*Trigger Warning: Covid Death*
The biggest constitutional value of any democratic society is protecting the lives of its people. Health and medical assistance are some of the most basic tenets of a dignified human life. Various endemics and pandemics have been a part of civilisation like measles, smallpox, cholera, dengue and even the ongoing Covid-19 pandemic. Every health emergency like this requires an adequate health infrastructure to combat it.
Health is an inevitable part of the right to life of an individual. The right to health amidst many human rights is one of the most valuable rights for citizen. It is the right that has to be granted regardless of the socio-economic status of a particular person. Preservation of human life is of paramount importance.
Health and life go hand in hand. As the right to life is the heart of all fundamental rights, the right to health remains the heart of the right to life. It is one such right that has to be ensured to everyone in every circumstance. The right to health is a non-derogable and inalienable right.
The Supreme Court in Paschim Banga Khet Mazdoor Samity vs. state of West Bengal rightly held that health and medical aid were part of the fundamental rights. From this, we can sense the sensitivity of this right, and thus, its importance.
Role of the State in Protecting Right to Health
Protecting the sanctity of an individuals life is the first responsibility of the state. In India, health is a subject of state and any public policy needed for health is the state’s responsibility. However, the centre is overwhelmingly responsible for the policy responses like lockdown, national/international travel restrictions, testing, availability of drugs, criteria for global procurement of emergency supplies, etc.
Article 21 of the Indian Constitution casts the obligation upon the state to preserve life. Therefore, while addressing Covid-19, the systematic application of the right to health to public health policies is quintessential.
India has a public-private partnership model in health infrastructure. The ongoing National Health Policy (NHP) of 2017 has the “health in all” approach and is based on the principles of universality, affordability, equity and patient-centric cure. This policy’s main objectives included:
- Reinforcing people’s trust in the public healthcare system.
- Aligning the private healthcare sector’s growth with public health goals and the quantitative goals.
- Progressively achieving universal health coverage (UHC).
The ongoing pandemic is the best time to analyse the extent of implementation of NHP 2017. As the country got struck with the pandemic in December 2020, the state and the central government took various measures to check the spread of the virus. Unfortunately, these measures were ill-planned and ill-timed and the result is that we are badly engulfed by the second wave.
The first wave at least didn’t affect the rural areas, which have even worse healthcare facilities. The second wave has engulfed the entire country, even the illiterate, unequipped areas of rural India.
People are begging all around, searching for leads to arrange ventilator beds, oxygen and critical drugs. Oxygen has become a scarce commodity and many are turned down just because of the non-availability of beds. The supreme court expanded the right to life as not just mere animal existence but dignified human life.
Leave dignified life at this point of time; even mere survival is a victory. The second wave has exposed the glaring gaps between the health infrastructure and government preparedness to deal with the virus. In 2020 itself, the WHO had stated in its Covid-19 report that 5% of total cases needed ventilator support, and around 15% of total tested positive cases needed hospital care.
Even the health workers had hinted towards a shortage of oxygen and even critical situations as Covid-19 caused Acute Respiratory Distress Syndrome (ARDS) and high mortality rate. Even after all these warnings, the government was seen napping and the aftermath is the panicked hunt for hospital beds, chronic underfunding and shortage.
And due to shortages and non-availability, there is an unreasonable and unprecedented hike in prices of everything. At the same time, private hospitals charging an unexpected amount is not uncommon. All this has made our lives miserable. As initiatives began for oxygen generating units, the central government took months to tender the project.
The centre approved 162 plants, and today, after 6 months, only 35–36 oxygen generating units are installed. The deaths that are recorded and the data that comes from the crematorium show entirely different pictures. This is a testimonial to the fact that not just the unavailability of beds, ventilator and oxygen, we are also lagging in testing.
We are failing at every stage, from testing to critical drugs to ventilators. The government’s inactivity has taken the lives of many. Vaccination in most states is free at government hospitals, but here again, we are lagging in availability and supply, which puts a big question mark on our public policies.
All this is a clear indictment of the government, but it is not even thinking to take moral responsibility for all the havoc. The crinkling health infrastructure of our nation is clearly a compromise on the right to health.
Judiciary, Right to Health and the Pandemic
High courts have come forward to protect the right to health of people during Covid-19 as what is expected from a vibrant judiciary. The Delhi high court strictly said that either beg, borrow or steal but provide oxygen. This is evidence of the fact how important our right to health is.
After the orders, the government came into action and airlifted oxygen generators and other supplies from abroad. Also, customs duty has been removed from the import of vaccines and oxygen. The Delhi high court also well established the seriousness of the scenario by stating that they won’t mind hanging anyone obstructing the oxygen supply.
Even after these strong statements of the Delhi high court, the state is not seen implementing the orders or understanding the seriousness of the issue. The hospitals in Delhi required 400 metric tonnes of oxygen but were supplied with 292 metric tonnes only.
The Allahabad high court was also observed calling out the state for these critical situations, including the higher courts and the election commission.
In its judgement In re inhumane conditions at quarantine centres pointing clearly towards elections during the pandemic, the court stated the Election commission, the Higher courts and the government failed to fathom the disastrous consequences of permitting election in few states and Panchayat elections in U.P. at the time of pandemic are definitely a compromise with the right to health of people of the areas, specifically with the right to health of polling officers who didn’t volunteer but under an obligation performed duty during elections even after reluctance.
The cost of these elections during Covid was the lives of 700 deaths of teaching staff in UP elections.
The Supreme Court ordered the release of prisoners to decongest jails amidst the pandemic. But the government is seen as inactive and unconcerned in this case as well. Jails lack proper care of hygiene, sanitisation and medical facilities. And we are time and again seeing the news of prisoners testing positive to covid, in critical situations and still not released.
Trials, investigation and arrests will make no sense if the accused do not remain alive. The most horrendous and inhumane case which I am aware of is that of Siddique Kappan (for the unversed, he is in jail for attempting to cover the Hathras gang rape case). He tested positive for Covid-19, has diabetes and other serious medical issues, but neither was released from jail nor given proper medical aid and food.
There are many Kappans in various jails of India. One must definitely note that even the prisoners, those under trial, everyone has their right to health.
Recently more than 100 dead bodies were seen floating in the river Ganga. There’s a serious discrepancy and underreporting of deaths. Where are we heading to? The state is still in a mode of denial and constantly denying these eye-opening instances and relying upon faulty data.
Thanks to our judiciary, it understands the sensitivity of the issue and is constantly giving orders uplifting the right to health of every individual during the pandemic.
Under the NHP 2017, various efforts have been made by the government to ensure the universalisation of healthcare facilities. But the pandemic has proved that we still have an inadequate health infrastructure. The public sector still has medical professionals’ inadequacy like doctors, nurses and paramedics.
The private sector has a better situation, but their costs are high and unaffordable for the majority rural and middle-class Indian population.
The Covid-19 pandemic has bought a clear picture that our health infrastructure and population are not congruent. Human life is impossible unless there’s a right to life. The heart of the right to life is the right to health and it’s the states foremost responsibility to preserve this right.