Our cancer research in India.

We want children in India to have exactly what any child who is faced with cancer anywhere in the developed countries has Why should they not? Most parents have decided to have only one child because they feel the inputs they need to give to make sure that this child reaches his or her full potential, is so great and when that child gets sick and you don’t have that much resources it’s a double whammy and the family is absolutely devasted. When a doctor says your child has cancer it only means my child is dying because nobody understands after that chemotherapy, radiation, surgery, this is what you need to do this test, that test. I was 14 when I came to know I was affected with leukaemia when my doctors told me that you have leukaemia I was like, I don’t want to go to treatment I just want to go home and have lots of food for the last time before I die and they were like, see listen to us carefully you undergo the treatment and we assure you you’ll live you’ll not die because leukaemia is one of the most curable cancers in the world. ALL is one of the most common cancers about 45% of all childhood cancer is acute lymphoblastic leukaemia and in a country like ours, that’s a large number of new cases of childhood cancer, relative to the rest of the world. We are currently researching appropriate therapy for a child with leukaemia in India this is the Icicle trial, and Professor Vaskar Saha is leading that trial Dr Vaskar Saha came back from the UK to India to take up this challenge to actually look at developing a standard of care protocol. So when the opportunity came I had two options one was to move to India and leave Manchester The University of Manchester or continue as I am doing now where I work both at The University of Manchester and at the Tata Medical Centre in Kolkata I was encouraged to do the latter by my seniors at the University and they said you are going to need support and you’re also going to need a lot of interactions and The University of Manchester can support you in this. So I went with the experience, 25 years of experience as a paediatric oncologist but I had now learnt how to set up a laboratory how to set up a research institute and all that has actually been that six years of working in The University of Manchester before I went to India. The aim of this programme is to ask people who are internationally known to bring back their skills and their laboratory to India so that people from India can benefit. The University has a large team of people working on very similar problems and the challenge was then to say ok we’ve got this knowledge, we’ve acquired this knowledge can we apply it somewhere else, and that was the challenge of India. With the training I have received in the United Kingdom the experience of The University of Manchester in running such programmes it kind of looked to me that I was the guy who should take this challenge up and if I didn’t take it up, who was going to take it up? The Margdarshi Fellowship is our highest fellowship and Vaskar was our first Margdarshi Fellow. Our overall vision is to really support the best people who do biomedical research in India but it’s not just giving them funds to do research it’s also to develop the next generation of science leaders in the country. So when the child comes here with his parents and looks at our hospital it’s actually quite daunting for a new person coming from a village to even see this structure and say ‘my god what am I going to do here?’ So let’s take that family right, the family has shown up from some remote village they want to know that their kid is going to come out surviving and to know that worldwide the standard is 80-95% It’s almost unethical to say why should we be exposing them to treatment which is maybe still at 40 or 50% and yet there are challenges of countries like ours why have we not been able to get there? So one of things that people say is that it’s the cost of treatment therapy is expensive, cancer is expensive and families can’t afford them. That is actually not true and that is what I found out here. Most hospitals will subsidise therapy for poor patients there are a number of govermental organisations and non-govermental organisations that actually make therapy quite affordable but what it doesn’t take care of is the fact that patients in India and I guess worldwide will travel to where they think is the best place for care for their family and their children. Many of these families actually come from remote places from small places, from villages. They have come to the cities to get their child treated and sometimes they’re spending 3 years at a place far away from home. I have the worlds most wonderful job because what I do I take the families most precious possession I restore this child back to the bosom of their family in perfect health but I return that family back to poverty for a whole generation and that’s really a challenge we’ve got. If you talk to the parents they will say that they’ve had to sell assets, they’ve had to borrow money and usually it’s from the local community and we have this sort of tongue in cheek saying that it takes a whole village to treat 1 child with leukemia because that’s the kind of support. What we’re trying to do here is to make the therapy much more systematic, make it uniform and decrease this entire cost and burden and this lottery of treatment. He has capitalised change for leukaemia so even those who are not following the same protocol are moving up the game for better standards for better treatment, for better care. But the fact of the matter is that we have maybe 80,000 new cases of childhood cancer in the country so we can’t have 80,000 children going to the few centres that can offer the best standard of care. So what we need is protocols and standards where even the smallest centres can benefit and that is what is happening with the Icicle study and the Icicle protocol because many other smaller centres are picking it up. We talk about the living bridge between India and Britian the flow of people, ideas, technologies and certainly this example of The University of Manchester working with the Tata Medical Centre is one of the best examples I know of and so for example If you have illnesses emerging in this part of the world you can bring the technology of the world to the doorstep here to treat it. Science is global, health is global problems are global and solutions to problems in India may come from Manchester or solutions to problems in Manchester may come from India so therefore I think it’s very important for people to collaborate across boundaries across international borders. It’s about equity and it’s about making an impact and I think in some small way the work in India reflects them and the distillation of everything I’ve learnt in Manchester so this is my own wisdom this collective wisdom and collective effort I just happen to front it and we have benefited many thousands of children. What is the purpose of learning? Well the purpose of learning is to benefit other people and to pass it on. Universities like internationally ranked university like The University of Manchester owe it to society, we’re funded by society we have to turn it back to society and this is a larger global society. We are no longer a small island we are part of a large world and we owe it to the world to say that we have done this and we can benefit everybody in this world.

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