Amid growing global uncertainty, the field of oncology continues to offer hope through groundbreaking innovations. Recent advances have demonstrated how science can significantly improve outcomes for cancer patients. For example, a multinational clinical trial showed that Daraxonasib, a new oral therapy for pancreatic cancer patients with KRAS mutations, more than doubled average survival from six months to 13 months while causing fewer side effects than conventional chemotherapy. Similarly, the immunotherapy drug Pembrolizumab, used in treating multiple cancers including breast, lung, cervical, and head and neck cancers, is now available in a quick under-the-skin injection format that can reduce treatment time from hours to minutes. Patients on this drug might now potentially walk in-and out of an OPD instead of spending precious hours hooked up to IV lines to get their therapy. But when these will be available to us in India, and at what cost – we can’t say.Oncology (AFP)While such innovations are transforming cancer care globally, access to them remains a major challenge in India. New technologies often take years to reach Indian patients, and affordability remains a significant concern. At the same time, many patients are facing shortages of essential platinum-based chemotherapy drugs such as carboplatin and cisplatin due to global supply chain disruptions.Recognising these challenges, the Indian Cancer Society (Delhi) recently convened experts from across the health care ecosystem to discuss barriers to innovation and identify practical solutions.One of the biggest obstacles is financial access. Out-of-pocket expenditure continues to account for a large proportion of healthcare spending in India. Advanced diagnostics and therapies remain beyond the reach of most patients. Although the Pradhan Mantri Jan Arogya Yojana (PMJAY) has expanded health care coverage, it currently provides limited support for many newer therapies and the sophisticated diagnostic tests required to determine patient eligibility. Private insurance has its own challenges. Reimbursement tussles between insurers patients and hospitals are common – a large contributor is the fact that in the absence of standardised treatment guidelines in India, insurers view some regimens tried by doctors as discretionary rather than evidence-based (often because they have not reconciled their rates with the latest available treatments) and a lack of up-to-date Indian data-based therapeutic protocols.This stems from the lack of robust Indian cancer data, which is the next big concern. Cancer notification is not universally mandated, resulting in incomplete registries and limited evidence for policy-making, insurance coverage, and treatment planning. In today’s age of AI – researchers globally are using data to build/train models that can help screen and diagnose cancers, find and project results for new drug / therapy mechanisms and more. The absence, therefore, of comprehensive Indian health data limits India's ability to contribute to and benefit from global innovation. India must also strengthen its research ecosystem. Greater investment in clinical trials, drug discovery, diagnostics development, research infrastructure, and scientific talent is essential. Regulatory reforms can help increase participation in global clinical trials and ensure Indian patients gain earlier access to promising therapies. Indian patients don’t always have access to the trials for the latest molecules and have to wait till they reach market elsewhere, cross regulatory requirements in-country and then finally make it to market. When time in a person’s life is limited – this wait can seem endless and futile.We know the problems and here are some suggestions on what we can do to solve them in four main points:Equity must guide access policies, with expanded insurance coverage and innovative financing mechanisms (e.g., cross subsidised treatment of low-income /public sector patients in the private sector; blended financing; pooled procurement of commodities to bring down costs, etc.) through public-private collaboration.Cancer notification should be mandated across the country, to strengthen registries, improve the quality of data and contribute to standardised treatment protocols and R&D.Investment in the Indian research ecosystem ( for clinical trials, drug discovery, and diagnostics development) must increase; this will elevate India's role in global cancer research and innovation, and allow us to contribute to, and benefit from the latest scientific developments.Prevention and early detection should remain national priorities to break the pattern of late-stage presentation; supported by awareness initiatives and AI-driven screening technologies – we must move toward predictive and preventive medicine.Innovation alone cannot transform cancer outcomes unless it is equitably accessible to all who need it. As the country with one of the highest cancer burdens in the world, and in keeping with our aspirations of Viksit Bharat 2047, we must be nimble and deliberate in expanding access to the latest scientific technology for the treatment of disease, especially in cancer. Encouraging news comes to us today with the validation by the WHO body of an indigenous HPV DNA test (for cervical cancer screening); this can now be deployed at scale to provide much needed testing in our endeavour to eliminate cervical cancer. With collective effort, collaboration, and commitment, we can ensure that the promise of innovation reaches every patient. (The views expressed are personal)This article is authored by Jyotsna Govil, chairperson, and Dr Indira Behara, advisor, Indian Cancer Society (Delhi).