LAW AS A MEDICINE FOR PUBLIC HEALTH

Akshay Ghosh
3rd Year LL.B Student, Durgapur Institute of Legal Studies, Kaji Nazrul University

ABSTRACT
Law is everywhere whether it relates to public safety, public rights, public duties or even public health.The question is what is public

health? Public Health is "the science and art of preventing disease, prolonging life and promoting health through the organized efforts

and informed choices of society, organizations, public and private, communities and individual “Public Health Law essentially regulates

the Core public health functions. A sound public health law infrastructure is important because it establishes the powers and duties of

government to pre-vent injury and disease and promote the population’s health. The core idea I propose is that statutes, regulations, and

litigation can be pivotal tools for creating the conditions for people to lead healthier and safer lives. In this first article, I construct a

definition of public health law, borrowing from ideas in constitutional law and theories of democracy. Law serves public health in at least

two ways: First, law is itself a component of the public health infrastructure. ‘Infrastructure” public health laws include legislatures’

enactments that authorize the creation of government public health agencies and other statutes that endow them with broad legal

authorities, for example, the authority to gather data, inspect, license, educate, and design interventions. “Interventional” or categorical

public health laws are narrower in scope and seek to prevent or limit the danger posed by specific threats to health, examples include the

authority to restrict minor' access to cigarettes, chlorinate public drinking water, mandate child safety seats in cars, quarantine people

exposed to communicable diseases. What is dealt within this paper has overlapping components of both of these dimensions.

Through this article, I discuss public health and law in different stages as follows: (1)What is Public health law, (2)the responsibility of

government,,(3) Environmental Health,(4Constitutional design of public health and law,(5) Different state and central legislation.

INTRODUCTION

Public health aims at controlling and preventing the spread of diseases by making regimental choices for society, individuals, and private

and public sectors. Public health services reduce exposure to various communicable and non-communicable diseases by implementing

vector and reservoir control and sanitation. Public health law helps in the refine understanding of the role played by the government in

order to ensure that the citizens of the country are healthy. Although there have been consistent interventions in the past to address

public health problems, there is a need for a systematic framework that allows the use of ‘modern legal tools’ for compound health

problems. We analyse the past and present healthcare systems and conclude if new ways have brought any societal changes.

WHAT IS PUBLIC HEALTH LAW

A systematic understanding of public health law requires a careful examination of what is public. A public entity acts on behalf of the

people and gains its legitimacy through a political process. A characteristic form of public or state action occurs when a democratically

elected government exercises power or duties to protect and promote the population’s health. Government, of course, is not solely

involved in the work of public health. The private sector (eg, managed care organizations, hospitals, and pharmaceutical companies),

charities, and community-based organizations are full partners. Nevertheless, the government has the primary responsibility to advance

the public’s health because it acts on behalf of the people.

RESPONSIBILITY OF GOVERNMENT

The government of India plays a significant role in the healthcare sector. India has one of the largest populations in the

world, and its citizens need access to quality healthcare. The government of India plays a key role in funding healthcare

initiatives, as well as improving accessibility and quality of care.

One aspect of the government’s role in healthcare is ensuring that all Indians have access to basic health services. The

National Rural Health Mission (NRHM) is a key program that helps to achieve this goal. NRHM provides rural Indians

with access to essential health services, such as primary healthcare, maternal and child health care, and pandemic

response measures. In addition, the NRHM provides financial assistance for hospitals and clinics that provide medical

services to rural Indians

The government of India also plays a critical role in funding healthcare initiatives outside of India’s borders. For example,

the India Global Health Initiative (IGHI) funds healthcare projects overseas that aim to improve public health outcomes.

IGHI has funded projects in Nigeria, Nepal, and Haiti. These projects have helped to reduce rates of disease spread and

improve public health outcomes

Overall, the government of India plays an important role in facilitating access to quality healthcare for its citizens

ENVIRONMENTAL HEALTH

Environmental risk due to chemical exposures; air, water and soil pollution; climate change and ultraviolet radiation

contribute to different diseases and injuries. WHO estimates high mortality rate per year due to the significant

respiratory disease and sickness in adults and children caused by air pollution. The United Nations Childrens Fund

(UNICEF) recently reported problems associated with lack of access to clean drinking water. Polluted water and soil

affects marine and plant life consumed by humans which serves as a breeding ground for diseases such as cholera and

typhoid fever. Environmental pollutants have various adverse and harmful health effects such as increase in oxidative

stress, infant mortality, perinatal disorders, respiratory disorders, allergy, malignancies, cardiovascular disorders,

endothelial dysfunction, mental disorders and others. Studies have shown that exposures to environmental particulates

are linked to increased risk of morbidity and mortality from organ disturbances, diseases, cancer and other chronic

diseases.

As a branch of public health, environmental healthis concerned with all aspects of the factors affecting human health,

including environmental and occupational medicine,environmental science, toxicologyandepidemiology. Combinational

information on epidemiology, toxicology and exposure science can be used to conduct a risk assessment on chemicals

and other risk factors which in turn can help protect human health.

Maintaining environmental health, safe and healthy communities is possible through surveillance systems and public

education on the protection of important resources, monitoring hazards, investigation and response delivered for

disease treatment. Delivery of services and implementation of environmental health policies through monitoring and

control activities play an important role in improving environmental parameters, encouraging the use of environmental

friendly behaviour and healthy technologies .Different kinds of interventions and public awareness programmes are

promoted based on the strength of the scientific knowledge regarding the magnitude of adverse health effects and

impact of environmental pollution on public health. Competent health professionals help in ensuring reduction and

prevention of the harmful public health effects due to environmental factors.

CONSTITUTIONAL DESIGN OF PUBLIC HEALTH AND LAW

The government over the past few years have been arguing whether to shift public health to the Concurrent list from

the State list. The Concurrent list which is authorised by the Parliament and State legislatures, shares matters over

mental health, drugs, food safety, health related economic and social planning, registration of birth and death and other

vital statistics for health etc. Parliament, however has no authority over legislating matters which fall under the State

list, which include public health, sanitation and hygiene, etc.

There are 8 states which have drafted a public health law as public health law is a state subject. Since there has to be a

uniformity in the public health law, the Central Government has drafted 3 models of Public Health Act; The Model Public

Health Bill by Central Bureau of Health Intelligence (1987); The National Public Health Bill by the National Institute of

Communicable Diseases (2002); and The National Health Bill by the Ministry of Health and Family Welfare Task Force

(2009). The laws that are put forward today need to be rewritten and a lot of rational thinking needs to be done for the

problems faced by the country in the present scenario .

The public health system is famished by funds because of the contrariety of the constitutional provisions. The

Prevention of Food Adulteration Act, 1954 is one of the few legislation under public health which is still implemented.

However, the act has a lot of flaws; it exclusively talks about food adulteration and is more conditioned in punishing the

offenders rather than help businesses implement the same. In India states have been given the authority to legislate

their own health laws, but the majority of the states aren’t doing so. There are a few legislations which talk about the

1860s which had a vision to protect the citizens in the phase of a pandemic. Post-independence, laws were more

effective and outcomes seemed to look promising.

DIFFERENT STATE AND CENTRAL LEGISLATION

There are various State Acts, State Bills and Modal Acts made by various agencies at Central level, which are available

now. There is also a public health ordinance released prior to independence. These documents are listed below:

1. Public Health (Emergency provisions) Ordinance, 1944

This is an ordinance released by way of the powers conferred by section 72 of the Government of India Act, 1935 to

make special provisions in regard to public health in India. The purpose of this ordinance was to ensure the provision of

adequate medical services, of preventing the spread of human disease, of safeguarding the public health and for

providing or maintaining services essential to the health of the community. This ordinance gives the government to

supersede the local authority if the latter fails to comply with any rule or order made in this direction.

2. Tamil Nadu Public Health Act, 1939

One of the earliest legislations in the area of Public Health in the pre -independent India comes from Tamil Nadu. The

authorities faced difficulties in implementing the act which led to the constitution of ‘The Tamil Nadu Public Health Act

Amendment Committee’ to make recommendations with regard to the amendments that need to be made to the Act.

The report of the working group members has proposed the amendments following the below mentioned criteria in its

report to the Director Public health & preventive medicine. Out of that, four amendments were related to adaptation of

laws, one related to extension of the act to transferred territory and eight were related to principal act. The last of the

amendments were made in 1990

3. Kerala Public Health Bill, 2009

This draft is a revision to the existing Travancore Cochin Public Health Act, 1939 which covered the southern part of

Kerala (and the Northern part was covered by the Madras Public Health Act of 1939). This also has followed a coercive

approach but also has recognized need for providing ‘essential public health services and functions’. This act also takes

about creation of ‘Public Health Boards’ at state level.

4. Gujarat Public Health Bill, 2009

This act follows a rights based approach. This act also regulates ‘healthcare establishments’. Besides the conventional

areas, this act also comes forward with ‘public health planning’, ‘public health impact assessment’ and clearance of

projects, ‘disaster management’, ‘obligations of the state government’, provision for ‘free and universal access to

healthcare services’, ‘public health rights’, ‘reasoned order’ by ‘designated district courts’, ‘public dialogues’ and ‘public

hearings’, and ‘least restrictive alternative’, when rights of citizens have to be infringed for public purposes. This Act was

a paradigm shift in the thinking of public health legislation, in an Indian State.

5. The Assam Public Health Act, 2010

This is a rights based legislation. This has been promulgated ‘for the protection and fulfillment of rights in relation to

health and well-being, health equity and justice, including those related to all the underlying departments of health as

well as health care and for achieving the goal of health for all’.