The Budget 2025 was splashed across headlines with its innumerable numbers and policies, but lurking behind the balance sheets is a threat that it has not accounted for yet — the silent, merciless clutches of cancer. The World Health Organisation (WHO) states that it remains one of humanity's most deadly enemies, responsible for one in every six fatalities. For years, cancer has been blamed on genetics and lifestyle, but a far greater threat lurks in our environment — polluted air, contaminated water and toxic soil, fueling a surge in lung, skin and gastrointestinal cancers. Each breath and sip taken brings millions closer to the disease. 

As the government shapes its fiscal path, the key question remains: Will it prioritize treatment alone or tackle the root cause through stronger environmental policies? The choice made today will determine whether India secures a healthier future or allows cancer’s relentless rise to continue. 2025 must be the year of decisive action. 

Government initiative on cancer
The Union Budget 2025-26 has provided Rs 99,858.56 crore (1.94% of the total budget) to healthcare. The allocations are Rs 37,226.92 crore for NHM, Rs 9,406 crore for Ayushman Bharat (AB PM-JAY), Rs 4,200 crore for PMABHIM, and Rs 2,445 crore for the Pharmaceutical PLI plan. Also, 200 cancer centres will be set up in district hospitals with the aim of reducing the cost of cancer treatment. For this, the government has provided full exemptions from basic customs duty on 36 life-saving drugs. 

This budget for 2025–2026 is said to be in line with the many measures that the government has put in place to fight cancer from its root cause.

1.    Daycare cancer facilities: It is the government’s plan to put in place 200 daycare cancer facilities in district hospitals by 2025–2026.
2.    Expenditure on Health: The 2025–2026 Union expenditure has earmarked Rs 99,858.56 crore for health, which is an 11 percent increase but 1.94 percent of the total expenditure. Nevertheless, there is the question of whether it will be enough for India's 1.4 billion people, given the country's current Rs 715 per capita health spending and the new health risks that come with pollution. 

India's reaction must go beyond traditional healthcare spending since pollution is becoming a major carcinogen. The rising cancer burden, which accounts for 9% of all deaths in India, highlights the need for specialized, climate-resilient cancer treatment facilities. These facilities must contain pollution protection measures, ecologically appropriate medical waste disposal, and long-term healthcare infrastructure. Without addressing the environmental causes of cancer, India faces a growing healthcare crisis in which treatment efforts are reactionary rather than preventative, and the long-term viability of healthcare is dubious. The mortality rate due to cancer is rapidly increasing (Fig. 1)


 
Figure 1: Mortality Trends of 23 Major Cancers in the Indian Population between 2000-2019

Cancer Treatment in India: Costs & Challenges
The average cost of cancer treatment in India is Rs 5,03,118, whereas the minimum and maximum costs vary between Rs 90,000 and Rs 28,00,000, respectively, depending on various factors including the type and stage of the cancer. Different targeted therapies for a specific type of cancer, such as chemotherapy, hormone therapy, immunotherapy, radiation therapy, etc., range from Rs 1,00,000 to Rs 50,00,000 according to your stage and place.


  
Figure 2: Incidence of cancer cases in India

Uttar Pradesh, Bihar, West Bengal, Maharashtra and Tamil Nadu have reported a sharp rise in cancer cases from 2021 to 2024, with Uttar Pradesh paying the maximum price owing to heavy air and water pollution as well as inadequate healthcare access (Fig. 2). While Tamil Nadu contends with industrial and agricultural pollution, Maharashtra grapples with urban and industrial contamination. In West Bengal, arsenic-tainted water is a serious health hazard; in Bihar, pesticide-contaminated farmland compounds the problem. Inadequate healthcare infrastructure further compounds this problem. With rising pollution and patterns of failed policy, cancer in India is no longer a matter of medicine — it is a need for rapid systemic reform of environment and health care.

States with the lowest cancer incidence — Sikkim, Arunachal Pradesh, Goa, Nagaland, and Mizoram — have characteristic protective factors in common. Little industrialization keeps their air cleaner and exposure to harmful pollutants lower; their rural and mountainous landscapes help maximize the avoidance of known carcinogens. Traditional ways of life, including a diet heavy in fresh, organic food and lower use of tobacco and alcohol, also play a role in lower cancer rates. Moreover, extensive public health awareness and early diagnosis interventions, especially in Goa and Mizoram, keep communities healthier.

Despite offering Rs 5 lakh per household coverage for hospitalisation under Ayushman Bharat, this amount is often inadequate for complete cancer treatment. However, increased access to preventive measures locally manufactured cancer drugs, environmentally sustainable hospital infrastructure and better early detection will produce significant long-term cost savings. Pollution-related illnesses, especially lung cancer and cardiovascular diseases, now account for 1.4% of India’s GDP, demonstrating the huge health and economic burden of air pollution. The link between air pollution and chronic disease is revealed by some blunt numbers we cannot ignore. By adopting an integrated strategy that leverages healthcare investments while also proactively reforming environmental policies, we can lower costs, improve treatment outcomes, and build a more sustainable healthcare ecosystem.

Cancer's double blow: The crushing cost beyond treatment
The socioeconomic impact of cancer on individuals, families and health care systems has devastating implications for almost every country in the world, particularly in low- and middle-income countries. Excessive treatment costs, productivity loss and healthcare access barriers leave patients and families in financial and psychological ruin, and no treatment expenditure can reverse this process. Environmental factors — including industrial pollution, hazardous chemicals, and UV exposure — drive rising cancer rates but impose more economic burdens at the same time.

Advancing these types of policies—to reduce emissions, switch to clean energy and adopt enhanced agricultural practices—could all play a role in reducing cancer incidence and easing burdens on health systems. Reducing cancers' population level impacts will require a synergistic approach that marries the concepts of environmental sustainability with equity in healthcare access.

Can India's healthcare go green while fighting cancer?
Millions of people fight cancer daily in hospitals, but these same institutions pollute and drain budgets and resources from the environment. Which is why the 2025 Union Budget is unapologetically bold — healing should never be at the expense of our planet.

Hospitals designed for energy efficiency are a game-changer. Solar panels, smart architectural design and sustainable garbage use are not just environmentally friendly options, but also smart economic investments. While there are intimidating upfront costs, long-term savings from the latter can allow greater access to healthcare in underserved communities.

The shift toward climate-smart cancer centers represents the next big step forward. Research has repeatedly shown that hospitals that build with natural light, clean air and green spaces not only mitigate environmental damage but help patients heal faster. The Economic Survey 2024-25 promotes this perspective and establishes that sustainability and advanced treatment are not mutually exclusive.

But time is running out. As cancer cases driven by pollution soar, India is confronted with a growing crisis. Clean air and eco-conscious health care aren’t luxuries; they’re necessities. The choice is a grim one — heal the patients or allow the system to become the disease itself. What path will India take?

Dr Barun Kumar Thakur teaches Economics, while Akansha Jain and Abhimanyu Chaudhary are students, at FLAME University, Pune. Views are personal.