Public health policy continues to be governed by British law

It was in 2007 that the first concerted effort was made to amend the Public Health Act of 1939 in order to make it more relevant to contextual needs of a changed world.

These draft amendments, approved by a specially-appointed committee, are yet to be incorporated into the Act.

As a result, the old Act, known as the Death Relief Act, drawn up during pre-Independence times, continues to govern public health policy in the State. Having a modern law is all the more significant in Tamil Nadu which is the only State in the country to continue to maintain a dedicated cadre for public health activities.

“The draft amendments were suggested and ratified by an expert committee, way back in 2007. The exercise was taken up as it was believed to be essential to bring the public health governance to meet the challenges of changing urban/rural scenarios and the latest scientific interventions,” says S.Elango, former director of Public Health.

He was the member-secretary of the group that went into the amendments.

Law plays a very important role in public health, the preamble to the draft amendments says.

It is particularly effective in ensuring effective regulation particularly in times of epidemics, and disease break-outs, besides legislating to ensure basic, minimum hygiene and sanitation facilities in public and private settlements.

Changing global scenario

Besides, with the changing world order and newer forms of transmission of diseases (with increased global travel), new disease-causing vectors, emerging resistant strains, and better forms of treatment, it is essential that a progressive State like Tamil Nadu to be at the forefront, Dr. Elango adds.

“Population dynamics, migration, changes in climate, lifestyle changes and the developments in the transport system are the major causes of epidemics and pandemic threats,” are reasons enough for the amendment, members of the Working Committee noted.

The Hindu's story on the proposed amendments was carried on April 18, 2008

(http://www.hindu.com/2008/04/18/stories/2008041860360900.htm)

Renewed efforts promised

The amendments are pending with the government for clearance, according to official sources. They acknowledge that not much effort had been put into pushing the amendments, but add that renewed efforts will be made in the future.

“In fact, the governments of Maharashtra, Gujarat, and Karnataka had asked us for copies of the Act, as they were impressed by the comprehensive nature of the proposals. It was touted to be a progressive model, the possibility of replicating it in other states was to be examined,” Dr. Elango adds.

Regulation of construction norms to prevent breeding of mosquitoes (for a State in which several areas remain endemic to malaria and filariasis), mandating reportage of infectious diseases, and imposing strict penalties for violation of the provisions of the Act, are some of the key recommendations that are expected to make a difference to the State.

Waste disposal

Proper disposal of plastic wastes and bio medical wastes have also been specified.

The inability to impose strict penal conditions on violations has always impeded the implementation of the Act, public health officials feel. For instance, under the Act, fines range between Rs. 10 and a maximum of Rs. 200.

“People get away scot-free despite gross violations which cause public health hazards in the community, simply because the fine amount is really low. If the amendments are implemented, then the fine amount could be as high as Rs. 1 lakh.”