Surrogacy bill

who want to have children but owing to various reasons cannot,” Yadav said.

He said it is for this reason that they have recommended that single men and same-sex partners should be kept out of the proposed law’s ambit. “Surrogacy rules cannot be on par with rules of adoption. Even in the case of adoption, a single man is not allowed to adopt a girl child. There is a restriction in adoption rules as well.”

Noting that restricting the surrogate mother to be a ‘close relative’ potentially limits the availability of surrogate mothers, affecting the genuinely needy persons, the panel has recommended removal of this requirement from the Bill.

The Committee recommended that “a willing woman shall act as surrogate mother and be permitted to undergo surrogacy procedures as per the provisions of this Act.” It also suggested increasing the insurance cover for the surrogate mother from proposed 16 months to 36 months.

The Surrogacy (Regulation) Bill, 2019 is yet to be passed by the Rajya Sabha. The committee held 10 meetings since the Bill was referred to it by the Rajya Sabha on November 21, 2019.

Regarding the eligibility criteria for availing surrogacy procedure, the committee recommended removing the provision of requirement of five years as the period of inability to conceive before opting for the procedure.

It noted that there may be certain proven medical conditions such as absence of uterus by birth, non-functional uterus and removal of uterus due to cancer, or cases where normal pregnancy is ruled out and it is medically proven beyond any doubt that surrogacy is the only option.

The panel further observed that the requirement of obtaining certificate of proven infertility is not at all justified in such cases. With the proposed deletion of the definition of ‘infertility’, needy persons can avail surrogacy any time on the basis of a certificate of medical indication requiring gestational surrogacy, it said.

“There are conditions under which a single person genuinely needs to avail surrogacy option to have [a] child. One such situation is a young aged widow, who is otherwise capable but cannot carry child because of fear of social stigma attached to pregnancy of widow in our society,” the panel noted.

The committee recommended that a child born through surrogacy should have all the legal rights of a biological heir and that people of Indian origin, who opt for it in India, will need to follow the laws of their respective countries.

Yadav said the panel concluded following extensive feedback exercise that while any “willing woman” can be allowed to have a child through surrogacy and instead of limiting it to close relatives, there was agreement that it cannot be done on a commercial scale.

Strongly backing the provision of the Bill allowing only altruistic surrogacy and not commercial, the panel opined that “the sublime and divine instinct of motherhood could not be al l owed t o be t urned i nt o mechanical paid service of procreation devoid of divine warmth and affection”.

The select committee has recommended that the Assisted Reproductive Technologies (Regulation) Bill, which is awaiting the Cabinet’s approval, may be taken up before the Surrogacy (Regulation) Bill. It has said it should be done since the ART Bill primarily deals with technical, scientific and medical aspects of surrogacy. cal cancer rates have fallen because of improved hygiene in most parts of in India, according to the report.

The WHO classifies India’s national cancer registry programme among the world’s “high quality population-based registries”, which is the international gold standard for cancer estimates.

There is massive heterogeneity in cancer incidence across states, said the report, a feature reflected in NCRP data. “Incidence rates are the highest in Mizoram, where one in five men and women are at risk of developing cancer during their lifetimes, while in Barshi, Maharashtra, only one in 22 men and 1 in 18 women are at a lifetime risk,” said Dr Mathur.

The WHO-ICAR report puts the number of cancer cases reported in India in 2018 at 1.16 million and deaths in the country at 784,800 in the same time period. “NCRP doesn’t publish mortality (death) estimates as the medical certification of death in India is poor, which makes the data incomplete,” said Dr Mathur.

But according to the ICMR-LED India State-level Disease Burden Initiative study on cancer published in The Lancet Oncology in 2018, cancer deaths have more than doubled in India over the past 26 years, going up from 382,000 in 1990 to 813,000 in 2016, and accounted for 8.3% of total deaths in 2016.

CANCER IN THE WORLD Globally, 18.1 million people in 2018 were living with cancer, which killed 9.6 million in a single year, said the WHO report. By 2040, those figures will nearly double, with the greatest increase in low and middle income countries, where more than twothirds of the world’s cancers will occur.

Cancer causes about 30% of all premature deaths from non-communicable diseases in people in the age group 30-69. The WHO warned that global cancer rates could rise by 60% over the next 20 years unless cancer diagnosis and management is ramped up in low and middle-income countries. Tobacco is the biggest risk factor for cancer, with about 80% of the world’s smokers in low and middle-income countries. In addition, 64% of the world’s daily smokers live in 10 countries, and half of the world’s male smokers live in just three countries, China, India, and Indonesia. There are 164 million users of smokeless tobacco, 69 million smokers, and 42 million smokers and chewers in India, said the report.

COST OF CANCER

Cancer treatments are expensive, and usually include a combination of chemo-, endocrine and targeted therapies; surgery; radiotherapy; nuclear medicine; bone-marrow transplantation; and cancer cell therapy. “The cost of targeted treatment on the WHO EML (essential medicines list) for early-stage Her2-positive breast cancer, for example, would be about 10 years of average annual wages in India and South Africa, and 1.7 years in the USA,” according to the report.

People over the age of 30 years are examined physically for signs of oral and breast cancers, and visual exam with acetic acid for cervical cancer at the community level under India’s National Programme for Prevention and Control of Cancer, Diabetes, Cardiovascular Disease and Stroke.

In India, more than 90% of patients with oral cancer belong to the lower-middle socioeconomic status, according to the ICAR report.

Breast cancer and colorectal cancer, on the other hand, were associated with urbanisation and more common in more developed states.