India is currently tackling the COVID-19 pandemic based on regulations derived from the Epidemic Diseases Act 1897 – a legislation that was formulated over a century ago. 123 years ago to be precise. The two-page legislation was hurriedly passed on February 4, 1897 by the British when the bubonic plague struck India and killed thousands.
With astronomical advances in the field of medicine – indeed, in every field, over the last 123 years, the Epidemic Diseases Act 1897 is outdated. It’s so outdated, that the act mentions quarantine of persons at ‘ports’ in the country – but makes no mention of buses or trains, and definitely no aircraft or metro. It does not mention anything about the medical facilities that the government needs to set up to tackle epidemics.
Since health is a state subject, respective state governments gazetted a list of regulations to be followed in tackling the COVID-19 pandemic. And although state governments have been enforcing stringent regulations to curb the spread of novel coronavirus in the country, experts argue that the country needs a new legislation that fits the modern times as a “lesson from the struggles of the COVID-19 outbreak.”
Protocols for quarantine
Speaking to TNM, Dr Dileep Malavankar, Public Health Management expert at the Indian Institute of Public Health, says that one of the things lacking in the current legislation is the lack of clarity on protocols related to movement of persons in the wake of a pandemic.
“State governments have had to issue orders to lockdown public places. If there is a legislation already in place with all these aspects in it, it will automatically come into effect when there is an epidemic outbreak. There needs to be protocols on task forces, transportation of samples, and more testing facilities,” he says, adding that the spread of an epidemic or pandemic can be stopped if local authorities are given powers to monitor who comes in and goes out of the state during a prescribed period, that is necessary to curb the spread.
“In many cases of COVID-19 in India, there is a pattern of people going to different places. When police follow up on addresses, it is the permanent ones on the IDs. Many people have moved cities and their permanent addresses are different. Those people who have to be quarantined must check or report to local health authorities or the police before they leave town during an outbreak. This way, it can be easier to track people. A new legislation should list down methods to trace contacts, and the curbs to be put in place to make it easier,” he explains.
He further says that there have to be protocols about releasing information about people who have been infected keeping in mind the stigma they could suffer.
No movement in forming a comprehensive new legislation
In 2008, the government of India brought in the Management of Biological Disaster Guidelines, when the government was looking at a framework to tackle bio-terrorism. These guidelines were framed as the government realised that the Epidemic Diseases Act was inadequate.
During the first term of the UPA, the Public Health Emergencies Bill was drafted. It faced opposition from state governments as the draft bill gave more powers to the Centre in matters of health, which is a state subject. The draft bill was then junked.
In 2017, the Modi government introduced the Public Health (Prevention, Control and Management of Epidemics, Bio-terrorism and Disasters) Bill 2017, and proposed to repeal the 1897 act. This new legislation, too, gave powers to the Centre rather than state governments and was put in cold storage.
Need for a legislation that mandates adequate infrastructure
“We have a National Disaster Management Plan that was formed in 2019, which is detailed. This is what governments across states have been following now,” a senior Health Department official in Karnataka says, adding that we need something similar to tackle epidemics and pandemics.
Speaking to TNM, T Sundaraman, former Dean of the School of Health System Studies says that the biggest problem India is currently facing in the wake of the coronavirus pandemic is the lack of infrastructure to effectively treat and manage epidemics.
“Since independence, our governments have focused on providing primary-level health care. We lack infrastructure to tackle pandemics. If we had a legislation to handle epidemics, it would become mandatory to set up tertiary-level care at hospitals. These would include the manpower to operate medical equipment, training of these people who handle such equipment, and most importantly, the presence of adequate infrastructure. The old act does not list any of these things,” Sudaraman says.