Constitutional Basis of Public Health

The Constitution makes protection of health a responsibility of the Indian State through fundamental rights, Directive Principles and the distribution of legislative powers. Public health is primarily administered by states, but the Union, states and local bodies have constitutionally assigned roles.

Right to life and Directive Principles

The enforceable foundation is Article 21, whose guarantee of life and personal liberty has been interpreted by the Supreme Court to include the right to health and timely medical care. The Directive Principles provide more specific responsibilities, although Article 37 makes them non-justiciable while declaring them fundamental in governance.

• Article 47 identifies improvement of public health as a primary duty of the State, alongside raising nutrition and living standards; it also directs action against intoxicating drinks and drugs injurious to health, except for medicinal purposes.
• Article 39(e) requires protection of workers' health and strength and children's tender age against abuse.
• Article 41 addresses public assistance in sickness and disablement, subject to the State's economic capacity and development.
• Article 42 directs the State to secure humane working conditions and maternity relief.

Distribution of legislative responsibility

Under Article 246 and the Seventh Schedule, health responsibilities are distributed across different levels of government rather than assigned exclusively to one authority.

• State List Entry 6 covers public health and sanitation, hospitals and dispensaries.
• Union List Entry 28 covers port quarantine, while Entry 81 covers inter-state quarantine.
• Concurrent List Entry 29 covers prevention of the inter-state spread of infectious or contagious diseases and pests affecting humans, animals or plants.
• Concurrent List Entry 20A covers population control and family planning.

Role of local governments

Articles 243G and 243W permit state legislatures to endow Panchayats and Municipalities with powers relating to scheduled subjects.

• The Eleventh Schedule includes health and sanitation, hospitals, primary health centres and dispensaries.
• The Twelfth Schedule includes public health, sanitation, conservancy and solid-waste management.