Tuberculosis is one of the most dreaded disease due to it’s nature of spread, morbidity and mortality. It attacks the host body wherever immune system is weak be it HIV infection, age specific vulnerability, comorbidity or history of tobacco consumption or alcohol. India accounts for more than one fourth TB disease burden and mortality. This necessitated to accelerate the revised national tuberculosis control programme to reframed to national tuberculosis elimination programme.
To assess the progress made and take corrective measures 2015 has been taken as a base year to track the progress. Central TB Division developed National Strategic Plan that gives a roadmap for the period of 2017-2025. The four broader pillars of strategy are detect, treat, prevent and build. Under these broader themes, Govt. affirms its commitment to provide free diagnostic services and ATT drugs for treatment to reduce morbidity and mortality with aim to reduce catastrophic cost due to tuberculosis.
In addition to this, Govt. extended direct benefit transfer of Rs. 500 per month to all notified TB patients during the course of treatment which has been further increased to Rs. 1000 per month from 1st November 2024. The years bygone has marked expansion of diagnostic services especially molecular testing and extending the programme upto Panchayat level with commitment to make TB Mukt Panchayat.
However, there are various shortcomings that need to be addressed before generating demand for services as it will lead to make the vulnerable more miserable and helpless. The current programme has limited supply of ATT drugs, consumables and often delay in release DBT payment for nutritional support.
This paper will evaluate the legal dimensions and framework to understand the ambit and scope of Article 21 and Article 47 to understand Govt. liability for non-supply of ATT drugs, delay or non-payment of DBT. Failure to provide anti-TB services to the citizens attracts Article 21 harmoniously read with Article 47 that mandates Govt. to provide timely drugs, DBT under nutritional support because in absence of treatment there are chances of affected person to have severity of disease that may lead to death. The failure to commitment to provide services for TB is tortuous in nature and covers law of tort. Failure owing to negligent and callous behaviour of the TB Officials draws both criminal (IPC 304 A, 166 & 269) and civil liability and hence makes both Central and State Govt. accountable. TB patients who suffer due to shortages of ATT drugs or delays in DBT payments can file claims for damages against the state. Under IPC Section 304A, death of a person caused due to negligent act is punishable under Indian Criminal law. The Govt. authority having the knowledge of TB burden in their respective jurisdiction and not taking any corrective action to provide timely treatment to TB patients may be brought before Court of law if the death occurs due to non-availability of ATT drugs. At the same time, due to shortage of drugs and non-compliance to treatment due to shortage of drugs shall invoke section IPC 269 causing spread of infectious diseases due to negligent act of not providing committed ATT drugs. Criminal action against officials who knowingly allow shortages, PILs under Article 32/226, and right to compensation for affected patients.
Proper assessment, forecasting and allocation of budget for programme under DBT and judicial oversight are essential to preserve the fundamental right to health. The delay in taking corrective measures shall make the plight more worrisome and prolong TB crisis and erode away the right guaranteed under Constitution. It is suggested to create of fast-track health rights tribunals and judicial monitoring of TB control programs through Supreme Court directives.
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