In recent times, efforts were made to fill in the lacunae created by
advancements in health science. In the light of such exertions the Public Health
(Prevention, Control and Management of Epidemic, Bioterrorism and Disaster)
Bill, 2017 is drafted. Lately, the bill garnered attention when the
administrators from the Union Ministry of Health and Family Welfare and other
government departments started the process of finalizing various provisions of
the upcoming Bill.
The public health bill, of 2017 is likely to supersede the 125-year-old,
Colonial Era law - The Epidemic Disease Act 1897 (EDA) which was implemented by
the British administration to control the Bubonic plague. This is because the
Epidemic Disease Act is not only archaic to counter the problems of the
contemporary world but also rendered ineffective when the whole of India was
combating the spread of Coronavirus.
Hence, this article would be overviewing the upcoming central public health law,
its need, its limitations and how this law would be different from the
previously implemented health laws.
About the Public Health Bill
On March 20, 2017, a meeting was hosted by the WaterAid India to discuss the
draft public health bill 2017. The discussion was fostered in the presence of
Mire Shiva (initiative for health and equity in society), Indira Chakravarty
(public health resource network), Arun Srivastava (national health systems
resource centre), Indranil Mukhopadhyaya (public health foundation of India) and
the officials of WaterAid. Members present in the meeting scanned through the
draft bill and raised concerns related to the intent behind this precipitous
introduction of the bill by the ministry and the implications if it gets passed
in the current form.
During the meeting, the WaterAid, along with the other experts, stressed the
need for further in-depth discussion and consultations with a much ampler group,
including the key health groups and other stakeholders. They were undisputed in
their opinion that government should not pass this bill in its current form and
should call for a larger consultation to address its pros and cons.
Resultantly, the Public Health Bill 2017 was prepared cooperatively by the
National Center for Disease Control (NCDC) and the Directorate General of Health
Services (DGHS) keeping in mind the need to empower local government bodies
during the pandemic or emergencies. It amalgamated provisions to give more teeth
to the government machinery so that they can tackle any emergency swiftly. 
The proposed law deals with restructured, wide-ranging, and scientific
provisions on surveillance, public health emergencies, disease notifications,
disasters, and bioterrorism. The bill aimed to meticulously address health
emergencies that India might face in the future.
The bill is to be introduced in the monsoon session of the parliament before the
third covid wave hits the country as speculated. Once the draft is ready it will
be placed in the public domain for consultation before being sent to the union
Nature and scope of the bill
The public health bill, of 2017 is comprehensive legislation that will encompass
all the aspects related to health, environment, food, and road safety because
sundry disease needs a multidisciplinary approach and interdepartmental
coordination as in the case of animal to human and human to animal transmitted
diseases. The latest legislation not only covers many aspects of health, but
also allusions mean to quarantine a patient, accountability of departments and
punitive actions in case of letdowns.
The bill sought to define appealing and analytical terms such as "bioterrorism",
"public health emergency", "social distancing" and "quarantine".
The bill defines lockdown as a "restriction with certain conditions or complete
prohibition of running any form of transport" on-road or inland water. The
definition includes "restrictions on movement, gathering of the person in any
place whether public or private". It also prohibits/restricts the working of
factories, plants, mining, construction or offices or educational institutions
Section2(d) provides the definition of the term "clinical establishment" and
gives a far-reaching and extensive meaning to it. Every medical facility,
unrelatedly of its composition, ownership, size, and specialty, is brought under
the scope of clinical establishments for the purpose of the bill. The eclectic
ambit of clinical establishments even includes the neat clinics of individuals
doctors and all kinds of research and diagnostic labs. The solitary exception in
this regard is clinical establishment owned, managed, and controlled by armed
forces. The utility of this definition is put forth in section 3 of the draft
Section 3 confers a barrage of powers to the state government, union
territories, district, and local administration.These instrumentalities may
mandate health measures including quarantine, isolation, and social distancing
to any person(s) or any class of persons, destroying animals or birds, isolating
infections, and agents.
They are empowered to veto certain activities, ban, or standardize drugs and
other hazardous substances, conduct medical tests, and commence diverse
decontamination measures. It empowers any official or person to enter and
scrutinize, minus prior notice, any premises where public health emergency has
either occurred or is likely to occur.
The bill aims to squeeze in an assortment of laws related to public health
emergencies like the Indian Ports Act, Livestock Importation Act, Aircraft
Rules, Drugs and Cosmetics Act and Disaster Management Act 2005. The bill aims
to put all these pre-existing laws in a single framework.
The bill proposes:
Challenges in implementation of the Public Health Bill
- A four-tier health administrative architecture
The Public Health bill 2017 proposes a four-tier health administration
architecture with "multisectoral" national, state, district and block level
public health authorities which will have well-defined powers to setting up
a public health cadre and even defining a lockdown. It is anticipated that
that the national public health authority will be commanded by the Union
health ministry and chaired by the health minsters of the state.
The district collector will lead the subsequent tier, block-level will be
directed by block medical superintendents or executives. The bill proposes
that the above authorities will have the power to take obligatory measures
for the prevention of non-communicable diseases and emerging infectious
- Collaboration and regulating private sectors
- Shift from sick case to wellness
- Increase in life expectancy birth from 67.5 to 70 by 2025.
- Reduction of TFR to 2.1 at national and sub national level by 2025
- Reduction under 5 mortalities to 23 by 2025 and MMR from current level
to 100 by 200.
- Reduction in infant mortality rate to 28
- Reduction in neonation mortality to 16 and still birth to single digit
- Reduction in premature mortality from cardiovascular disease, cancer,
diabetes, chronic respiratory disease by 2025.
Epidemic Disease Act 1897
- Without a steadfast heath cadre. It would be challenging to implement
the proposed health bill effectively.
- With the laid-back access to the internet, many fabricated claims and
false warnings can supper, causing fear and panic among the people. Addition
of penalties to prevent such activities should be considered. Provisions of
payment of compensation to the people affected by the government orders
during an epidemic may be considered.
- All the power of the government at each level are clearly mentioned, but
still conceivable violation of rights during public health emergency have
not been considered and its redressal mechanism are not lucidly defined.
Appeal can be made under this act, but still the extent to make an appeal is
very limited in the context of the sections of the bill.
- Maintaining an equilibrium between the rights provided by the
constitution and the powers of the government is essential for the public
- It has restricted reference to ethical frameworks or the protection of
human rights during the response to epidemics.
The Epidemic Disease Act, 1897 is a colonial era legislation that is still used
as primary law to control a mass epidemic. It was legislated to control the
deadly bubonic plague in Bombay. As the plague assumed epidemic proportions, the
colonial response was typical- one driven by panic, high handedness, ill
planning, and severe measure. The Epidemic Disease Act was a result of
"stringent measure" which Queen Victoria had directed her government to take to
tackle the plague outbreak.
The act is one of the shortest legislations in the country, containing four
sections only. Section 2 of the act vests the state government to take such
measures and prescribes transitory regulations as maybe required to control an
epidemic disease. Section 2A empowers the central government to scrutinize any
ship leaving or arriving in port and for the custody of any person sailing or
Section 3 provides for chastisement under section 188 of the Indian Penal Code
for any person flouting the act. If any disobedience by a person causes or tend
to cause danger to human life, health, or safety, then they may be punished with
imprisonment up to six months and/or fine up to Rs. 1000. Section 4 provides
legal protection to persons for anything done under the act.
Limitations of Epidemic Disease Act
The act has major inadequacy in this era of changing dynamics in public health
emergency management. Communicable diseases and their spread have changed over
the years. The novel viral disease, which are more virulent and potent in form,
pose relentless challenges for us.
There is increased intercontinental travel, global connectivity, greater
migration, boosted urbanization, closed urban spaces, climate change, man-made
ecological changes, increasing intensity of contact with animals and birds,
fluctuating climate conditions, technologies of mass food production, breakdown
of public health measures and biosafety lapses, and more pressure on natural
resources. The act is not in consonance with changing prerequisite of modern-day
epidemic disease prevention and control.
In the Epidemic Disease Act the definition or description of a "dangerous
" is not provided. There is no perfect definition of whether
an epidemic is "dangerous" based on the magnitude of the problems, the severity
of the problem, the age of population affected or its potential to spread
internationally. It is fundamental to know who decide or what a dangerous
epidemic disease is and what criteria the definition is based on. 
The act is solely regulatory in nature and lacks specific heath focus. It does
not describe the duties of the government in preventing and controlling
epidemic. The act emphases the power of the government but is taciturn on the
rights of citizens. It has no provisions that take the people's interest into
consideration. The act is also silent on the ethical aspects or human rights
principles that come into pay during the enforcement of laws.
As for the ethical aspects of a national epidemic, it is necessary to address
unbiassed access to healthcare. the ethics of public health actions taken in
response to an outbreak should be considered as should the obligation of
healthcare workers during an outbreak and obligations of society to them in
How is Public Health Bill different from Epidemic Disease Act?
The two acts differ in context of the scope, inclusion of diseases which can be
a threat to public health, penalties, division of powers among different
administrative authorities and making appeal regarding any order passes under
The Epidemic Disease Act only focused disinfecting railways and ports
considering them the only entry points not mentioning the roads crossing and air
travel, which are considers in public health bill. In case of any disputes the
Epidemic Disease Act does not postulate powers which administrative authority
will supersede, that are clearly mentioned in the Public Health Bill with
provisions to amend.
To prevent any confusion, proper definition of disinfection, derating,
isolation, quarantine, public health emergency of national concern etc. are
clearly mentioned in the Public Health Bill but not in Epidemic Disease Act.
The concept of public health services is laid down in Public Health Bill which
includes health promotion, immunization, prevention, treatment of disease
services, environmental sanitation and includes looking after for such services
which are relevant in case of pandemics like COVID-19 but are missing in the
epidemic disease act.
There is a necessity to strengthen legal frameworks to thwart and control the
entry, spread and existence of communicable diseases in India. A centralized
public health law can turn out to be a game changer. As its implementation would
warrant a legal framework for providing essential public health services and
powers for an adequate response to public health emergencies through effectual
collaboration between the center and the state. The bill adopts a right based
approach and upholds the right to treatment and care. It clearly states the
public health obligations of the government.
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Award Winning Article Is Written By: Ms.Ilika Grover
Authentication No: AR211989730452-29-0422
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