rate and supply shocks.
- Caregiver training must ensure quality control, supervision, and ethical standards to avoid unsafe task shifting.
Way Forward
- Incentivise domestic production of oncology and rare-disease drugs through R&D grants, PLI-like schemes, and faster regulatory approvals.
- Integrate trained caregivers into Ayushman Bharat–PMJAY, geriatric care, and palliative care programmes for institutional linkage and demand certainty.
- Expand public oncology infrastructure and early screening to complement drug affordability measures.
- Establish clear legal scope of practice for caregivers, ensuring patient safety and professional accountability.
Data & Facts
- Cancer cases in India projected to cross 1.5 million annually (ICMR estimates).
- OOPE still forms ~48–50% of total health expenditure in India, among highest globally.
- Rare diseases affect ~70–90 million Indians (estimated).
- India has doctor–population ratio ~1:1500 (below WHO ideal 1:1000) → need allied workforce.
- Palliative care access remains limited; only ~1–2% of those in need receive it.
