Killer disease gathering extra pace

Cancer is considered the sixth killer disease in Bangladesh with about 150,000 annual casualties. To the total number of cancer patients estimated at 1.3-1.5 million, 0.2 million new patients are added every year. Now what is most alarming is the fact that 66 per cent of all cancer patients here are in the age group of 30-65 years, considered the main workforce of a country. An international body on cancer research has estimated cancer-related death rate at 7.5 per cent in 2005 which is predicted to rise to 13 per cent in 2030.
Even at the current rate of death from cancer, the human and economic costs are enormous. In this country two-thirds of the healthcare cost is privately financed through out-of-pocket payments and in case of cancer the pattern of expenditure is no different. The increasing incidence of cancer means that the poor are also getting the disease in an increasing number. What happens to poor families when one or more of its members are diagnosed with lymphoma or leukaemia is simply beyond description. Whatever material possession the family has is disposed of for the highly costly treatment of the disease. Most likely the patients die and the families get devastated.
It is exactly at this point a review of the health policy and the use of tobacco in the country is urgently warranted. A study carried out by the World Health Organisation (WHO) brings to the fore the bizarre economy of tobacco industry by showing that the annual cost of illnesses in relation to tobacco stands at Tk 50.9 billion but the annual earning from the sector is only Tk 24.8 billion. Clearly, here is a strong case for waging a war against the tobacco sector.
Patients not suffering lung cancer may now have other types of the disease on account of arsenic-contaminated water, adulterated or carcinogenic foods. These are areas where the axiom, 'prevention rather than cure' should be applied first. At the same time, access to treatment of the disease for the poor has to be facilitated by bringing about reform to the country's health policy. This country is yet to provide the latest facilities for cancer treatment. Rising incidence of non-communicable diseases like cancer calls for establishment of such facilities. Those who can afford the treatment have to seek it abroad and the money drained out of the country is not a small amount.
Making treatment of the disease available to the poor may be possible if there is a coordinated effort to increase the number of facilities with quality treatment. If the best possible cure is available here, the rich patients will have no urgency to go abroad for treatment and the income proceeds will more than compensate for free or partly rebated treatment for poor patients.   
Various international studies have documented a strong association between income inequality and excess mortality. In a study by Kennedy et al, income inequality was shown to directly affect the total mortality in a given population [p<0.05]5. The same study measure income inequality by 'Robin Hood Index', which is the part of income that needs to be redistributed from the rich to the poor to achieve economic equality. 1.0% rise in this index led to 21.7 excess deaths per 100,000 populations. This shows the profound effect income inequality has on the health of a population.