This article is written by Soumya Shefali Chandrakar, a first-year law student of Hidayatullah National Law University.
Table of Contents.
- The Epidemics and pandemics in India
- 19th century
- 20th century
- 21st century
- History of the 1897 Epidemic Disease Act
- Provisions of the 1897 Epidemic Disease Act
- Examples of implementation
- Implementing the Epidemic Disease Act to tackle COVID-19
- Limitations of the act
- The Epidemic Disease (amendment) Ordinance 2020
The public health and sanitation are included within the state list. However, India’s central government and state government both are empowered to manage health related matters. Short while ago, many Indian States have put into effect various provisions of the Epidemic disease act of 1897. These regulations have been rolled out in response to the COVID-19 Pandemic, as the number of cases is increasing in an alarming rate. The epidemic disease act is the main legislative framework for the prevention of transmission of dangerous epidemic diseases. The act enables the central government to take indispensable measures to deal with dangerous epidemic diseases. The act also allows the states to take essential measures, make required changes and formulate regulations to deal with epidemics within their state jurisdictions.
India has come across many large outbreaks of emerging and re-emerging infectious disease in the recent past. Hence, it is important to critically evaluate the epidemic disease act 1897, and its importance in the current context.
The epidemics and pandemics in India.
India has witnessed various epidemics and pandemics all over history. Given below are such outbreaks known to have occurred in the 19th – 21st century and are arranged in accordance to chronology.
1st cholera pandemic (1817):
This is considered to be the first major epidemic of the 19th century in British-Colonized India and was described as probably the most terrifying of all. The first case was reported on 23rd August 1817.
2nd cholera pandemic (1829):
The second outbreak started around 1826 from Bengal and spread through the rivers to various parts of Northern India.
3rd cholera pandemic (1852):
This third cholera pandemic started around 1852 and lasted till the late 1860s.
4th cholera pandemic (1863):
This began around 1863. This infection was spread from Mecca to several countries. The Kumbh mela at Haridwar in April 1867 has been considered to be responsible for the epidemic spread of cholera in Northern India. The Madras presidency in 1877 was the worst hit and the cholera epidemic was responsible for about 10% of the annual mortality rate.
5th cholera pandemic (1881):
The fifth cholera pandemic was considerably less fatal as compared to the previous four. It was during this pandemic (1881-1869) that Robert Koch proved that cholera was transmitted through the fecal-oral route after studying the outbreak in Calcutta and Egypt.
Bombay plague epidemic (1896):
This plague began in September 1896 in colonial Bombay creating a lot of social and political frenzy. The rapid growth of commerce in Bombay led to an increase in population and thereby overcrowding. The anti-plague campaign was started to battle this epidemic. The plague killed thousands and many people were forced out of the city.
6th cholera pandemic (1899):
The sixth cholera pandemic began around 1899 and major outbreaks were noted in Bombay, Calcutta and Madras. While the infection throughout the 20th century was caused by O1 serotype of Vibrio cholera and confined mostly through the Asian Subcontinent, the sixth cholera pandemic brought about surprising challenges. This cholera infection was caused by an unknown, non-O1 serotype of V. cholera and spread to many distinct countries including United States.
Influenza pandemic (1918):
This is also known as the Spanish flu 0f 1918-19. This has been known to have caused around 20-50 million deaths worldwide and is considered as most devastating. This was caused by H1N1 strain of influenza and was severe.
Polio epidemic (1970-1990):
India was the worst affected by polio among the developing countries until the late 1990s.
Smallpox epidemic (1974):
It is known as one of the worst small pox epidemics of the 20th century. India contributed to about 85% of this epidemic worldwide. Small pox was eradicated in by the World Health Organization (WHO) small pox eradication program. It was the first disease to be combated globally and was declared eradicated by WHO in 1980.
Surat plague epidemic (1994):
Plague cases in Surat were first reported in September 1994 and further it spread to other cities in India. Fewer than 1,200 people were found positive it lasted for less than two weeks but it is considered important due to its high fatality.
Plague of Northern India (2002):
The plague of the Northern India broke out in Shimla district of Himachal Pradesh in February 2002. As soon as the plague was detected, immediate measures were taken like fumigation, evacuation and chemoprophylaxis that lead to further control of the epidemic.
Dengue epidemic (2003):
In 2003 during September, there occurred an outbreak of dengue in Delhi. It reached its peak around October-November and lasted until early December. The mortality rate was around 3%.It became a major outbreak in India in spite of the widespread preventative measures taken to control DF.
SARS epidemic (2003):
SARS (Severe acute respiratory syndrome) is considered as the first serious infectious disease outbreak of the Twenty-first century. It initially started in the Guandong province of China in 2003 and spread quickly to about 30 countries across Asia, America and Europe.
Meningococcal Meningitis epidemic (2005):
In early 2005, a sudden surge had been noted in Meningococcemia and Meningococcal Meningitis cases in India. Cases were reported from Delhi and the surrounding states of Uttar Pradesh and Maharashtra. Case management, early detection through surveillance was aimed at prevention of spread.
Chikungunya outbreak (2006):
Around 3.4 million cases of chikungunya were reported in Ahmedabad 2006 with 2944 deaths estimated. The mortality rate in 2006 epidemic was substantially increased when compared with that in the previous four years. In December there occurred another epidemic in South India where the states of Andhra Pradesh, Karnataka and Tamil nadu were affected.
Dengue outbreak (2006):
The outbreak began in early September of 2006 and the first case was reported from Delhi. By the end of September, it began to spread to other states like Rajasthan, Kerala, Gujrat, Chandigarh and Uttar Pradesh.
Gujrat jaundice epidemic (2009):
Modasa town in Gujrat witnessed the outbreak of hepatitis B in 2009. This is of significance because almost all outbreaks of viral hepatitis in India were considered to be due to hepatitis E which is feco-orally transmitted. It was a long-lasting epidemic and control was achieved by mass public awareness and health action.
H1N1 flu pandemic (2009):
The H1N1 flu pandemic began in May 2009 and spread globally by July 2009. By August 2010, it was declared pandemic and around 18500 deaths were reported from all around the world.
Odisha jaundice epidemic (2014):
The outbreak began in November 2014 in kantalbai, a remote village in Odisha. It was confirmed that jaundice was caused by the hepatitis E virus. This 2014 Odisha jaundice epidemic was one of the many outbreaks in Odisha and the most common cause being HEV. This is transmitted enterically and has affected several people especially of the low socio-economic category.
Indian swine flu outbreak (2015):
It refers to the outbreak of 2009 H1N1 flu pandemic in India. This outbreak in 2015 is considered as resurgence of the infection and the most plausible reasons are considered to be low temperature, decreasing host immunity and failure of vaccination campaign after 2010. Rajasthan, Maharashtra and Gujrat were the worst affected states in India during this pandemic.
Nipah outbreak (2018):
The virus was first noted in the late 1990s in Singapore and Malaysia. The natural host for this disease is the fruit bat and transmission is from direct person to person contact. This Nipah virus outbreak began in May 2018 in Kozhikode district, Kerala. This is the first Nipah virus outbreak reported in Kerala and the third known to have occurred in India. Spread of awareness about this infection, isolation of the infected and post outbreak surveillance led to the control of this outbreak.
Coronavirus Pandemic (COVID-19) 2020:
The 2019-20 coronavirus pandemic is an ongoing pandemic of coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus2 (SARS-coV-2). The outbreak was first identified in Wuhan, China in December 2019, and was recognized as pandemic by the World Health Organization (WHO) on 11 March. The first case of the 2019-20 Coronavirus pandemic in India was reported on 30 January 2020, originating from China. As of May 05, 2020, the ministry of health and family welfare have confirmed a total of 33,514 active cases, 14,182 recoveries and 1694 deaths in India. The total number of coronavirus cases around the globe surged past 37,28,254 with 12,42,575 recoveries and 2,58,360 deaths on May 05, 2020.
History of the 1897 Epidemic Disease Act
The Epidemic Diseases Act of 1897, a two-page law with four sections in it, has remained predominantly unaltered since its existence. The 1896 bubonic plague epidemic of Bombay, which started in September that year and evenly spread to most parts of the subcontinent, is a widely known catastrophe from colonial India. On January 19, 1897, about four months after the plague was identified in Bombay, Queen Victoria “directed Government to take the most stringent measures at their disposal for the eradication of the pestilence.” The Epidemic Diseases Act is the avatar these stringent measures eventually took. A week after Victoria’s address, the Epidemic Diseases Bill was brought in the Council of the Governor-General of India in Calcutta (now Kolkata) for the “better prevention of the spread of dangerous epidemic diseases.” Aftermath this became the Preamble of the Act. The member who introduced it, John Woodburn, acknowledged that the powers mentioned in the Bill were bizarre but necessary. Using powers conferred by the Act, colonies authorities would search suspected plague cases in homes and among passengers, with forcible apartheid, evacuations, and annihilation of infected places.
Provisions of the 1897 Epidemic Diseases Act
The Two-page Act, which consists four sections, aims to provide “for the better prevention of the spread of Dangerous Epidemic Diseases”.
Section 1 of the Epidemic Disease Act defines the Short Title and Extent.
Section 2 of the Act enables the state governments/UTs to take special measures and promulgate regulations for containing the outbreak.
“Power to take special measures and prescribe regulations as to dangerous epidemic disease. —
(1) When at any time the State Government is satisfied that the State or any part thereof is visited by, or threatened with, an outbreak of any dangerous epidemic disease, the State Government, if it thinks that the ordinary provisions of the law for the time being in force are insufficient for the purpose, may take, or require or empower any person to take, such measures and, by public notice, prescribe such temporary regulations to be observed by the public or by any person or class of persons as it shall deem necessary to prevent the outbreak of such disease or the spread thereof, and may determine in what manner and by whom any expenses incurred (including compensation if any) shall be defrayed.
(2) In particular and without prejudice to the generality of the foregoing provisions, the State Government may take measures and prescribe regulations for—
(b) the inspection of persons travelling by railway or otherwise, and the segregation, in hospital, temporary accommodation or otherwise, of persons suspected by the inspecting officer of being infected with any such disease.”
[2A. Powers of Central Government
When the Central Government is satisfied that India or any part thereof is visited by, or threatened with, an outbreak of any dangerous epidemic disease and that the ordinary provisions of the law for time being in force are insufficient to prevent the outbreak of such disease or the spread thereof, the Central Government may take measures and prescribe regulations for the inspection of any ship or vessel leaving or arriving at any port in [the territories to which this Act extends]and for such detention thereof, or of any person intending to sail therein, or arriving thereby, as may be necessary.]
Section 3 provides penalties for disobeying any regulation or order made under the Act. These are according to Section 188 of the Indian Penal Code (Disobedience to order duly promulgated by public servant).
Section 4 gives legal protection to the implementing officers acting under the Act.
Examples of Implementation
The Act has been frequently used to incorporate many diseases in India such as swine flu, cholera, malaria and dengue. In 2018, the Act was enforced as cholera began to spread in a region of Gujarat. In 2015, it was used to tackle dengue and malaria in Chandigarh and in 2009 it was enforced in Pune to combat swine flu. Starting in March 2020, the act is being invoked across India in order to limit the spread of coronavirus disease 2019.
Implementing the Epidemic Disease Act to tackle COVID-19
The country’s first case of Coronavirus was from Kerala, the patient is a student who had returned from Wuhan, China. As the transmission escalated alarmingly in March, the Union Ministry of Health and Family Welfare advised all the States and Union Territories to invoke provisions of Section 2 of The Epidemic Disease Act, 1897, On 11 March 2020. This comes after a review meeting chaired by the Cabinet Secretary Rajeev Gauba. The act enables the Central and the State government to take measures as may be warranted or necessary to control the further spread of the disease. Thus, under such a situation the Central government may take measures and prescribe regulations allowing for the inspection of any aircraft, ship or vessel for leaving or arriving and for the detention of any person arriving or intending to sail.
The State government under such situation may adopt or authorize all measures including quarantine, to prevent the outbreak of the disease. Also, the State government may seize the State’s territory to further stop the spread of the disease.
Limitations of the Act
Historians have castigated the Act for its potential for abuse. In 1897, the year the law was enforced, freedom fighter Bal Gangadhar Tilak was punished with 18 months’ rigorous imprisonment after his newspapers Kesari and Mahratta admonished imperial authorities for their handling of the plague epidemic. Also, if we talk about the current scenario the 1897 Epidemic Disease Act is an outmoded legislative framework. The archaic act has a number of shortcomings which can be attributed to the changing needs and priorities in public health emergency management. Also, the word dangerous epidemic disease has not been defined. Moreover, there is no mention of availability and distribution of vaccine and drugs during such a situation.
The Epidemic Diseases (Amendment) Ordinance 2020
The Epidemic Diseases (Amendment) Ordinance, 2020 was promulgated on April 22, 2020. The Ordinance amends the Act to provide protections for healthcare personnel combatting epidemic diseases and expands the powers of the central government to prevent the spread of such diseases.
The Ordinance defines healthcare service personnel as a person who is at risk of contracting the epidemic disease while carrying out duties related to the epidemic. They include: (i) public and clinical healthcare providers such as doctors and nurses, (ii) any person empowered under the Act to take measures to prevent the outbreak of the disease, and (iii) other persons designated as such by the state government.
Protection for healthcare personnel and damage to property: The Ordinance also states that no person can: (i) commit or abet the commission of an act of violence against a healthcare service personnel, or (ii) abet or cause damage or loss to any property during an epidemic. Contravention of this provision is punishable with imprisonment between three months and five years, and a fine between Rs 50,000 and two lakh rupees. If an act of violence against a healthcare service personnel causes grievous harm, the person committing the offence will be punishable with imprisonment between six months and seven years, and a fine between one lakh rupees and five lakh rupees. These offences are cognizable and non-bailable.
Compensation: In the case of damage or loss of property, the compensation payable to the victim will be twice the amount of the fair market value of the damaged or lost property, as determined by the Court. If the convicted person fails to pay the compensation, the amount will be recovered as an arrear of land revenue under the Revenue Recovery Act, 1890.
Investigation: Cases registered under the Ordinance will be investigated by a police officer not below the rank of Inspector. The investigation must be completed within 30 days from the date of registration of the First Information Report.
Trial: The inquiry or trial should be concluded within one year. If it is not concluded within this time period, the Judge must record the reasons for the delay and extend the time period. However, the time period may not be extended for more than six months at a time.
India has stood strong through several Epidemics and Pandemics. Good medical care and efficient researches have made it possible to fight every infection and luckily, we have been able to even eradicate a few. Promulgating an ordinance to the century old law will further help combating the COVID-19.
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