PANKAJ SINHA versus UNION OF INDIA AND OTHERS on 14 September 2018

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[2018] 13 S.C.R. 334

SUPREME COURT REPORTS

[2018] 13 S.C.R.

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PANKAJ SINHA

v.

UNION OF INDIA AND OTHERS

(Writ Petition (Civil) No.767 of 2014)

BSEPTEMBER 14, 2018

[DIPAK MISRA, CJI, A.M. KHANWILKAR AND

DR. D.Y. CHANDRACHUD, JJ.]

Constitution of India – Art.32 – Protection of leprosy affectedpersons and their family members – Petitioner sought directions forCthe Union of India and the States to conduct periodic national surveyfor determining new cases relating to detection rate of leprosy andto conduct regular and sustainable massive awareness campaignsfor the general public to dispel the fear associated with leprosyand support and encourage the people afflicted by the said diseaseDto lead a life of equality and dignity – Held: Following directionswere issued: (i) Union of India and the States to undertake periodicalnational surveys for determining the prevalence rate and new casesdetection rate of leprosy and, at the same time, publish and bringthe reports of National Sample Survey of Leprosy conducted in2010-2011 and subsequent thereto into the public domain;E(ii) On the Leprosy day, Union of India and the States shouldorganize massive awareness campaigns to increase public awarenessabout the signs and symptoms of leprosy and the fact that it is curableby the Multi Drug Therapy (MDT), which is available free of costat all government health care facilities and further to ensure that itFdo not go out of stock at all Primary Health Centres (PHCs) acrossthe country; (iii) Union as well as the States, to inform the citizenrythat under the National Leprosy Eradication Programme (NLEP),treatment is provided free of cost to all leprosy cases diagnosedthrough general health care system including NGOs; (iv) Awarenesscampaigns spreading information that a person affected by leprosyGshould not be isolated from the family members or the communityand that he can lead a normal married life, can take part in socialevents and go to work or school as normal; (v) Medical institutions,both Government and private, to desist from any discriminatorybehavior while examining and treating leprosy patients, and toHensure that treatment of leprosy should be integrated into general health care which usher in a no-isolation method in general wardsand OPD services; (vi) Patients affected with leprosy, for whompartial deformity can be corrected by surgery, should be advisedand provided adequate facility and opportunity to undergo suchsurgeries; (vii) The possibility of including leprosy education inschool curricula so as to give correct information about leprosyand leprosy patients and prevent discrimination against them shouldbe explored; (viii) Union and the State Governments must ensurethat both private and public schools do not discriminate againstchildren hailing from leprosy affected families and attempt shouldbe made to provide them free education; (ix) Due attention must bepaid to ensure that persons affected with leprosy are issued BPLcards so that they can avail benefits under various Governmentschemes which would also enable them to secure their right to food;(x) The Union and the States should endeavor to provide MCRfootware free of cost to all leprosy affected persons in the country;(xi) The Union and the State Government must pro-actively planand formulate a comprehensive community based rehabilitationscheme which shall cater to all basic facilities and needs of theleprosy affected persons and their families, and implementing schemefor providing at least a minimum assistance, preferably on a monthlybasis, to all leprosy affected persons for rehabilitation; (xii) UnionGovernment may consider framing separate rules for assessingdisability of the leprosy affected persons for the purpose of issuingdisability certificate under the Rights of Persons with DisabilitiesAct, 2016 – Rights of Persons with Disabilities Act, 2016.

Dhirendra Pandua v. State of Orissa and Others(2008) 17 SCC 311 : [2008] 13 SCR 714– referred to.

Case Law Reference

[2008] 13 SCR 714 referred toPara 10

CIVIL ORIGINAL JURISDICTION: Writ Petition (Civil)No. 767 of 2014.

Under Article 32 of the Constitution of India.

K. K. Venugopal, AG, Maninder Singh, Ms. Pinky Anand, ASGs,Surya P. Misra, AG, Odisha, S. S. Shamshery, AAG, Rajasthan, RajuRamachandran, Colin Gonsalves, K. Radhakrishnan, Ms. V. Mohana,Sr. Advs., Ms. Pallavi Mohan, Ms. Rashmi Nandakumar, Ms. Dhvani AB

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AMehta, Kabi Ali Ziya Choudhry, Satya Mitra, R. Balasubramanian,Shailendra Saini, Ms. Saudamini Sharma, Sayooj Mohandas, A.K.Sharma, R. B. Yadav, B. V. Balram Das, Prabhas Bajaj, Ms. Aarti Sharma,Akshay Amritanshu, Ravindra Kumar Verma, G. S. Makker, Ms. DeepaKulkarni, Nishant Ramakantrao Katneshwarkar, Ranjan Mukherjee, S.C. Ghosh, Nishe Rajen Shonker, Ms. Anu K. Joy, Alim Anvar, AbhishekBAtrey, Krishnam Mishra, Shuvodeep Roy, Rituraj Biswas, Ms. PrachiMishra, Arjun Garg, Ms. Pragya Garg, Nikhil Goel, Naveen Goel,Ashutosh Ghode, Ranjan Mukherjee, Daniel Stone Lyngdoh, PrashantMathur, Guntur Prabhakar Ms. Prerna Singh, G. M. Kawoosa, M. ShoebAlam, Ms. Fauzia Shakil, Ujjwal Singh, Mojahid Karim Khan, MerusagarCSamantray, Ashutosh Kumar Sharma, Ankur Prakash, Dr. Monika Gusain,Dipak K. Nag, Parmanand Gaur, Ekansh Bansal, Ms. Aruna Mathur,Avneesh Arputham, Ms. Anuradha Arputham, Ms. Simran Jeet(for M/s. Arputham Aruna And Co.), Ms. Hemantika Wahi, Ms. Vishakha,Ms. Mamta Singh, Ms. K. Enatoli Sema, Edward Belho, Amit KumarSingh, K. Luikang Michael, Shibashish Misra, Aniruddha P. Mayee, A.DSelvin Raja, Abhinav Mukerji, Mrs. Bihu Sharma, Ms. Purnima Krishna,Siddharth Garg, K. V. Vijayakumar, Ms. Maitreyee Mishra, Aditya PratapSingh, Mohd. Waquas, Tapesh K. Singh, Yashvardhan, Apoorv Shukla,Jagjit Singh Chhabra, G. Prakash, Jishnu M.L., Mrs. Priyanka Prakash,Mrs. Beena Prakash, Karan Bharihoke, Aman Panwar, Ms. NavkiranEBolay, Amit Sharma, Ankit Raj, Ms. Indira Bhakar, Ms. Ruchi Kohli,Leishangthem Roshmani Kh., Ms. Maibam Babina, Ms. RachanaSrivastava, Ms. Monika, Pratap Venugopal, Ms. Surekha Raman,Ms. Niharika, Ms. Kanika Kalaiyarasan, Kuldeep S. Parihar, H. S. Parihar,Sanjai Kumar Pathak, Ms. Shashi Pathak, Arvind Kumar Tripathi,Akhilendra Singh, Ms.Uttara Babbar, Ms. Akanksha Choudhary,FMs. Bhavana Duhoon, S. Udaya Kumar Sagar, Gopal Singh, ManishKumar, Shreyas Jain, Anil Shrivastav, Ms. Ritika Sethi, Kshatrashal Raj,Ms. Tanya Chaudhry, Ms. Pratyusha Priyadarshini (for M/s. Parekh &Co.), Ashok Kumar Singh, V. N. Raghupathy, B. Balaji, Shikhar Garg,Mudit Makhija, P. V. Yogeswaran, Pratap Venugopal, Ms. SurekhaGRaman, Ms. Niharika, Ms. Kanika Kalaiyarasan (for M/s. K J JohnAnd Co.), Dinesh Kumar Garg, Chanchal Kumar Ganguli, MishraSaurabh, Vishwa Pal Singh, Varinder Kumar Sharma, Rohit K. Singh,Mrs. Anil Katiyar, Suhaan Mukerji, Ms. Astha Sharma, Harsh HirooGorsahani, Amit Verma, Vishal Prasad (for PLR Chambers & Co.),Advs. for the appearing parties.H

The Judgment of the Court was delivered by DIPAK MISRA, CJI. 1. The instant writ petition preferred underArticle 32 of the Constitution of India seeks issue of directions to theUnion of India and the States, the respondent Nos. 1 to 30 herein, toconduct periodic national survey for determining new cases relating todetection rate of leprosy and to publish and bring in the public domainthe reports of National Sample Survey on Leprosy conducted in 2010-2011and further to conduct regular and sustainable massive awarenesscampaigns for the general public to dispel the fear associated with leprosyand support and encourage the people afflicted by the said disease tolead a life of equality and dignity.

2. It is also prayed that the respondents should ensure that Multi-Drug Therapy (MDT) drugs and other drugs for management of leprosyand complications in leprosy are available free of cost and do not go outof stock at all Primary Health Centres (PHCs) in the country and alsodirect all hospitals and health care institutions throughout the country,whether private or Government, not to discriminate against women withleprosy and not to turn them away and deny them treatment. A relief isalso sought to issue mandamus to all the schools in the country not todiscriminate against children from leprosy affected families and to providethem free education. The petitioners also seek for providing hygienicconditions in leprosy colonies and to make MCR footwear available freeof cost to the leprosy affected persons in the country. That apart, aprayer has been made to direct the Union of India to frame separaterules for evaluation of disabilities suffered by leprosy affected personsfor the purpose of issuing disability certificate in exercise of the powergranted under the Rights of Persons with Disabilities Act, 2016 (No. 49of 2016).

3. When the matter was listed on 1[st] September, 2014, thefollowing order came to be passed:- “In support of the petition preferred under Article 32 of theConstitution of India, it is submitted by Mr. Gonsalves that despitethe human civilization has advanced in advancement made in thefield of medicine and in spite of civilisation having reached thepinnacle of scientific research, an effective cure, namely, Multi-Drug Therapy (MDT) which has been available since 1981 thatcan completely cure 99% of leprosy bacteria, due to apathy of A

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the Government of India and the State Governments, people arestill suffering from the said disease, which is treated as a socialstigma.

It is urged by him, had people been made aware by the competentauthorities of the Central Government and the State Governments,millions of people who are suffering from leprosy would havebeen cured and come to the mainstream of life and would nothave been ostracized from the society. Learned senior counselwould contend that because of non-concern, the leprosy affectsmore than one lakhs twenty five thousand persons yearlythroughout the country, which is completely avoidable.

It is averred in the petition that they are not allowed to haveeducation, sanitary benefits, community based rehabilitation as aresult of which they are driven to streets and eventually turn tobegging or compelled to live in so-called leprosy homes wherethey are treated as unpersons or aliens.

In the writ petition, number of prayers have been made whichpertains to issuance of directions for availability of the drugs atprimary health centres and proper administration of the same fortreatment of the pregnant women suffering from leprosy in anapposite manner with dignity, and making provision in educationalinstitutions whether government or private, so that discriminationagainst the children of the leprosy affected families due to somekind of inhibition which has no constitutional sanction, is stoppedand for providing banking facilities and establishment of suchcolonies where they can live for temporary period till they arecured and come to the society, etc.”

4. On 28[th] November, 2014, the Court passed the following order:- “Mr. Maninder Singh, learned Additional Solicitor Generalappearing for Union of India prays for four weeks time to file therequisite data as directed by this Court vide order dated 1.9.2014.Mr Singh has assured this Court that he will not seek furtheradjournment.

The respondent States shall file their respective replies within thesaid period. If, they are unable to collect the data throughout theState, whatever data they have collected during the time grantedby us, shall be brought on record.

We have granted four weeks time as we are inclined to think thatthis is a cause which can be taken on a priority basis by the States,for what has been agitated before us is that the leprosy, as ontoday, is curable. Yet, because of apathy shown by the concernedauthorities, it still remains a stigmatic disease in the society. It isinconceivable as it affects the human dignity and the basic conceptof humanness.”

5. Be it noted, the Insurance Regulatory and DevelopmentAuthority (IRDA) and the Reserve Bank of India (RBI) were arrayedas respondent Nos.31 and 32 in the writ petition and they had taken timeto obtain instructions.

6. On 13[th] January, 2015, after taking note of the submissionsmade by the learned counsel for the parties, the Court had noted thus:- “Needless to say, curability is admitted depending upon the degree.As advised at present, we are of the convinced view that moreprogressive steps are required to be taken by the Union of Indiaand the States. It would be advisable, if the Union of India and theStates can think of having Leprosy Cure Centres, where medicationfollow up and other treatment protocols are followed in properprospective so that the stigmatic disease is eradicated or reducedto a significant percentage. Mr. Maninder Singh, learned AdditionalSolicitor General and other learned counsel appearing for variousStates pray for four weeks’ time to obtain instructions in thisregard.”

7. Taking into consideration the affidavits filed and instructionsobtained, the Court, on 23[rd] April, 2015, passed the following order:- “It is submitted by Mr. Maninder Singh, learned Additional SolicitorGeneral appearing for Union of India, that as far as prayers(A) and (B) are concerned, he will produce the data and the reportas prayed for and also file a reply supported by an affidavit in thatregard. As far as prayer (E) is concerned, we would likeMr. Maninder Singh, learned Additional Solicitor General to obtaininstructions whether the concerned Ministry, i.e., Ministry ofHealth and Family Welfare, Government of India, has any teamwhich is exclusively meant to look after the leprosy homes orleprosy colonies and eventually the patients suffering from leprosy.We would like the affidavit to contain what kind of treatment is A

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administered when the initial symptoms get manifested. Inessence, whether there is any machinery to that effect. We haveso directed as there is no dispute that the leprosy is totally curablein 21st century. We accept the submission of Mr. Kamlesh KumarMishra, learned counsel for the petitioner, that the Union of Indiaand all the State Governments have a duty to see that this centuryold stigmatic disease is eradicated. We also accept his submissionthat it can be done with a concerted effort by the Union of Indiaand the States.

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Mr. Ranjit Rao, learned AAG for the State of U.P., has submittedthat in the State of U.P. there is a rehabilitation programme of theleprosy patients and throughout the State, the patients areadministered medicines and some of them have been cured. Be itnoted, the Director Genearal of Medical and Health, Governmentof U.P. has filed an affidavit in that regard. At this juncture, it isnecessary to state that the affidavit reflects that there are 72leprosy centres and in the 72 centres, approximately 5,000persons, including the leprosy patients and their dependents, areresiding. The said aspect is required to be verified andaccordingly we constitute a Committee consisting of Mr. AshokGupta, learned senior counsel, Supreme Court of India, Mr. OmSubhash Tripathi, M-1, Govindpur, Allahabad and Mr. ChanderShekhar Singh, 58/14, Lai Bhadur Shastri Marg, Civil Lines,Allahabad.

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The Committee shall initially visit the leprosy homes at Lucknow,Banaras and Agra. The Committee shall submit a report withineight weeks hence. The State Government shall pay the fees ofthe members of the Committee which is conceded to by Mr. RanjitRao, learned AAG. This concession is given in presence of Mr.Vijay Bahadur Singh, learned Advocate General for the State ofU.P. We are not determining the quantum of fees. We hope thatthe State will fix the quantum, regard being had to the experienceof the 5 members of the Committee at the Bar. The visits of theCommittee shall be coordinate by Mr. Rao after holding discussionswith Mr. Ashok Gupta, learned senior counsel.”

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8. It is worthy to note here that during the pendency of this writpetition, another Writ Petition (Civil) No. 1151 of 2017 was filed seekingHthe relief that number of legislations be declared as unconstitutional being violative of Articles 14, 19(1)(d), 19(1) (g) and 21 of theConstitution of India. In the course of hearing of the said writ petition,our attention had been drawn to the 256[th] Report of the LawCommission. The said report had been submitted on the basis of theinitiative taken by the Union of India titled “Legal EnactmentsSimplification and Streamlining”. The Law Commission had referred tothe provisions of the Leprosy Act and adverted to the Second InterimReport No.249 wherein it had been mentioned that India is a member ofthe U.N. General Assembly which unanimously passed a resolution onthe elimination of discrimination against persons affected by leprosy andtheir family members. As per the Law Commission Report, the LeprosyAct was against the spirit of the Resolution and, therefore, requiredimmediate repeal in consultation with the States. Paragraphs 2.2.1, 2.2.2and 2.2.3 were reproduced by this Court when the said writ petition wastaken up on 5[th] July, 2018. We think it appropriate to reproduce the saidparagraphs and other paragraphs that had been adverted to for properappreciation:- “In paragraphs 2.2.1 to 2.2.3, there has been a reference to thefacts and myths surrounding leprosy. We think it appropriate toreproduce the said paragraphs:

“2.2.1 There are several myths and distortions surroundingLeprosy that are sought to be clarified in this Chapter. Suchmyths consider Leprosy as a hereditary and infectious diseasethat is caused due to impure blood and poverty. Many alsobelieve that the infection of Leprosy spreads through food andwater and is difficult to detect. However, all such beliefs arenot based on evidence and therefore without merit.

2.2.2Leprosy is not a hereditary disease and is not causeddue to impure blood or poverty, but due to the causative agentMycobacterium Leprae as mentioned above. Further, eventhough Leprosy is a chronic infectious disease, it is neitherdifficult to diagnose nor hard to treat. The main considerationfor an effective Leprosy treatment is early detection andregularity in treatment.

2.2.3All persons are not susceptible to Leprosy, althoughinsanitary conditions, malnutrition and lack of personal hygienemay increase the chances of getting infected by the Leprosy A

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SUPREME COURT REPORTS

bacillus or a host of other diseases and infections caused onaccount of such conditions. Further, Leprosy is not a fataldisease, even though on account of the stigma and discrimination,it may cause permanent psychological and social damage tothe victims.”

In paragraph 2.4.2., it has been mentioned that leprosy is acompletely curable disease. We think it relevant to reproduceparagraph 2.4.2. which is to the following effect:

“2.4.2 Although Leprosy is the cause of irreversible disabilities,with advances in science and technology in the field of Leprosytreatment during the last three decades, it is now a completelycurable disease that can be rendered non-infectious in the initialstages of the treatment itself. The treatment that has made itpossible to cure Leprosy is the process of Multi-Drug Therapy(“MDT”), which was first recommended by the WHO in early1980s after over 40 years of research and testing. Under MDT,powerful drugs such as Rifamipicin, Clofazimine and others incombination with Dapsone, are administered to the affectedperson to effectively fight the Leprosy bacillus. Over the pasttwo decades, more than 15 million Persons affected by Leprosyare said to have been cured under MDT.”

Eventually, after analysing various aspects, the Law Commissionrecommended as follows:

“7.13 This statute should be titled as the “Elimination ofDiscrimination against Persons affected by Leprosy Bill, 2015”.This stand-alone law, apart from comprehensively covering therepeal/modification of the specified statutes, shall containprinciples of nondiscrimination and equal protection before law.These principles shall specify that (1) No person, or public orprivate establishment shall discriminate against any personaffected by Leprosy, or members of his family on any groundin relation to their affliction of Leprosy, or their disability, physicalattributes or any other form of their association with Leprosy;and (2) All persons affected by Leprosy and members of theirfamily shall be entitled to the recognition, enjoyment andexercise, on an equal basis, of all human rights includingfreedoms guaranteed by the Constitution of India. Further, the law shall also contain enabling provisions regarding affirmativeaction and repeal and amend discriminatory provisions listedabove.

7.14 A model Bill is provided in the Annexure for theconsideration of the Government of India. The Law Commissionof India believes that the fact that India is home to the mostnumber of Persons affected by Leprosy in the world is a matterof deep shame. Further, despite clear scientific evidence andpioneering social efforts, the stigma associated with leprosystill continues unabated. The proposed Bill is an important stepin eliminating the social discrimination faced by such persons, anecessary precursor to their reintegration into society. As ahumane society that believes in human rights for all, especiallyits poorest, the Law Commission believes that the Bill shouldbe converted into a law as expeditiously as possible by theGovernment of India.”

9. After referring to the same, the Court observed:- “The annexure contains a draft Bill, namely, EliminatingDiscrimination Against Persons Affected by Leprosy (EDPAL)Bill, 2015. The Law Commission recommended the repeal of theLepers Act and other laws, which create any kind of stigma,disability or discrimination against persons suffering from leprosy.Despite the recommendations made by the Law Commission, it issubmitted by Mr.Raju Ramachandran, learned senior counsel forthe petitioner, no steps have been taken to repeal those obsoletelaws, except for the Lepers Act which has been repealed.”

10. In the said order, a reference was made to a two-Judge Benchdecision rendered in Dhirendra Pandua vs. State of Orissa andOthers[1] wherein the learned Judges had taken note of the progressmade in the field of science and technology and curability of leprosy.The said paragraphs read as follows:- “29. It is true that now with aggressive medication a patient maybe fully cured of the disease, yet the Legislature in its wisdom hasthought it fit to retain such provisions in the statute in order toeliminate the danger of its being transmitted to other people fromthe person affected by the disease. Having regard to these 1 (2008) 17 SCC 311

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circumstances, we are convinced that the said classification doesbear a reasonable and just relation with the object sought to beachieved by the statute in question and cannot be said to beunreasonable or arbitrary. Accordingly, we hold that Sections16(l)(iv) and 17 (l)(b) of the Act are not violative of Article 14 ofthe Constitution.

30. Before parting with this case, we deem it appropriate to pointout that having regard to the changed concept and knowledgegained about the disease of leprosy, on the recommendation ofthe Working Group on Eradication of Leprosy, appointed by theGovernment of India, many State Governments and UnionTerritories have repealed the antiquated Lepers Act, 1898 andsubsequent similar State Acts, providing for the segregation andmedical treatment of pauper lepers suffering from infectious typeof disease. Therefore, keeping in view the present thinking andresearches carried on leprosy as also on tuberculosis, and withprofessional input, the Legislature may seriously consider whetherit is still necessary to retain such provisions in the statutes.”

11. In the said order, the Court emphasized on social awakening,the curability of the disease and lack of professional approach to thesame and the social stigma that still remains attached to the said disease.The directions issued by the Court in the said case are to the followingeffect:- “(i) The Union of India and the Department of Health and otherconcerned Departments shall carry out awareness campaigns atvarious levels so that people come to know about the curability ofthe disease and of its not being contagious.

(ii) Some responsible authorities, at least two, shall be exclusivelynominated for the said duty.

(iii) There should be specific programmes on All India Radioand Doordarshan, both at the Central and the State level, as alsoon the regional channels, for educating people about the fact thatleprosy is not a communicable disease and not to treat any personsuffering from that disease with any kind of stigma ordiscrimination.

(iv) The programmes shall be shown on Doordarshan, both onthe national and the regional channels, to the extent feasible onprime time so that the people can see them.

(v) Hospitals should not decline to treat such patients sufferingfrom leprosy for administering the first dosage and thereafterprovide treatment if they suffer from any other disease. It has tobe remembered that a person has a right to avail the treatment inthe government hospitals.

(vi) The awareness campaign must cover all areas from urbanareas to the panchayat level so that there will be a concrete andholistic approach with regard to awareness.

(vii) The Union of India and the States shall take steps torehabilitate persons suffering from leprosy to bring them in themain-stream. It should be the primary duty of the State to see thatthis category of persons does not suffer from any kind of stigma.

(viii) We would commend to the Union of India and the StateGovernments to apprise us about the steps taken with regard tothe repeal of the provisions where leprosy has been treated as astigmatic disability. A report of compliance shall be filed by theUnion of India as well as all the States.”

12. The said writ petition was adjourned to 20[th] August, 2018,seeking due compliance. On 20[th] August, 2018, after hearing the learnedAttorney General for India and learned counsel for the parties, the Courtpassed the following order:- “In the course of hearing of the petition, we sought the assistanceof Mr. K.K. Venugopal, learned Attorney General for India.According to Mr. Venugopal, apart from positive law and repealof statutes which relate to the stigma attached to leprosy patients,there has to be awareness campaign at various levels so that thepeople come to know that the disease is not incurable and further,after administration of the first dosage, it ceases to be contagious.Learned Attorney General would also submit that the patientssuffering from leprosy, who have lost their limbs, can be broughtto the mainstream of society if certain treatments are given byplastic surgery.

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Mr. Raju Ramachandran, learned senior counsel for the petitionersubmitted that pending repeal of the enactments, this Court shouldissue directions so that the patients suffering from leprosy live alife of dignity with decency. Regard being had to thenon-adversarial submissions at the Bar, we would ask the learnedAttorney General as well as Mr.Raju Ramachandran, learnedsenior counsel for the petitioner to give their suggestions inwriting so that this Court will be in a position to issue appropriatedirections.

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Let the matter be listed on 10.09.2018.

In the meantime, learned Attorney General shall apprise us whethera recommendation can be made to the legislature to pass anaffirmative law conferring certain rights and benefits on thepersons suffering from leprosy and any statute, rule, regulationorenactment, running counter to the affirmative law, shall betreated to have been repealed.”

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13. On 10[th] September, 2018, the following order came to bepassed:- “Mr. Raju Ramachandran, learned senior counsel has filedcertain ‘Suggestions’ as part of his submissions. He has given 11suggestions.

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Out of the 11 suggestions, suggestion nos.10 and 11 pertain to thelegislative realm. Mr. Venugopal, learned Attorney General wouldpray for six weeks’ time in respect of these two aspects.

As far as the other 9 suggestions are concerned, prima facie weFare of the view that they would fall within the executive sphere.The said suggestions are - (i) Awareness, Sensitisation andDissemination of action taken; (ii) Nondiscrimination;(iii) Pensionary benefits for persons affected by leprosy;(iv) Healthcare and Rehabilitation; (v) Housing assistance;(vi) Education; (vii) Employment and livelihood; (viii) Welfare;Gand (ix) Language and Expression.

We would request Mr. Venugopal, learned Attorney General toassist with regard to the aforesaid 9 aspects by filing his suggestionswithin four weeks hence.

All the States shall file their response with regard to the stepstaken and to be taken, keeping in view the constitutional goal.”

14. In the instant writ petition, the petitioner has drawn the attentionof the Court to the fact that although leprosy as a disease has beenscientifically and medically proven to be curable and manageable withMDT, yet the fact remains that millions of people and their familymembers still suffer from leprosy and the social, economic and culturalstigma attached to the said disease. This fact reveals the lack ofawareness and the prevailing misguided notions in the society pertainingto leprosy. Further, the miserable plight of the persons afflicted withleprosy does not end here. It has been highlighted that due to the disabilitythat entails as a result of the disease, the people affected by leprosysuffer additional discrimination in the form of denial of access to healthservices, education and livelihood options. At present, majority of thepopulace which is afflicted with leprosy live as a marginalized section inthe society deprived of even basic human rights which manifestly resultsin violation of the fundamental right to equality and right to live withdignity.

15. It has been further brought to the attention of the Court thatas per the requirements of the World Health Organization (WHO), allcountries are required to achieve a prevalence of less than one leprosycase per 10,000 persons and although India had declared way back in31.12.2005 that it has achieved the said goal of elimination of leprosy,yet the progress reports of NLEP which have been reporting prevalencerate in certain States of the Ministry of Health and Family Welfare expositan entirely different reality. As per the said reports, out of 642 districts inIndia, only 543 districts have achieved a prevalence rate of less than onecase of leprosy for 10,000 persons. The underestimation of the cases ofleprosy and the declaration of elimination of leprosy has resulted in theintegration of leprosy in general health services thereby leading todiversion of funds which would have otherwise been dedicated toeliminating leprosy.

16. The petitioners have expressed deep concern over the factthat although a National Sample Survey of Leprosy was conducted bythe respondent No. 1, Union of India, yet the said survey has never beenbrought out in the public domain. The desired results have not beenachieved due to improper dispensation of the MDT drugs through the A

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APHCs established for the said purpose. It is urged that the staff ofPHCs display sheer lack of sensitivity while dealing with patients affectedwith leprosy as a consequence of which the level of stigma and isolationstill prevails amongst the said patients. Several incidents have also beenreported which have brought to light the discriminatory treatment metedout by the Government hospitals to leprosy affected pregnant womenBand cases wherein women have been refused treatment solely on accountof being affected by leprosy. Another aspect, that is, the area of educationhas also been brought forth by the petitioners. It has been urged thatlack of adequate education facilities would further magnify the sense ofinsecurity and stigma prevailing amongst the persons affected withCleprosy. For any development to take place, the first step would be in thedirection of ensuring quality education for the children who are the wardsof people affected with leprosy.

17. It has been pointed out that several instances have come tofore highlighting that the persons affected with leprosy are being providedDwith APL cards and not BPL cards which prevented these people fromclaiming benefits under various schemes brought out by the Government,such as the Antyodaya Anna Yojana (AAY), which again deprives thissection of the populace from claiming their right to food. Deprivation ofhousing and other basic civic amenities, adequate sanitary facilities andrehabilitation programmes are yet other serious concerns which, if notEaddressed, would lead to the entire reformatory process taking a hugesetback.

18. Keeping in view the factual matrix in entirety and thesubmissions advanced, we think it appropriate to issue the followingdirections :-F

(i) The Union and the States are to undertake periodical nationalsurveys for determining the prevalence rate and new casesdetection rate of leprosy and, at the same time, publish and bringthe reports of the National Sample Survey of Leprosy conductedin 2010-11 and subsequent thereto into the public domain. ThatGapart, the activities of the National Leprosy EradicationProgramme (NLEP) must be given wide publicity;

(ii) On leprosy day which is internationally observed every year onthe last Sunday of January, the Union of India along with all StateGovernments should organize massive awareness campaigns toH

increase public awareness about the signs and symptoms ofleprosy and the fact that it is perfectly curable by the Multi DrugTherapy (MDT). Awareness should also be spread about the freeavailability of MDT at all government health care facilities in thecountry, the prescribed course for MDT treatment and all otherrelevant information related to MDT. The content andinformation contained in the awareness programmes shoulddiscontinue to use frightening images of people disabled withleprosy and instead use positive images of cured persons sharingtheir experiences of being cured of leprosy;

(iii) The Union and the States are to ensure that drugs for managementof leprosy and its complications including the MDT drugs areavailable free of cost and do not go out of stock at all PrimaryHealth Centres (PHCs) or, as the case may be, public healthfacilities in the country;

(iv) All-year awareness campaigns should also be run, by the Unionas well as the States, to inform the citizenry that under theNational Leprosy Eradication Programme (NLEP), treatment isprovided free of cost to all leprosy cases diagnosed through generalhealth care system including NGOs;

(v) The Union and the States must organize seminars at all levelswhich serve as platforms to hear the views and experiencesdirectly from the former patients and their families as well asdoctors, social workers, experts, NGOs and Government officials;

(vi) The awareness campaigns must include information that a personaffected by leprosy is not required to be sent to any special clinicor hospital or sanatorium and should not be isolated from thefamily members or the community. The awareness campaignsshould also inform that a person affected with leprosy can lead anormal married life, can have children, can take part in socialevents and go to work or school as normal. Acceptability of leprosypatients in the society would go a long way in reducing the stigmaattached to the disease;

(vii) Health care to leprosy patients, at both Government as well asprivate run medical institutions, must be such that medicalofficials and representatives desist from any discriminatory AB

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Abehaviour while examining and treating leprosy patients.Treatment of leprosy should be integrated into general healthcare which will usher in a no-isolation method in general wardsand OPD services. In particular, it must be ensured that thereis no discrimination against women suffering from leprosy andthey are given equal and adequate opportunities for treatmentBin any hospital of their choice. To this effect, proactive measuresmust be taken for sensitization of hospital personnel;

(viii) Patients affected with leprosy, for whom partial deformity canbe corrected by surgery, should be advised and providedadequate facility and opportunity to undergo such surgeries;C(ix) The possibility of including leprosy education in school curriculaso as to give correct information about leprosy and leprosypatients and prevent discrimination against them should beexplored; D(x) The Union and the State Governments must ensure that bothprivate and public schools do not discriminate against childrenhailing from leprosy affected families. Such children should notbe turned away and attempt should be made to provide themfree education; E(xi) Due attention must be paid to ensure that the persons affectedwith leprosy are issued BPL cards so that they can avail thebenefits under AAY scheme and other similar schemes whichwould enable them to secure their right to food;

(xii) The Union and the States should endeavour to provide MCRfootwear free of cost to all leprosy affected persons in theFcountry;

(xiii) The States together with the Union of India should considerformulating and implementing a scheme for providing at least aminimum assistance, preferably on a monthly basis, to all leprosyaffected persons for rehabilitation;G

(xiv) The Union and the State Governments must pro-actively planand formulate a comprehensive community based rehabilitationscheme which shall cater to all basic facilities and needs of theleprosy affected persons and their families. The scheme shall H

PANKAJ SINHA v. UNION OF INDIA AND OTHERS[DIPAK MISRA, CJI]

be aimed at eliminating the stigma that is associated with personsafflicted with leprosy.

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(xv) The Union Government may consider framing separate rulesfor assessing the disability quotient of the leprosy affectedpersons for the purpose of issuing disability certificate in exerciseof the power granted under the Rights of Persons withBDisabilities Act, 2016 (No. 49 of 2016).

19. The writ petition is, accordingly, disposed of. There shall beno order as to costs.

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Ankit Gyan

Petition disposed of.

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