Public Health Rights and Constitutional Duties of the State

Public Health Rights and Constitutional Duties of the State

Public health lies at the heart of human development and national progress. In India, the right to health is not explicitly mentioned in the Constitution, yet it has been judicially recognized as a fundamental right derived from Article 21, which guarantees the right to life and personal liberty. The State’s constitutional duty to protect and promote public health flows from both the Fundamental Rights and the Directive Principles of State Policy (DPSPs). Together, they create a framework where health is not just a policy goal but a constitutional obligation.

The Directive Principles, especially Article 38, Article 39(e), Article 41, Article 42, and Article 47, explicitly mandate the State to ensure the health and well-being of its citizens. Article 47 directs the State to raise the level of nutrition, improve public health, and prohibit intoxicating substances injurious to health. These provisions reflect the framers’ vision that a healthy population is essential for democracy and economic growth. While these principles are non-justiciable, they serve as guiding values for legislative and policy action.

Judicial interpretation has played a transformative role in elevating public health to a fundamental right. In Consumer Education and Research Centre v. Union of India (1995), the Supreme Court held that the right to health and medical care is a fundamental right under Article 21. Similarly, in Paschim Banga Khet Mazdoor Samity v. State of West Bengal (1996), the Court ruled that the failure of a government hospital to provide timely medical treatment violates the right to life. Through such judgments, the judiciary has consistently emphasized that healthcare is not charity but a constitutional entitlement.

The State’s duty in this context extends beyond curative care to encompass preventive and promotive health measures—ensuring clean drinking water, sanitation, immunization, nutrition, and control of epidemics. The COVID-19 pandemic highlighted the urgency of strengthening India’s public health system and the State’s responsibility to provide accessible and affordable healthcare. The National Health Mission (NHM), Ayushman Bharat, and Right to Health Acts enacted by states like Rajasthan represent steps toward realizing this duty.

However, India’s public health infrastructure continues to face challenges such as inadequate funding, shortage of medical professionals, unequal access, and poor rural health facilities. Despite the constitutional commitment, India’s public health expenditure remains around 2% of GDP, far below global standards. This gap undermines the State’s ability to fulfill its duty under the Constitution.

Moreover, the federal nature of healthcare governance often leads to overlapping responsibilities between the Union and State governments. While health is a State subject under the Seventh Schedule, national-level programs and funds are centrally driven, demanding better coordination and accountability mechanisms. The Right to Information Act (RTI) and Public Interest Litigation (PIL) have empowered citizens to hold authorities accountable for failures in health services, reinforcing democratic oversight in this domain.

In the broader constitutional philosophy, ensuring public health aligns with the Preamble’s promise of justice—social, economic, and political. The State’s duty to maintain public health is also intertwined with other fundamental rights, such as the right to equality (Article 14) and the right against discrimination (Article 15), ensuring equitable access to medical care irrespective of class, caste, or gender.

In conclusion, public health rights and the State’s constitutional duties form two sides of the same coin. While the right to health has evolved as a fundamental human right, its realization depends on the State’s active role in policy, funding, and governance. True fulfillment of this duty requires the government to treat health not merely as a welfare function but as a core component of constitutional governance. A healthy citizenry is the foundation of a strong nation, and ensuring it is not just a policy choice—it is a constitutional necessity and moral responsibility of the State.