The Right to Public Health is a fundamental feature of human well-being and is unreservedly protected under Article 21 of the Indian Constitution, which guarantees the right to life. This right is supported and enforced through a broad framework of central and state laws, including the Epidemic Diseases Act, Clinical Establishments Act, and various public health legislations at the state level. Additionally, numerous governmental schemes such as Ayushman Bharat, National Health Mission (NHM), and state-specific health cover programs aim to provide accessible and affordable healthcare to all. The integration of legal provisions with targeted welfare schemes strengthens the scope of public health delivery, ensuring a rights-based approach to healthcare in India. The right to public health is a cornerstone of human dignity and a fundamental aspect of socio-economic development. While not clearly stated in the Indian Constitution as a fundamental right, the Supreme Court has interpreted the Right to Health as an intrinsic part of the Right to Life under Article 21. Public health is a multidimensional domain that requires coordinated efforts between various stakeholders, including governments, institutions, and communities.
In India, the legal framework governing public health is spread across both central and state laws, owing to the federal structure of the Constitution. Disease Control and Epidemics, Drug and Medical Regulation, Food Safety and Consumer Health, Environmental and Occupational Health, Medical Education and Practice, Insurance and Access. Public Health Acts are very much helpful to the poor and middleclass society.
The right to public health is a cornerstone of human dignity and a fundamental aspect of socio-economic development. While not explicitly stated in the Indian Constitution as a fundamental right, the Supreme Court has understand the Right to Health as an inherent part of the Right to Life under Article 21. Public health refers to the communal efforts of society, governments, and institution to prevent disease, prolong life, and promote health through organized efforts and informed choices. In India, this responsibility is shared across central and state governments, with various laws, policies, and schemes aiming to ensure available, reasonably priced, and equitable healthcare for all citizens. India’s public health system is governed by a complex legal and administrative framework. Under the Constitution of India, health is primarily a State subject under List II (Seventh Schedule), allowing state governments the power to legislate on matters related to public health and sanitation.
However, the Central Government also plays a critical role in regulating healthcare standards, coordinating inter-state issues, and supporting health programs financially and technically, especially through entries in the Concurrent List and Union List. Several central laws govern public health matters. The Epidemic Diseases Act, 1897, and the Drugs and Cosmetics Act, 1940, are key statutes that regulate disease control and quality of medicines respectively. The Food Safety and Standards Act, 2006, ensure food safety, while the Clinical Establishments Act, 2010, seeks to standardize health services across India. More recently, the National Medical Commission Act, 2019, replaced the Medical Council of India to enhance clearness and answerability in medical education and practice. State governments, meanwhile, often enact their own public health acts to address regional challenges. States like Tamil Nadu, Maharashtra, and Kerala have robust legal frameworks and infrastructure behind primary healthcare delivery, vaccination, disease control, and maternal-child health services. The variation across states in terms of governance capacity, resource availability, and administrative priorities results in significant disparities in health outcomes. To operation a lie the right to health, the Indian government has launched several flagship schemes.
At the central level, the Ayushman Bharat – Pradhan Mantri Jan Arogya Yojana (PM-JAY) is a landmark initiative, providing health insurance coverage of 5 lakh per family per year for secondary and tertiary hospitalization. The National Health Mission (NHM), including the Rural Health Mission and Urban Health Mission, aims to strengthen the healthcare infrastructure and improve access to quality care. Schemes like Janani Suraksha Yojana, Mission Indradhanush, and Rashtriya Swasthya Bima Yojana also contribute considerably to public health delivery. In conclusion, the right to public health in India is supported by a collaborative legal and policy framework between the Centre and the States. While significant progress has been made, continuous reforms, increased funding, and better implementation mechanisms are required to ensure universal health coverage and reduce health inequity across the country.
Right to Public Health
The Right to Public Health is an essential component of human well-being and social justice. It signifies not only access to medical treatment but also the broader availability of preventive, ancient, and rehabilitative health services. In the Indian context, though the Constitution does not openly mention the “Right to Health” as a fundamental right, the judiciary has played a transformative role in interpreting it as part of the Right to Life under Article 21. Public health encompasses all organized measures—public or private—to prevent disease, promote health, and prolong life among the population as a whole. It is not confined merely to treating illnesses but includes creating conditions where people can lead healthy lives, including access to clean drinking water, proper sanitation, healthy food, pollution-free environments, and awareness of health-related matters.
The Supreme Court of India has, through various landmark judgments, emphasized that the Right to Health is integral to the Right to Life. In Consumer Education and Research Centre v. Union of India (1995), the Court held that the health and strength of workers is an integral facet of the right to life. Similarly, in Paschim Banga Khet Mazdoor Samity v. State of West Bengal (1996), the Court laid down the duty of the state to provide sufficient medical facilities. The Directive Principles of State Policy further reinforce this vision. Article 47 of the Constitution directs the State to raise the level of nutrition and the standard of living and to improve public health as among its primary duties. While not justiciable in a court of law, these principles provide important guidance for legislative and policy action. In practice, the delivery of public health services in India is a shared responsibility between the Central and State Governments. Health is a State subject under the Seventh Schedule of the Constitution, giving states the primary role in health administration. However, the Centre plays a vital role in formulating national health policies, funding major schemes, and regulating health standards. Over the years, numerous governmental schemes have been introduced to make healthcare more accessible. The National Health Mission (NHM), which includes both rural and urban health missions, aims at intensification the health system and civilizing service delivery.
The Ayushman Bharat scheme, launched in 2018, marked a important step toward universal health coverage by providing free health insurance to over 50 crore people. It also includes the creation of Health and Wellness center for comprehensive primary care. Several legislations at both the central and state levels contribute to public health governance. These include the Epidemic Diseases Act, 1897, the Food Safety and Standards Act, 2006, and various State Public Health Acts. Together, these form the legal foundation for health regulation, disease control, and emergency responses. In conclusion, the Right to Public Health is a critical component of human rights and social equity. While constitutional interpretation, legislative frameworks, and government schemes have strengthened its foundation, much work remains to make healthcare universally accessible and equitable. Ensuring this right in practice requires continued political commitment, adequate funding, and efficient service delivery at all levels.
Scope of Different Central and State Laws in Public Health
Public health is a multidimensional domain that requires coordinated efforts between various stakeholders, including governments, institutions, and communities. In India, the legal framework governing public health is spread across both central and state laws, owing to the federal structure of the Constitution. While “Public Health and Sanitation” is placed under the State List (List II, Schedule VII) of the Indian Constitution, the Central Government also holds significant legislative and regulatory authority through the Concurrent List (List III) and its overarching role in national policy-making and health security. This dual responsibility has given rise to a complex and interdependent legislative landscape that defines the scope and implementation of health governance across the country. This article delves into the scope of different central and state laws in public health, highlighting their roles, interrelations, and impact.
1. Constitutional Basis for Public Health Laws
The Indian Constitution does not clearly mention the “Right to Health” as a fundamental right. However, through judicial interpretation, it has been read into Article 21 (Right to Life and Personal Liberty). Moreover, Directive Principles of State Policy (Part IV)—particularly Article 39(e), 41, 42, and 47—found the foundation for health and welfare legislation, urging the state to secure just and humane conditions of work, public assistance, maternity relief, and improvement of public health. Despite health being a state subject, the Central Government plays a critical role in setting national policies, coordinate disease control program, ensure drug and food safety, and regulating medical education and research.
2. Scope of Central Laws in Public Health
Central laws generally focus on consistency, regulation, and countrywide health issues, particularly those involving inter-state implications. Key areas of central legislation include:
a. Disease Control and Epidemics
The Epidemic Diseases Act, 1897: One of the oldest public health laws in India, this Act empowers both central and state governments to take special measures during outbreaks. It gained renewed attention during the COVID-19 pandemic and was temporarily supplemented by the Disaster Management Act, 2005. Proposed Public Health Bill Intended to replace the outdated Epidemic Diseases Act, this aims to provide a more comprehensive legal framework for preventing and controlling public health emergencies.
b. Drug and Medical Regulation
Drugs and Cosmetics Act, 1940: Regulates the import, manufacture, distribution, and sale of drugs and cosmetics. Drugs and Magic Remedies (Objectionable Advertisements) Act, 1954: Prohibits misleading advertisements related to drugs and treatments.
c. Food Safety and Consumer Health
Food Safety and Standards Act, 2006: Recognized the Food Safety and Standards Authority of India (FSSAI) to regulate food quality and standards.
d. Environmental and Occupational Health
Environment (Protection) Act, 1986, and Air/Water Pollution Acts: Indirectly impact public health by addressing environmental determinants of health. Factories Act, 1948: Ensures health, safety, and welfare of workers in industrial settings.
e. Medical Education and Practice
National Medical Commission Act, 2019: Replaced the Medical Council of India to enhance transparency in medical education and maintain standards.
f. Insurance and Access
Employees’ State Insurance Act, 1948: Provides medical and cash benefits to workers in case of sickness, motherhood, and service injury.
The Central Government also runs large-scale public health programs under National Health Mission (NHM) and Ayushman Bharat, where the legislation supports funding, policy guidance, and program frameworks.
3. Scope of State Laws in Public Health
While central laws address regulation, states are primarily responsible for implementing healthcare services, establish health infrastructure, and addressing region-specific health challenges. Each state may enact public health laws suited to its demographic, geographic, and epidemiological context.
a. Public Health Acts
Many Indian states have their own public health laws:
Maharashtra Public Health Act, 1949
Tamil Nadu Public Health Act, 1939
Kerala Public Health Act (Draft) these laws empower local authorities to control infectious diseases, ensure sanitation, conduct health inspections, and regulate municipal health communications.
b. State-specific Regulatory Bodies
States have their medical councils, nursing councils, and drug control establishment that enforce standards in practice and monitor compliance with central acts.
c. State Insurance Schemes and Welfare Programs
Many states have launched health insurance schemes independent of or complementary to central schemes. For example:
Aarogyasri (Andhra Pradesh and Telangana)
Bhamashah Swasthya Bima Yojana (Rajasthan)
Mahatma Jyotiba Phule Jan Arogya Yojana (Maharashtra)
These schemes have their own legal structures and rules, representative the autonomy of states in shaping health welfare initiatives.
d. Municipal and Panchayat Laws
States regulate urban and rural local bodies that provide public health services like water supply, waste disposal, and vaccination. Municipal laws often include physical condition and hygiene codes specific to urban environments.
4. Challenges and the Need for Coordination
While both central and state laws play unique and complementary roles in public health governance, several challenges persist. One significant issue is the overlap in jurisdictions, which becomes especially problematic during national health crises such as the COVID-19 pandemic. Conflicting responsibilities between central and state authorities can result in administrative confusion and inefficiencies. Additionally, many state public health laws are outdated, often remnants of colonial-era statutes.
These laws are ill-equipped to address modern health threats, including non-communicable diseases, pandemics, and environmental health concerns. Furthermore, there is considerable disparity in institutional capacity across states, leading to unequal enforcement of laws and uneven delivery of health services. To address these challenges, it is imperative to modernize state public health laws, enhance intergovernmental coordination, and develop legal frameworks that are more responsive, adaptable, and suited to contemporary public health needs.
5. Way Forward
To improve the effectiveness and reach of public health law in India, the following steps are crucial:
Draft and implement a comprehensive National Public Health Act that clearly defines roles and responsibilities during emergencies and standardizes response protocols across states. Update and harmonize state-level health laws to reflect modern scientific knowledge, health priorities, and the constitutional mandate. Strengthen intergovernmental coordination mechanisms to bridge the gap between central policymaking and state-level execution. Enhance legal awareness and training among health professionals and administrators to ensure proper implementation of health regulations.
Government Scheme on right to public health
National-Level Schemes
1. Ayushman Bharat – Pradhan Mantri Jan Arogya Yojana (PM-JAY)
Launched in 2018, PM-JAY is a national public health insurance scheme providing free access to health insurance coverage for low-income earners in India. It offers an annual health cover of 5 lakh per family for secondary and tertiary care hospitalization. The scheme is means-tested and covers approximately 50 crore (500 million) people, making it the world’s largest government-sponsored healthcare program.
2. Expansion for Senior Citizens
In September 2024, the Indian government expanded its healthcare program to include all citizens aged 70 and above, regardless of income. This initiative provides an annual medical insurance coverage of 5 lakh per family, benefiting an additional 60 million people.
3. Pradhan Mantri Atmanirbhar Swasth Bharat Yojana (PMASBY)
Announced in 2021, PMASBY aims to strengthen India’s public health infrastructure by 2025–26. With a budget of ₹64,180 crore, the program focuses on enhancing the capacity of primary, secondary, and tertiary healthcare systems across the country.
State-Level Initiative: Rajasthan
Rajasthan Right to Health Care Act, 2022
Rajasthan became the first Indian state to enact a law guaranteeing the right to health. The Rajasthan Right to Health Care Act, passed in March 2023, entitles every resident to free Out Patient Department (OPD) and In Patient Department (IPD) services at all public health facilities. Additionally, select private hospitals are mandated to provide free emergency care. The act encompasses 20 rights based on Articles 21 and 47 of the Indian Constitution. However, the act faced criticism from private healthcare providers and the Indian Medical Association. Concerns were raised about the lack of clarity on reimbursement for private hospitals and the definition of “emergency” services. Following negotiations, the government amended the act to exempt hospitals with fewer than 50 beds and those not built with government assistance.
The right to health is an intrinsic part of the right to life, enshrined under Article 21 of the Constitution of India. Recognizing health as a fundamental human right, the Indian government has implemented various schemes and policies to provide affordable and accessible healthcare to all. These initiatives aim to reduce disparities in health outcomes and promote equity in access to healthcare services.
One of the most transformative schemes in this context is the Ayushman Bharat – Pradhan Mantri Jan Arogya Yojana (PM-JAY), launched in 2018. This flagship health insurance scheme provides an annual health cover of ₹5 lakh per family for secondary and tertiary care hospitalization. Targeted at over 10 crore vulnerable families, PM-JAY is considered the world’s largest government-funded healthcare program. It ensures cashless and paperless access to services at both public and empaneled private hospitals across India. This scheme plays a critical role in protecting poor families from catastrophic health expenditures, thus realizing the right to public health on a practical level (Ministry of Health and Family Welfare, 2023).
In 2024, the government expanded PM-JAY benefits to include all senior citizens aged 70 and above, irrespective of their income status. This expansion extended healthcare coverage to an additional 60 million people and reinforced the state’s commitment to elder care and health equity (Reuters, 2024).
Another major initiative is the Pradhan Mantri Atmanirbhar Swasth Bharat Yojana (PMASBY), announced in 2021. With a financial outlay of ₹64,180 crore over five years, PMASBY aims to strengthen the country’s health infrastructure by developing capacities for diagnostics and treatment in urban and rural areas. It includes the establishment of critical care units in districts, public health labs, and health wellness centers. This scheme complements PM-JAY by building the physical and institutional infrastructure needed to deliver healthcare services more effectively. At the state level, Rajasthan took a landmark step by passing the Rajasthan Right to Health Care Act, 2022, becoming the first state to legally recognize the right to health. The Act guarantees free OPD and IPD services at all public hospitals and selected private facilities, especially in emergencies.
It enshrines 20 specific health rights, such as access to informed consent, dignified care, and timely treatment. Despite initial resistance from private healthcare providers, the Act marks a significant advancement in statutory recognition of health rights in India (Rajasthan Government Gazette, 2023). While these schemes collectively demonstrate the Indian government’s intent to uphold the right to health, challenges remain. Issues such as uneven implementation, inadequate funding, shortage of healthcare workers, and lack of public awareness hinder their full potential. Nonetheless, these programs have laid the foundation for a more inclusive and equitable healthcare system.
Related Case Law
1. Paschim Banga Khet Mazdoor Samity v. State of West Bengal (1996) AIR 2426, SC
Facts: A labourer who suffered a serious head injury was denied treatment by multiple government hospitals due to lack of facilities. He approached the Supreme Court under Article 32.
Judgment: The Supreme Court held that the right to life under Article 21 includes the right to health and medical care. The state is constitutionally obligated to provide adequate medical facilities to the public.
Significance: This case is a cornerstone in recognizing health as a fundamental right. The Court stated that failure of a government hospital to provide timely medical treatment to a person in need is a violation of the right to life.
2. Consumer Education and Research Centre (CERC) v. Union of India (1995) 3 SCC 42
Facts: Workers in asbestos industries were not provided with proper health safeguards.
Judgment: The Supreme Court ruled that the right to health and medical care of workers is a fundamental right under Article 21 and Directive Principles (Articles 39(e), 41, 43, and 48A) reinforce this obligation.
Significance: The Court emphasized that the government and employers must ensure healthy working conditions and provide health care for workers.
3. State of Punjab v. Mohinder Singh Chawla (1997) 2 SCC 83
Facts: A government servant demanded reimbursement for medical treatment taken abroad, which was denied by the state.
Judgment: The Supreme Court held that the right to health is integral to Article 21, and the state has an obligation to provide medical assistance to government employees.
Significance: This case reinforced the principle that health care is a right not only for the general public but also for state employees, especially in life-threatening conditions.
4. Parmanand Katara v. Union of India (1989) AIR 2039, SC
Facts: A motorcyclist injured in a road accident was denied treatment by a hospital citing medico-legal procedures.
Judgment: The Court held that every doctor, whether in a government or private hospital, has the professional obligation to extend medical aid immediately to preserve life, regardless of procedural formalities.
Significance: The case laid down that saving lives is paramount and established that health care delivery cannot be delayed on procedural grounds.
5. Mohd. Ahmed (Minor) v. Union of India (2014) Delhi HC
Facts: A poor minor suffering from a rare disease (Gaucher’s disease) approached the court to get free medical treatment.
Judgment: The Delhi High Court directed the government to bear the cost of treatment, observing that right to health is part of the right to life and the state cannot deny medical treatment based on lack of funds.
Significance: It extended the right to health specifically for marginalized and poor individuals suffering from rare diseases.
Conclusion: The scope of central and state laws in public health reflects the complexity and diversity of India’s federal structure. Central laws ensure uniformity in standards and a national framework for health security, while state laws enable tailored responses and implementation at the grassroots. A well-balanced and coordinated legal system is essential to realizing the constitutional promise of the Right to Life and ensuring equitable and effective public health for all.
These initiatives reflect India’s commitment to ensuring the right to health for its citizens through both national and state-level programs. While national schemes like PM-JAY and PMASBY aim to provide broad healthcare coverage and infrastructure development, state-level efforts like Rajasthan’s Right to Health Care Act focus on localized implementation of health rights. These cases collectively reinforce that the right to public health is a fundamental right under Article 21 of the Constitution of India. The judiciary has played a proactive role in expanding this right to include access to emergency care, affordable treatment, occupational safety, and state responsibility in healthcare infrastructure.
References:
- Ministry of Health and Family Welfare. (2023). Ayushman Bharat PM-JAY. https://pmjay.gov.in
- Reuters. (2024). India expands free health cover to citizens aged 70 and above.
- Press Information Bureau, Government of India. (2021). Launch of PMASBY.
- Government of Rajasthan. (2023). Rajasthan Right to Health Care Act, 2022.
- The Constitution of India – Article 21 and Article 47.
Relevant Website Links:
- National Health Mission (NHM) – Central government initiative to strengthen public health systems.
🔗 https://nhm.gov.in - Ayushman Bharat – PM-JAY – Flagship health insurance scheme under the right to public health.
🔗 https://pmjay.gov.in - Ministry of Health and Family Welfare – Legal, policy, and scheme updates.
🔗 https://mohfw.gov.in
State Health Policy Documents – Check individual state health department websites for laws like the Rajasthan Right to Health Act.
Example: Rajasthan Health Department – https://rajswasthya.nic.in
– Dr. Meenu D. Sharma, Assistant Professor
Department of Law, Madhav University (Abu road)