Bill in Waiting: Assessing the Prospects of The Public Health (Prevention, Control, and Management of Epidemics, Bio-terrorism, and Disasters) Bill, 2017

15-05-2024

The year 2017 saw a significant proposal emerge in India's public health landscape, i.e. the Public Health (Prevention, Control and Management of Epidemics, Bio-terrorism and Disasters) Bill, 2017. This draft bill, prepared by the National Centre for Disease Control (NCDC) and the Directorate General of Health Services (DGHS), addressed critical gaps in the existing legal framework for managing public health emergencies. While it never reached the stage of being tabled in Parliament, the bill's provisions offer valuable insights into potential approaches for tackling epidemics, bioterrorism threats, and disasters. India's Vulnerability and the Need for Reform Prior to the 2017 bill, India primarily relied on the Epidemic Diseases Act (EDA) of 1897 to manage public health emergencies. This colonial-era legislation, though outdated, provided the central government with powers to take measures like quarantines and disinfection during epidemics. The Law Commission's report (number 286) pinpointed several weaknesses in the Epidemic Diseases Act 1897. The Act's unclear language and lack of precise definitions for key terms like "epidemic" create confusion and hinder consistent enforcement. Additionally, the division of power between central and state governments is ambiguous, potentially leading to jurisdictional disputes that stall coordinated responses. Local governments are also left out, with undefined roles in outbreak management. Furthermore, the Act lacks specific regulations for crucial areas like price control and availability of essential medicines during emergencies. Vaccine development, procurement, and distribution are similarly left without a legal framework. Safe disposal of infectious medical waste, a significant health risk during outbreaks, is also not addressed by the Act. Finally, there's no legal framework for ensuring effective and accurate public communication during public health emergencies. These limitations underscore the urgent need for a more comprehensive and up-to-date legal framework to manage public health emergencies in India effectively (Government of India, Law Commission Report No. 286, A Comprehensive Review of Epidemic Diseases Act, 1897). Key Features of the Bill The Public Health Bill, 2017 aimed to create a comprehensive framework for managing public health emergencies. It established clear definitions for key terms like "public health emergency" and "bioterrorism.[1]"  A national public health surveillance system was mandated for early detection of outbreaks, along with empowering local authorities to implement control measures like quarantines. Bioterrorism preparedness was addressed with specific investigation and decontamination procedures. The bill emphasized collaboration between government departments and community engagement through clear communication strategies. Public health rights, likely including access to information and healthcare during emergencies, were also part of the bill's vision. The envisioned four-tier health system would be crucial for implementing the Public Health Bill effectively. This system comprises village clinics as the first point of contact in rural areas, followed by community health centers offering comprehensive primary care. District hospitals with specialized services would act as referral points for these centers. Finally, medical colleges and regional specialty hospitals located in major cities would provide advanced medical care, conduct research, and train healthcare professionals. These features combined aimed to significantly improve India's preparedness and response capabilities for future public health threats. [1] Section 2 of Public Health (Prevention, Control and Management of Epidemics, Bio-terrorism and Disasters) Bill, 2017 Challenges and Concerns: The 2017 Public Health Bill, despite its promise, faced hurdles. Striking a balance between the central government's authority and the power of individual states in managing healthcare emergencies would have been a critical challenge. Additionally, implementing the bill's measures would have required substantial investments in public health infrastructure and training a robust workforce. Finally, concerns regarding civil liberties arose. The bill would have needed to carefully consider how to ensure effective public health interventions during outbreaks while safeguarding individual freedoms. The Bill's Fate and Its Legacy The Public Health Bill of 2017, despite its promise, never made it to Parliament. The government's focus shifted towards strengthening primary healthcare through other initiatives. Additionally, the initial concerns about bioterrorism that spurred the bill's creation may not have materialized as significantly as anticipated. While the bill might have needed further refinement regarding federalism and individual liberties, its legacy remains important. It underscored the need for a strong legal framework to manage public health emergencies and provided valuable insights for future legislation. The discussions around public health preparedness continue, especially with the lessons learned from the COVID-19 pandemic informing potential reforms. Despite its potential benefits, the Public Health Bill has not been introduced in Parliament. Concerns regarding the broad powers granted to authorities and potential infringement on individual liberties have stalled its progress. Moving forward, it's crucial to address these concerns through proper safeguards within the bill. Open discussions with public health experts, legal professionals, and the public are essential to refine the bill for reintroduction. By adapting the provisions to reflect contemporary public health needs and incorporating necessary safeguards, India can move towards a more robust legal framework for managing public health emergencies and protecting the well-being of its citizens.