RGCIRC's Evolution Under D.S. Negi: A Quiet Revolution in Cancer Care and Accessibility
By Arunima Rajan
In an interview with Arunima Rajan, D.S. Negi, CEO of Rajiv Gandhi Cancer Institute and Research Centre (RGCIRC), discusses his evolving vision for patient-centric cancer care, the institute's strides in innovation, and the pressing need for preventive strategies in India.
When you became the CEO of Rajiv Gandhi Cancer Institute & Research Centre (RGCIRC) in 2007, what was the big vision you had in mind? Has that vision evolved over the years, considering the changes in healthcare and cancer care?
I took on the role in 2007 after a long career in public service, including my last position as the Principal Secretary of Health in Delhi. This experience has given me a strong understanding of the healthcare sector, especially the primary healthcare system and the gaps and weaknesses in the private sector.
Joining a hospital was an intriguing shift, and over the years, my vision has indeed evolved. In government, the focus is often macro-level policymaking, but I needed to take a micro-level approach in a hospital. I had to understand the intricacies of processes, protocols, standard operating procedures, and the dynamics of human relationships—how doctors and nurses coordinate and integrate their efforts. It was a fascinating study of human interaction and technological advancements in diagnostics and therapies, particularly cancer care.
Having joined the hospital about a decade after its inception, I recognised the complexities of cancer treatment, which not only involves high costs but also emotional and financial stress for patients. Our mission is not just to diagnose and treat but to alleviate the fear surrounding cancer. Over the years, my vision has indeed evolved. I focused on improving patient care and enhancing the processes, protocols, and relationships.
Additionally, our approach has had to adapt to rapid cancer treatment and technology advancements. While we began focusing on fundamental patient care, we have also embraced innovative treatments and integrated research into our practice. This dual focus has become essential in navigating the complexities of cancer care today.
How do you prioritise patient care at RGCIRC, especially considering the emotional and financial challenges that cancer patients and their families face?
D.S. Negi, CEO, Rajiv Gandhi Cancer Institute and Research Centre
Our relationship with patients is not transactional but built on deeper values. Everyone here receives equal treatment, regardless of whether they are Indian or foreign. Our motto is that
no one should leave RGCIRC without receiving care or have to stop treatment due to financial constraints. To support this, we have implemented various philanthropic initiatives. For example, we provide free beds for patients who cannot afford treatment and offer significant discounts on medications and consumables. Annually, we allocate a substantial budget to patient welfare, ensuring that financial barriers do not prevent access to necessary care. We are investing nearly Rs 50 crore in our patient welfare scheme, which includes free bed services and case-by-case discounts. Our program offers free bed services, personalised discounts, and reduced prices on medications and supplies. Patients can receive discounts of up to 20% on medications and up to 50% on other healthcare products.
Many NGOs and corporates support our patient assistance programs. We also receive significant support from the Prime Minister's Relief Fund, ensuring everything spent goes directly to patient care, with any excess funds returned. Together, these resources maximise the benefits for our patients. Over the years, we have cultivated a unique ecosystem where patients feel valued and understood. The focus is on building relationships and reassuring patients that they are in a place that cares for them holistically.
Over the years, we have made various improvements, and visitors to our facility can see the quality of patient care we provide. In 2024, Newsweek International, one of the leading American magazines, ranked RGCIRC as one of the Best Specialised Hospitals in the Asia Pacific and one of the World's Best Specialized Hospitals for 2025.
What is the institute's most significant success in terms of advancements in cancer care?
Our institute has been at the forefront of adopting state-of-the-art technology to keep up with global advancements. We have introduced cutting-edge technologies like High-Intensity Focused Ultrasound (HIFU), robotic surgery, cyber knife, 3D printing technology, ND-YAG lasers, etc. We are working towards developing indigenous Car T cell therapy soon, and through these advancements, we continue to provide world-class oncology care. We have invested in new robotic technologies, including the SS Mantra, which has improved our surgical capabilities. In July 2024, RGCIRC reached a landmark achievement with the successful completion of a clinical trial on telesurgery using the SSI Mantra Surgical Robotic System. Dr Sudhir Kumar Rawal, MD, RGCIRC, has played a crucial role in helping to develop the SSI Mantra robotic system, providing essential clinical feedback to refine the technology. This successful trial builds on RGCIRC's pioneering efforts, which began with India's first-ever telesurgery in cancer care. The initial telesurgery, performed in collaboration with SS Innovations, marked a significant step in breaking geographical barriers in healthcare delivery. This collaboration aligns with the mission of 'decentralising excellence' and positioning India at the forefront of global surgical innovation. This success exemplifies the 'Make in India' initiative, establishing its practical applications in real-world settings.
Cancer prevention is challenging, especially in India, where many forgo screenings. Have you implemented any prevention or screening initiatives?
My public service experience has significantly shaped my approach at RGCIRC. One key lesson I have learned is the importance of preventive healthcare. For example, the government invests heavily in measures like promoting proper hand hygiene, which can eliminate up to 80% of minor health issues. Unfortunately, these strategies often go unnoticed, leading many patients to suffer from preventable diseases. This oversight contributes to overcrowding in clinics and primary healthcare centres, which frequently lack the necessary resources to manage these conditions. As a result, patients are pushed to seek care at secondary hospitals, which should primarily serve as referral centres. This misalignment calls for urgent policy reform.
At RGCIRC, I have prioritised prevention as a critical strategy to reduce disease incidence. Since launching our prevention initiatives in 2009, we have screened over 300,000 individuals and saved approximately 1,800 lives. This focus on prevention provides immense satisfaction and aligns with our mission to deliver comprehensive care.
We have been focusing on two types of prevention: population-based scientific screenings and occasional screenings in institutions and residential areas. Over the past decade, we have conducted systematic, free screenings in underserved areas, targeting populations of about 10 lakh. RGCIRC has conducted more than 25,000 screenings in the last one year. Our teams, supported by NGOs, identify individuals for screening needs, particularly for breast, cervical, and oral cancers.
How do you plan to scale these efforts, and what challenges do you foresee in expanding this program?
To scale up our efforts, we aim to significantly increase screening activities and concentrate our focus on high-risk areas, particularly those heavily impacted by tobacco use. This targeted approach will complement and optimise our follow-up activities to ensure patients receive continuous care and support. Additionally, we will actively promote awareness and dissemination of HPV vaccines among the target population, recognising the critical role these vaccines play in cancer prevention.
However, we foresee several challenges in expanding this program. One of the primary obstacles is the need for an increased workforce within our department to handle the growing demand for services. Furthermore, achieving better integration among various departments will enhance overall effectiveness and streamline patient care. We also need to tackle issues related to patient compliance, which can be significantly affected by socioeconomic factors such as poverty, the social stigma surrounding specific health issues, and a general lack of awareness or ignorance about the importance of screenings and vaccinations. Addressing these challenges will be crucial for the success of our expanded efforts.
Given your extensive experience in healthcare policy, what immediate changes do you think are necessary for cancer care in India?
One critical area for change is enhancing the primary healthcare system, which is the backbone of our healthcare delivery. There's a significant gap in preventive care, and we need to focus on equipping primary care facilities with better resources and training to address preventable diseases, including cancers. Moreover, increasing awareness and access to screening programs is essential. Policy initiatives should support establishing more robust referral systems to ensure patients receive timely care without overwhelming tertiary hospitals. Addressing these foundational issues can improve cancer outcomes and overall public health in India.