Comprehensive Public Health Law

IN NEWS

• The Standing Committee on Home Affairs highlighted the need for a comprehensive public health Act, in a report that was submitted to Rajya Sabha Chairman Venkaiah Naidu.

WHY A PUBLIC HEALTH ACT IS NEEDED- The COVID lessons:

• Handle epidemics and pandemics: There is a vacuum due to absence of specific legislation to tackle pandemic like covid19 in India. We were still depending on British era legislation Epidemic diseases Act 1897 to tackle covid 19. Also, agencies like NDMA lack specialised legislations and mandates to handle pandemics.
• To regulate private hospitals: COVID-19 has exposed the dangers of excessive reliance on private tertiary care. In times of a pandemic, there were several reported instances of beds reserved for COVID-19 patients in private hospitals being sold at exorbitant rates.
• Overcome prolonged underinvestment: India’s public expenditure on health as a percentage of GDP is a little over 1.4%, one of the lowest in the world. This has left millions seeking help from a highly commercialised private sector with little regulatory oversight. 

• Better insurance facilities: Medical insurance was not extended to patients with COVID-19 infection during initial days of pandemic. There is need to have regulatory oversight on all hospitals working in the country to prevent refusal to accept insurance claims. 
• To curb black marketing: For instance, Chloroquine tablets were hoarded by pharmacies during initial days of pandemic and sold above the maximum retail price.
• Ensure uniform standards: To bring about product standardisation through legal backing which will help curb spurious drugs.
• Foster better cooperation: a legal mandate can contribute to strengthening the public health system at the grass-roots level. Thus it can eliminate lacunaes in coordination between public sector, corporates and voluntary sector in extending support to people during health disasters.
• Ensure child welfare: The committee expressed concern that with schools shut down now for more than nine months, many children were deprived of mid-day meal. Many States continued the scheme by delivering dry ration to students at their homes or giving them allowances. But this was not uniform.
• Promote sustainable growth: India has committed itself to covenants such as the Sustainable Development Goals, but continues to evade making the right to health a full legal and justiciable right under the National Health Policy.

HEALTH RECOMMENDATIONS BY STANDING COMMITTEE ON HOME AFFAIRS

• A comprehensive Public Health Act, as a response to the extreme stresses caused by COVID-19
• An effective functional institutional mechanism is needed for co-ordination between the Centre, states and Union Territories for quick response to such a crisis in future.
• More fund should be allocated to public hospitals to strengthen the public health infrastructure, so that they can equip themselves appropriately to handle such pandemics in the future
• Government should be proactive by holding awareness campaigns on cheaper and effective repurposed medicines to prevent people from panicking and spending a huge amount of money on expensive drugs.
• Good quality and affordable medicines be provided to everyone, especially at a cheaper or subsidised rate to the marginalised sections of the society especially at the time of Pandemic like COVID-19
• A separate wing may be formed in the NDMA that will specialise in handling /managing pandemics like COVID-19 in future. This wing may take a leading role in building a partnership of government with the public sector, corporates, NGOs and other stakeholders
• At the time of a pandemic, measures should be taken by the Government to avoid social stigma and fear of isolation and quarantine, by making people aware and treating them with respect and empathy,
• In light of the mental pressures the coronavirus pandemic caused on various sections of people, the Committee recommended that health care centres across rural and urban areas must have mental healthcare professionals.
• Ministry of Home Affairs, along with the Department of Food and Public Distribution, shall take up the matter of distribution of mid day meals with the State governments to ensure that the local administrations are delivering the rations/ allowances in time and this should be continued until the schools reopen

COMPARISON WITH OTHER COUNTRIES:

• Australia:
  • The Australian constitution provides its Government with legislative powers to quarantine. An overarching law called the National Health Security Act (‘NHS Act’) and Agreement is also in place to abide by the obligations toward the IHR(International Health Regulations)
• The United States:
  • the Health and Human Services (‘HHS’) Department has laid down specific guidelines to assist states and prevent the spread of infectious diseases. 
  • The Robert T Stafford Act (‘RTS Act’) allowed unilateral invocation of emergency by the President. 
• The European Union:
  • decision 1082/13 serves as the principal legal instrument for threats to health, which endorses compliance with WHO’s IHR.
  • This decision of the EU requires signatory states to develop national plans for pandemics such as rationing of resources, enforced isolation or quarantine, and so on.
• China:
  • the law on Prevention and Treatment of Infectious Diseases (‘PTID’) categorizes infectious diseases into three classes based on their infectiousness and likelihood to cause an epidemic.
  • While China does have a legal framework to handle medical emergencies, the implementation of the same often leads to grave human rights violations.

CONCLUSION

• There is a need to bring in reform by formulating another comprehensive and ethical overarching healthcare law once the pandemic is under control.
• This is the right time for the legislative body of India to introduce Public Health Bill-2020 to empower the governments to handle such unforeseen situations like the COVID-19 pandemic.
• This will dawn a new era of healthcare wherein every citizen of the country would be able to avail the basic healthcare facilities with due deliberation.

PRACTICE QUESTION:

Q. In the light of the COVID-19 pandemic, discuss the need to have a Comprehensive Public Health Law in India?