Supreme Court Directs Action on Leprosy: Ensuring Dignity and Eradication (2018)

Date of the Judgment: 14 September 2018

Citation: Not Available

Judges: Dipak Misra, CJI, A.M. Khanwilkar, J., Dr. D.Y. Chandrachud, J.

Can a curable disease still cause social ostracization and discrimination? The Supreme Court of India addressed this critical question in a Public Interest Litigation concerning the rights of individuals affected by leprosy. The court sought to ensure that those affected by leprosy are treated with dignity and equality, directing the Union and State governments to take concrete actions to eliminate the stigma associated with the disease and provide necessary support. The judgment was delivered by a three-judge bench comprising Chief Justice Dipak Misra, Justice A.M. Khanwilkar, and Justice Dr. D.Y. Chandrachud.

Case Background

The writ petition was filed under Article 32 of the Constitution of India, seeking directions to the Union of India and various States to address the issues faced by people affected by leprosy. The petitioner highlighted the social stigma, discrimination, and lack of proper healthcare and rehabilitation facilities for leprosy patients despite the disease being curable with Multi-Drug Therapy (MDT). The petition also raised concerns about the non-publication of the National Sample Survey on Leprosy conducted in 2010-2011 and the lack of awareness campaigns.

The petitioner sought several reliefs, including:

• ✓ Conducting periodic national surveys to determine new leprosy cases.
• ✓ Publishing reports of the National Sample Survey on Leprosy.
• ✓ Conducting regular awareness campaigns to dispel fear and stigma.
• ✓ Ensuring free availability of MDT drugs at all Primary Health Centres (PHCs).
• ✓ Preventing discrimination against women with leprosy in hospitals.
• ✓ Ensuring free education for children from leprosy-affected families.
• ✓ Providing hygienic conditions in leprosy colonies.
• ✓ Providing free MCR footwear to leprosy-affected persons.
• ✓ Framing separate rules for evaluating disabilities suffered by leprosy-affected persons under the Rights of Persons with Disabilities Act, 2016.

Timeline

Course of Proceedings

The Supreme Court heard the matter on multiple occasions, issuing several interim orders. Initially, the Court sought data from the Union and State governments regarding leprosy cases and the availability of treatment. The Court also considered the recommendations of the Law Commission of India, which had advocated for the repeal of discriminatory laws against leprosy patients. The Court also took note of a previous decision in Dhirendra Pandua vs. State of Orissa and Others [(2008) 17 SCC 311], where the court had acknowledged the curability of leprosy and the need to reconsider outdated laws. The Court also sought assistance from the Attorney General for India to formulate comprehensive measures.

Legal Framework

The petition was filed under Article 32 of the Constitution of India, which grants the Supreme Court the power to issue directions or orders for the enforcement of fundamental rights. The Court also considered the Rights of Persons with Disabilities Act, 2016 (No. 49 of 2016), particularly regarding the evaluation of disabilities suffered by leprosy-affected persons. The Court also referred to the 256th Report of the Law Commission, which recommended the repeal of the Leprosy Act and other discriminatory laws that violate Articles 14, 19(1)(d), 19(1)(g), and 21 of the Constitution of India. The Law Commission emphasized the need to eliminate discrimination against persons affected by leprosy and their families.

Arguments

Petitioner’s Submissions:

• ✓ Despite the availability of Multi-Drug Therapy (MDT) since 1981, which can cure 99% of leprosy bacteria, the disease continues to affect a significant number of people due to government apathy.
• ✓ Lack of awareness and non-concern by authorities have led to the ostracization of leprosy patients from society.
• ✓ Leprosy patients are denied education, sanitary benefits, and community-based rehabilitation, forcing them into the streets or leprosy homes.
• ✓ There is a need for proper administration of drugs, treatment for pregnant women, and non-discriminatory practices in educational institutions.
• ✓ The National Sample Survey on Leprosy conducted in 2010-2011 has not been made public.
• ✓ Improper dispensation of MDT drugs through PHCs and lack of sensitivity by PHC staff have perpetuated the stigma.
• ✓ Discriminatory treatment by government hospitals towards leprosy-affected pregnant women is prevalent.
• ✓ Lack of adequate education facilities magnifies the sense of insecurity and stigma.
• ✓ Leprosy-affected individuals are often provided APL cards instead of BPL cards, depriving them of benefits under government schemes.
• ✓ There is a lack of housing, basic civic amenities, and rehabilitation programs.

Respondent’s Submissions:

• ✓ The Union of India assured the Court that it would provide the necessary data and reports.
• ✓ The Union of India and the States acknowledged the curability of leprosy and the need for progressive steps.
• ✓ Some States highlighted rehabilitation programs for leprosy patients and the availability of medicines.
• ✓ The Attorney General for India emphasized the need for awareness campaigns and affirmative laws to confer rights and benefits on leprosy patients.

Issues Framed by the Supreme Court

The Supreme Court did not explicitly frame issues in a separate section, but the following issues were implicitly addressed:

1. What measures should be taken to ensure the rights and dignity of persons affected by leprosy?
2. How to eliminate the social stigma and discrimination associated with leprosy?
3. What steps should be taken to ensure the availability of proper healthcare, education, and rehabilitation facilities for leprosy patients?
4. How to ensure the effective implementation of the National Leprosy Eradication Programme (NLEP)?
5. What actions are needed to address the discriminatory practices faced by leprosy patients in hospitals and schools?

Treatment of the Issue by the Court

Authorities

Cases Relied Upon:

• ✓ Dhirendra Pandua vs. State of Orissa and Others [(2008) 17 SCC 311] – The Supreme Court acknowledged the curability of leprosy and the need to reconsider outdated laws.

Legal Provisions Considered:

• ✓ Article 32 of the Constitution of India – Grants the Supreme Court the power to issue directions or orders for the enforcement of fundamental rights.
• ✓ Rights of Persons with Disabilities Act, 2016 (No. 49 of 2016) – Considered for framing separate rules for assessing the disability quotient of leprosy-affected persons.

Other Authorities:

• ✓ 256th Report of the Law Commission – Recommended the repeal of the Leprosy Act and other discriminatory laws.

Judgment

How each authority was viewed by the Court?

• ✓ Dhirendra Pandua vs. State of Orissa and Others [(2008) 17 SCC 311]: The Court took note of the progress made in the field of science and technology and the curability of leprosy.
• ✓ Article 32 of the Constitution of India: The Court used this provision to issue directions to the Union and State governments to protect the fundamental rights of persons affected by leprosy.
• ✓ Rights of Persons with Disabilities Act, 2016: The Court directed the Union Government to consider framing separate rules for assessing the disability quotient of leprosy-affected persons under this Act.
• ✓ 256th Report of the Law Commission: The Court relied on the recommendations of the Law Commission to address the discriminatory laws and practices against leprosy patients.

What weighed in the mind of the Court?

The Supreme Court was deeply concerned about the social stigma and discrimination faced by people affected by leprosy, despite the disease being curable. The Court emphasized the need for a multi-pronged approach involving awareness campaigns, proper healthcare, education, and rehabilitation. The Court was also influenced by the recommendations of the Law Commission and the need to ensure the fundamental rights of all citizens, including those affected by leprosy.

Logical Reasoning:

The Court considered the medical evidence that leprosy is curable and not highly contagious. It also considered the social and economic impact of the stigma associated with the disease. The court rejected the notion that leprosy patients should be isolated or discriminated against. The final decision was reached by considering the fundamental rights of all citizens and the need to ensure equality and dignity for all.

The Court stated, “It is inconceivable as it affects the human dignity and the basic concept of humanness.” The court also noted, “The fact that India is home to the most number of Persons affected by Leprosy in the world is a matter of deep shame.” Further, the Court emphasized, “The proposed Bill is an important step in eliminating the social discrimination faced by such persons, a necessary precursor to their reintegration into society.”

Key Takeaways

• ✓ The Union and State governments must conduct periodic national surveys to determine the prevalence of leprosy and publish the results.
• ✓ Massive awareness campaigns are essential to educate the public about the curability of leprosy and dispel associated myths and stigma.
• ✓ Multi-Drug Therapy (MDT) drugs must be available free of cost at all Primary Health Centres (PHCs) and public health facilities.
• ✓ Leprosy treatment should be integrated into general healthcare, with no discrimination against leprosy patients in hospitals.
• ✓ Children from leprosy-affected families should not be discriminated against and should be provided free education.
• ✓ Leprosy patients should be issued BPL cards to avail benefits under government schemes.
• ✓ MCR footwear should be provided free of cost to leprosy-affected persons.
• ✓ Rehabilitation schemes should be formulated and implemented to provide assistance to leprosy patients.
• ✓ The Union Government should consider framing separate rules for assessing the disability quotient of leprosy-affected persons under the Rights of Persons with Disabilities Act, 2016.

Directions

The Supreme Court issued the following directions:

1. The Union and States are to undertake periodic national surveys for determining the prevalence rate and new cases detection rate of leprosy and publish the reports of the National Sample Survey of Leprosy.
2. The Union of India along with all State Governments should organize massive awareness campaigns on leprosy day (last Sunday of January) and throughout the year.
3. The Union and the States are to ensure that drugs for management of leprosy and its complications, including MDT drugs, are available free of cost at all Primary Health Centres (PHCs).
4. The Union and the States must organize seminars at all levels to hear the views and experiences of former patients, doctors, social workers, and government officials.
5. Health care to leprosy patients, at both Government and private run medical institutions, must be such that medical officials and representatives desist from any discriminatory behaviour.
6. Patients affected with leprosy, for whom partial deformity can be corrected by surgery, should be advised and provided adequate facility and opportunity to undergo such surgeries.
7. The possibility of including leprosy education in school curricula should be explored.
8. The Union and the State Governments must ensure that both private and public schools do not discriminate against children hailing from leprosy affected families and provide them free education.
9. Due attention must be paid to ensure that the persons affected with leprosy are issued BPL cards.
10. The Union and the States should endeavour to provide MCR footwear free of cost to all leprosy affected persons in the country.
11. The States together with the Union of India should consider formulating and implementing a scheme for providing at least a minimum assistance to all leprosy affected persons for rehabilitation.
12. The Union and the State Governments must pro-actively plan and formulate a comprehensive community-based rehabilitation scheme.
13. The Union Government may consider framing separate rules for assessing the disability quotient of the leprosy affected persons for the purpose of issuing disability certificate in exercise of the power granted under the Rights of Persons with Disabilities Act, 2016.

Development of Law

The judgment reinforces the principle of non-discrimination and the right to live with dignity, particularly for marginalized communities. It emphasizes the state’s duty to ensure that all citizens, including those affected by leprosy, have access to healthcare, education, and rehabilitation. The judgment also highlights the need for a multi-pronged approach to address the social stigma associated with leprosy, including awareness campaigns, integration of leprosy treatment into general healthcare, and sensitization of healthcare personnel. This judgment also reinforces the need to follow the recommendations of the Law Commission.

Conclusion

The Supreme Court’s judgment in Pankaj Sinha vs. Union of India and Others is a landmark decision that seeks to address the deep-rooted issues of stigma and discrimination faced by people affected by leprosy. By issuing a series of comprehensive directions to the Union and State governments, the Court has paved the way for a more inclusive and equitable society where leprosy patients can live with dignity and have access to the necessary resources for their treatment and rehabilitation. The Court’s emphasis on awareness, non-discrimination, and proper healthcare is a significant step towards eradicating the social stigma associated with leprosy and ensuring the fundamental rights of all citizens.

Category

Parent Category: Public Interest Litigation

Child Categories:

• ✓ Rights of Persons with Disabilities
• ✓ Social Justice
• ✓ Healthcare
• ✓ Fundamental Rights
• ✓ Article 32, Constitution of India
• ✓ Rights of Persons with Disabilities Act, 2016

FAQ

Q: What is the main issue addressed in this Supreme Court judgment?

A: The judgment addresses the social stigma, discrimination, and lack of proper healthcare and rehabilitation facilities faced by individuals affected by leprosy, despite the disease being curable.

Q: What are the key directions given by the Supreme Court?

A: The Court directed the Union and State governments to conduct periodic national surveys, organize awareness campaigns, ensure free availability of MDT drugs, prevent discrimination in hospitals and schools, provide free education, issue BPL cards, provide MCR footwear, formulate rehabilitation schemes, and consider separate rules for assessing disability.

Q: What is Multi-Drug Therapy (MDT)?

A: MDT is a combination of drugs used to treat leprosy, which is highly effective in curing the disease.

Q: What is the significance of the National Leprosy Eradication Programme (NLEP)?

A: NLEP is a government program aimed at eliminating leprosy. The Court directed wide publicity of NLEP activities and free treatment under this program.

Q: How does this judgment impact people affected by leprosy?

A: This judgment aims to ensure that people affected by leprosy are treated with dignity, have access to healthcare, education, and rehabilitation, and are not discriminated against in society. It also mandates the government to take action to eradicate the stigma associated with the disease.

Q: What is the role of the Law Commission in this judgment?

A: The Court relied on the recommendations of the Law Commission, which had advocated for the repeal of discriminatory laws against leprosy patients.