Some health experts say investing in earlier diagnosis of breast cancer and improved testing, surgery and access to radiation therapy is more important than access to expensive drugs. “Chemotherapy is not the major issue for cancer control in India,” said Dr. Richard Sullivan, a professor of cancer policy and global health at King’s Health Partners’ Integrated Cancer Center in London.

But health advocates say similar arguments were made by the United States government and the pharmaceutical industry as they sought to protect patents on AIDS medicines through much of the 1990s, a stance that former President Bill Clinton has since said he regrets. It would be unfair to delay improving access to cancer drugs until India’s broken system for cancer care was fixed, they say. They note that more than twice as many people in India die of cancer than of AIDS.

As the world has made progress against malnutrition and infectious diseases, more people are living into old age and dying of chronic illnesses like heart disease and cancer, which now cause two-thirds of deaths globally. In 2012, there were 14.1 million new cancer cases across the world and 8.2 million cancer deaths, according to the World Health Organization. And the number of breast cancer cases is growing. About 6.3 million women were living with the disease last year.

The rise in the cancer caseload is already a heavy burden on India’s hobbled health system. Indian women, while less likely to get breast cancer than those in the United States, are far more likely to die of it. Breast cancer is diagnosed in about 115,000 women here every year, and in 2008 some 54,000 died from it, according to the World Health Organization.

At intersections in New Delhi, women carrying doctors’ notes beg for money for their prescribed treatments. India has just 27 dedicated public cancer centers for 1.2 billion people. The government has promised to add an additional 50 in the coming years, but medical experts say even that will be grossly inadequate.

India, which is one of the world’s leading producers of generic pharmaceuticals, has long viewed patent rights on medicines skeptically. It has already ruled invalid patents protecting exclusive sales of Novartis’s Gleevec, Pfizer’s Sutent and Roche’s Tarceva, all cancer medicines. In a landmark decision last year, the government agreed that the patent protecting Bayer’s Nexavar, also a cancer drug, was valid but overrode it anyway because a generic company promised to lower the price from $4,500 to about $140 per month of treatment.

The government is now considering canceling the exclusive sales rights on two other cancer medicines. Roche Holdings surrendered its patent on Herceptin this year in part because it viewed it as a losing battle. Each of these steps was greeted with acclaim in India and deep disapproval from business groups, legislators and drug makers in the United States.