National Public Health Policy Blueprint to Expand Equitable Radiation Therapy Access in India: A Scalable Model.

[PURPOSE] To propose a comprehensive national policy blueprint to expand equitable radiation therapy (RT) access in India, addressing persistent rural-urban disparities and aligning with global cancer control priorities.

[DESIGN] This expert viewpoint was informed by consultations with oncology practitioners from government and private centers, medical physicists, policy planners, and patient advocates. Drawing on Indian and global precedents, best practices were synthesized to develop a 10-point framework addressing infrastructure, financing, workforce, quality assurance, and governance.

[RESULTS] RT services in India remain highly centralized, with only 120 of 740 districts offering access, disproportionately affecting the 934 million rural population. Key strategies in the proposed blueprint include import duty reform to incentivize rural investment, quality-linked reimbursements under public insurance schemes, bundled workforce incentives, and regionally focused public-private partnerships. Additional measures include phased deployment of indigenous linear accelerators (LINACs), pooled brachytherapy services, mandatory cancer notification, and digital integration through the Ayushman Bharat Digital Mission. Use of artificial intelligence (AI) and remote planning is highlighted as a means to address workforce shortages. The framework is modular and designed for adaptation by other low- and middle-income countries (LMICs).

[CONCLUSION] This 10-point National RT Policy Blueprint provides a scalable pathway to strengthen oncology infrastructure and improve treatment equity in India, with direct relevance for LMICs pursuing universal health coverage and Sustainable Development Goal 3.4. Although promising, some elements such as indigenous LINAC deployment and AI-enabled remote planning are aspirational and contingent on phased implementation, infrastructure readiness, and sustained political commitment.