Better screening, better health

My vision for Hemogenomics is to further strengthen the words mentioned in our logo – Better Screening. Better Health.

Years back, a hepatitis infection my brother got from blood transfusion triggered what is today the leading provider of advanced (NAT) blood screening across India and preventing thousands of HIV and hepatitis infections.

Covid has made us aware of the lack of testing, diagnosis, proper triage, and treatment infrastructure, especially in semi-urban and rural areas. We need better strategies to deal with the healthcare problems faced by India, whether urgent like the current pandemic, or the prevalent risks of mortality due to non-communicable diseases.

Recent cancer cases and mortalities in family and friends has made one realise the huge gap in early cancer detection in India. It is sad to see people coming to hospitals with stage 3–4 stage of cancer, where treatment options are limited. They travel long distances to find a hospital with the required facilities and experienced clinicians. Whether it is AIDS or cancer, the effect is not only on the patient but the entire family. The time, cost, and trauma, can devastate whole families, and many just give up on their loved ones.

I remember a discussion with a prominent surgeon who talked about the skills of Indian surgeons because of the size of the tumors they had to excise. It’s ironic, that the reason for these large tumors is that we don’t detect cancers early. Many Indian radiologists also feel that they don’t require very sophisticated 3D mammography machines because patients come to the doctors when lesions have become large enough to be detected by simpler equipment.

Hemogenomics has decided to broaden its scope of screening to include cancer, especially the non-imaging based platforms We plan to screen for cervical, oral, and colo-rectal cancers in the next few years. For a country with 140 crore people, it’s a huge task. A lot needs to be done. Basic healthcare testing, or at least collection of samples and vital parameters, needs to be done locally, as much at the village and then district levels. One must reduce the pressure on the tertiary hospitals.

Government has to encourage and facilitate large screening programs. It needs to create an effective national program and provide guidelines and funding, it also needs to run awareness campaigns on cancer screening, especially in rural India at the village level (examples in the past include use of condoms and AIDS, vaccination including polio); in schools and colleges (to reach the youth and encourage them to educate their parents and others). Physical infrastructure and programs are useless without trained manpower. It is important to undertake skilling of healthcare workers. Apart from doctors – paramedics, nurses, ANMs (Auxiliary Nurses and Midwives), and laboratory technologists.

While the Government has made a lot of progress funding PHCs, strengthening District Hospitals and Regional Cancer Centres, setting up AIIMS and other tertiary care centres, there is a severe shortage of manpower and effectiveness testing and screening programs. The federal system in India also creates huge disparities, because most programs, even if partly funded by the centre, are under the purview the state.

While Hemogenomics will increase urban screening, it will broaden the reach of screening to the people who have the least access to healthcare. We plan to do this with a combination of strategies. The basic requirements will be of identifying appropriate systems and technologies, helping create trained manpower and the buy-in of the government and others.

Without getting into the specifics, the broad areas we are working on are:

• Look at global learnings, both from the developed and less developed countries;
• Create a group of experts from the clinical, public health and health economic domains to provide the basic framework;
• Identify gaps in India and look for solutions relevant to our needs, especially for rural India;
• Use technology. Time-tested global products need to be combined with Indian startups to find the best fit. These could include AI, scanners, digital testing etc.; and
• Do pilots and studies to validate the program.

We plan to make a difference in the lives of our fellow Indians by reducing the burden due to cancer, on their lives, those of their families, and the healthcare system, before it is too late. Unlike most other companies which focus on product sales and the bottom line, we would like to focus on number of people screened, cases detected, and interventions facilitated. We are a for profit company but with the heart of a not for profit. In this task, we will partner with global corporations, Indian start-ups and incubators, experts, global and Indian donors, and the State and Central Government.