TB was made notifiable in 2012 but non-compliance was not treated as a criminal offence
In a move that will have far-reaching consequences for India’s fight against TB, the Union health ministry has made it a criminal offence punishable with a jail term of 6 months to two years for clinical establishments, phamacies, chemists and druggists to not notify TB cases.
Tuberculosis was made a notifiable disease in 2012 but there was so far no criminal intent attributed to not doing so. Clinical establishments as per definition in the Clinical Establishments Act 2010 that has been referred to in the latest notification, include hospitals, nursing homes, clinics including those operated by a single doctor.
Prime minister Narendra Modi has vowed that India will end TB by 2025, five years ahead of the global deadline of 2030. TB kills an estimated 480,000 Indians every year and more than 1,400 per day
The ministry on Tuesday evening issued the notification under which non-reporting of TB cases to the local public health authorities by “Clinical Establishment, Pharmacy, Chemist and Druggist” would be treated as a criminal offence under the provisions of sections 269 and 270 of the Indian Penal Code (45 of 1860). This is what the two sections say:
269. Negligent act likely to spread infection of disease dangerous to life. – Whoever unlawfully or negligently does any act which is, and which he knows or has rea-
son to believe to be, likely to spread the infection of any disease dangerous to life, shall be punished with imprisonment of either description for a term which may extend to six months, or with fine, or with both.
270. Malignant act likely to spread infection of disease dangerous to life. – Whoever malignantly does any act which is, and which he knows or has reason to believe
to be, likely to spread the infection of any disease dangerous to life, shall be punished with imprisonment of either description for a term which may extend to two years,
or with fine, or with both.”
Prime minister Narendra Modi has vowed that India will end TB by 2025, five years ahead of the global deadline of 2030. TB kills an estimated 480,000 Indians every year and more than 1,400 every day. India also has more than a million ‘missing’ cases every year that are not notified and most remain either undiagnosed or unaccountably and inadequately diagnosed and treated in the private sector.
However for the accelerated deadline to be achieved, it is imperative for India to break the transmission cycle. Mandatory notification was supposed to ensure that as well as better adherence to the drug regimen but the missing cases show that compliance levels are still not good. Lack of notification also raises the prospect of drug resistance as patients who are not in the surveillance loop tend to drop out without completing the full dose of anti – TB medications causing the bacteria to develop resistance, necessitating more and more advanced generations of antibiotics to be used.
