PANKAJ SINHAversusUNION OF INDIA AND OTHERS

334                      [2018]REPORTS
               SUPREME COURT   13 S.C.R. 334               [2018] 13 S.C.R.


A                               PANKAJ SINHA
                                        v.
                      UNION OF INDIA AND OTHERS
                      (Writ Petition (Civil) No.767 of 2014)
B                            SEPTEMBER 14, 2018
             [DIPAK MISRA, CJI, A.M. KHANWILKAR AND
                        DR. D.Y. CHANDRACHUD, JJ.]
             Constitution of India – Art.32 – Protection of leprosy affected
      persons and their family members – Petitioner sought directions for
C
      the Union of India and the States to conduct periodic national survey
      for determining new cases relating to detection rate of leprosy and
      to conduct regular and sustainable massive awareness campaigns
      for the general public to dispel the fear associated with leprosy
      and support and encourage the people afflicted by the said disease
D     to lead a life of equality and dignity – Held: Following directions
      were issued: (i) Union of India and the States to undertake periodical
      national surveys for determining the prevalence rate and new cases
      detection rate of leprosy and, at the same time, publish and bring
      the reports of National Sample Survey of Leprosy conducted in
      2010-2011 and subsequent thereto into the public domain;
E
      (ii) On the Leprosy day, Union of India and the States should
      organize massive awareness campaigns to increase public awareness
      about the signs and symptoms of leprosy and the fact that it is curable
      by the Multi Drug Therapy (MDT), which is available free of cost
      at all government health care facilities and further to ensure that it
F     do not go out of stock at all Primary Health Centres (PHCs) across
      the country; (iii) Union as well as the States, to inform the citizenry
      that under the National Leprosy Eradication Programme (NLEP),
      treatment is provided free of cost to all leprosy cases diagnosed
      through general health care system including NGOs; (iv) Awareness
      campaigns spreading information that a person affected by leprosy
G
      should not be isolated from the family members or the community
      and that he can lead a normal married life, can take part in social
      events and go to work or school as normal; (v) Medical institutions,
      both Government and private, to desist from any discriminatory
      behavior while examining and treating leprosy patients, and to
H     ensure that treatment of leprosy should be integrated into general
                                       334
      PANKAJ SINHA v. UNION OF INDIA AND OTHERS                          335


health care which usher in a no-isolation method in general wards        A
and OPD services; (vi) Patients affected with leprosy, for whom
partial deformity can be corrected by surgery, should be advised
and provided adequate facility and opportunity to undergo such
surgeries; (vii) The possibility of including leprosy education in
school curricula so as to give correct information about leprosy
                                                                         B
and leprosy patients and prevent discrimination against them should
be explored; (viii) Union and the State Governments must ensure
that both private and public schools do not discriminate against
children hailing from leprosy affected families and attempt should
be made to provide them free education; (ix) Due attention must be
paid to ensure that persons affected with leprosy are issued BPL         C
cards so that they can avail benefits under various Government
schemes which would also enable them to secure their right to food;
(x) The Union and the States should endeavor to provide MCR
footware free of cost to all leprosy affected persons in the country;
(xi) The Union and the State Government must pro-actively plan
                                                                         D
and formulate a comprehensive community based rehabilitation
scheme which shall cater to all basic facilities and needs of the
leprosy affected persons and their families, and implementing scheme
for providing at least a minimum assistance, preferably on a monthly
basis, to all leprosy affected persons for rehabilitation; (xii) Union
Government may consider framing separate rules for assessing             E
disability of the leprosy affected persons for the purpose of issuing
disability certificate under the Rights of Persons with Disabilities
Act, 2016 – Rights of Persons with Disabilities Act, 2016.
       Dhirendra Pandua v. State of Orissa and Others
       (2008) 17 SCC 311 : [2008] 13 SCR 714                             F
       – referred to.
                         Case Law Reference
       [2008] 13 SCR 714            referred to          Para 10
      CIVIL ORIGINAL JURISDICTION: Writ Petition (Civil)
No. 767 of 2014.                                                         G
      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, Raju
Ramachandran, Colin Gonsalves, K. Radhakrishnan, Ms. V. Mohana,
Sr. Advs., Ms. Pallavi Mohan, Ms. Rashmi Nandakumar, Ms. Dhvani          H
336            SUPREME COURT REPORTS                        [2018] 13 S.C.R.


A     Mehta, 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. Deepa
      Kulkarni, Nishant Ramakantrao Katneshwarkar, Ranjan Mukherjee, S.
      C. Ghosh, Nishe Rajen Shonker, Ms. Anu K. Joy, Alim Anvar, Abhishek
B
      Atrey, Krishnam Mishra, Shuvodeep Roy, Rituraj Biswas, Ms. Prachi
      Mishra, Arjun Garg, Ms. Pragya Garg, Nikhil Goel, Naveen Goel,
      Ashutosh Ghode, Ranjan Mukherjee, Daniel Stone Lyngdoh, Prashant
      Mathur, Guntur Prabhakar Ms. Prerna Singh, G. M. Kawoosa, M. Shoeb
      Alam, Ms. Fauzia Shakil, Ujjwal Singh, Mojahid Karim Khan, Merusagar
C     Samantray, 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 Kumar
      Singh, K. Luikang Michael, Shibashish Misra, Aniruddha P. Mayee, A.
D
      Selvin Raja, Abhinav Mukerji, Mrs. Bihu Sharma, Ms. Purnima Krishna,
      Siddharth Garg, K. V. Vijayakumar, Ms. Maitreyee Mishra, Aditya Pratap
      Singh, 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. Navkiran
E     Bolay, Amit Sharma, Ankit Raj, Ms. Indira Bhakar, Ms. Ruchi Kohli,
      Leishangthem Roshmani Kh., Ms. Maibam Babina, Ms. Rachana
      Srivastava, 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,
F
      Ms. Bhavana Duhoon, S. Udaya Kumar Sagar, Gopal Singh, Manish
      Kumar, 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. Surekha
G     Raman, Ms. Niharika, Ms. Kanika Kalaiyarasan (for M/s. K J John
      And Co.), Dinesh Kumar Garg, Chanchal Kumar Ganguli, Mishra
      Saurabh, Vishwa Pal Singh, Varinder Kumar Sharma, Rohit K. Singh,
      Mrs. Anil Katiyar, Suhaan Mukerji, Ms. Astha Sharma, Harsh Hiroo
      Gorsahani, Amit Verma, Vishal Prasad (for PLR Chambers & Co.),
      Advs. for the appearing parties.
H
      PANKAJ SINHA v. UNION OF INDIA AND OTHERS                               337


      The Judgment of the Court was delivered by                              A
       DIPAK MISRA, CJI. 1. The instant writ petition preferred under
Article 32 of the Constitution of India seeks issue of directions to the
Union of India and the States, the respondent Nos. 1 to 30 herein, to
conduct periodic national survey for determining new cases relating to
detection rate of leprosy and to publish and bring in the public domain       B
the reports of National Sample Survey on Leprosy conducted in 2010-2011
and further to conduct regular and sustainable massive awareness
campaigns for the general public to dispel the fear associated with leprosy
and support and encourage the people afflicted by the said disease to
lead a life of equality and dignity.
                                                                              C
       2. It is also prayed that the respondents should ensure that Multi-
Drug Therapy (MDT) drugs and other drugs for management of leprosy
and complications in leprosy are available free of cost and do not go out
of stock at all Primary Health Centres (PHCs) in the country and also
direct all hospitals and health care institutions throughout the country,
whether private or Government, not to discriminate against women with         D
leprosy and not to turn them away and deny them treatment. A relief is
also sought to issue mandamus to all the schools in the country not to
discriminate against children from leprosy affected families and to provide
them free education. The petitioners also seek for providing hygienic
conditions in leprosy colonies and to make MCR footwear available free        E
of cost to the leprosy affected persons in the country. That apart, a
prayer has been made to direct the Union of India to frame separate
rules for evaluation of disabilities suffered by leprosy affected persons
for the purpose of issuing disability certificate in exercise of the power
granted under the Rights of Persons with Disabilities Act, 2016 (No. 49
of 2016).                                                                     F

      3. When the matter was listed on 1st September, 2014, the
following order came to be passed:-
      “In support of the petition preferred under Article 32 of the
      Constitution of India, it is submitted by Mr. Gonsalves that despite    G
      the human civilization has advanced in advancement made in the
      field of medicine and in spite of civilisation having reached the
      pinnacle of scientific research, an effective cure, namely, Multi-
      Drug Therapy (MDT) which has been available since 1981 that
      can completely cure 99% of leprosy bacteria, due to apathy of
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338           SUPREME COURT REPORTS                         [2018] 13 S.C.R.


A          the Government of India and the State Governments, people are
           still suffering from the said disease, which is treated as a social
           stigma.
           It is urged by him, had people been made aware by the competent
           authorities of the Central Government and the State Governments,
B          millions of people who are suffering from leprosy would have
           been cured and come to the mainstream of life and would not
           have been ostracized from the society. Learned senior counsel
           would contend that because of non-concern, the leprosy affects
           more than one lakhs twenty five thousand persons yearly
           throughout the country, which is completely avoidable.
C
           It is averred in the petition that they are not allowed to have
           education, sanitary benefits, community based rehabilitation as a
           result of which they are driven to streets and eventually turn to
           begging or compelled to live in so-called leprosy homes where
           they are treated as unpersons or aliens.
D
           In the writ petition, number of prayers have been made which
           pertains to issuance of directions for availability of the drugs at
           primary health centres and proper administration of the same for
           treatment of the pregnant women suffering from leprosy in an
           apposite manner with dignity, and making provision in educational
E          institutions whether government or private, so that discrimination
           against the children of the leprosy affected families due to some
           kind of inhibition which has no constitutional sanction, is stopped
           and for providing banking facilities and establishment of such
           colonies where they can live for temporary period till they are
F          cured and come to the society, etc.”
      4.   On 28th November, 2014, the Court passed the following order:-
           “Mr. Maninder Singh, learned Additional Solicitor General
           appearing for Union of India prays for four weeks time to file the
           requisite data as directed by this Court vide order dated 1.9.2014.
G          Mr Singh has assured this Court that he will not seek further
           adjournment.
           The respondent States shall file their respective replies within the
           said period. If, they are unable to collect the data throughout the
           State, whatever data they have collected during the time granted
H          by us, shall be brought on record.
      PANKAJ SINHA v. UNION OF INDIA AND OTHERS                                 339
                  [DIPAK MISRA, CJI]

      We have granted four weeks time as we are inclined to think that          A
      this 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 on
      today, is curable. Yet, because of apathy shown by the concerned
      authorities, it still remains a stigmatic disease in the society. It is
      inconceivable as it affects the human dignity and the basic concept
                                                                                B
      of humanness.”
       5. Be it noted, the Insurance Regulatory and Development
Authority (IRDA) and the Reserve Bank of India (RBI) were arrayed
as respondent Nos.31 and 32 in the writ petition and they had taken time
to obtain instructions.
                                                                                C
     6. On 13th January, 2015, after taking note of the submissions
made 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 more
      progressive steps are required to be taken by the Union of India          D
      and the States. It would be advisable, if the Union of India and the
      States can think of having Leprosy Cure Centres, where medication
      follow up and other treatment protocols are followed in proper
      prospective so that the stigmatic disease is eradicated or reduced
      to a significant percentage. Mr. Maninder Singh, learned Additional
      Solicitor General and other learned counsel appearing for various         E
      States pray for four weeks’ time to obtain instructions in this
      regard.”
      7. Taking into consideration the affidavits filed and instructions
obtained, the Court, on 23rd April, 2015, passed the following order:-
                                                                                F
      “It is submitted by Mr. Maninder Singh, learned Additional Solicitor
      General appearing for Union of India, that as far as prayers
      (A) and (B) are concerned, he will produce the data and the report
      as prayed for and also file a reply supported by an affidavit in that
      regard. As far as prayer (E) is concerned, we would like
      Mr. Maninder Singh, learned Additional Solicitor General to obtain        G
      instructions whether the concerned Ministry, i.e., Ministry of
      Health and Family Welfare, Government of India, has any team
      which is exclusively meant to look after the leprosy homes or
      leprosy colonies and eventually the patients suffering from leprosy.
      We would like the affidavit to contain what kind of treatment is
                                                                                H
340            SUPREME COURT REPORTS                          [2018] 13 S.C.R.


A           administered when the initial symptoms get manifested. In
            essence, whether there is any machinery to that effect. We have
            so directed as there is no dispute that the leprosy is totally curable
            in 21st century. We accept the submission of Mr. Kamlesh Kumar
            Mishra, learned counsel for the petitioner, that the Union of India
            and all the State Governments have a duty to see that this century
B
            old stigmatic disease is eradicated. We also accept his submission
            that it can be done with a concerted effort by the Union of India
            and the States.
            Mr. Ranjit Rao, learned AAG for the State of U.P., has submitted
            that in the State of U.P. there is a rehabilitation programme of the
C           leprosy patients and throughout the State, the patients are
            administered medicines and some of them have been cured. Be it
            noted, the Director Genearal of Medical and Health, Government
            of U.P. has filed an affidavit in that regard. At this juncture, it is
            necessary to state that the affidavit reflects that there are 72
D           leprosy centres and in the 72 centres, approximately 5,000
            persons, including the leprosy patients and their dependents, are
            residing. The said aspect is required to be verified and
            accordingly we constitute a Committee consisting of Mr. Ashok
            Gupta, learned senior counsel, Supreme Court of India, Mr. Om
            Subhash Tripathi, M-1, Govindpur, Allahabad and Mr. Chander
E           Shekhar Singh, 58/14, Lai Bhadur Shastri Marg, Civil Lines,
            Allahabad.
            The Committee shall initially visit the leprosy homes at Lucknow,
            Banaras and Agra. The Committee shall submit a report within
            eight weeks hence. The State Government shall pay the fees of
F           the members of the Committee which is conceded to by Mr. Ranjit
            Rao, learned AAG. This concession is given in presence of Mr.
            Vijay Bahadur Singh, learned Advocate General for the State of
            U.P. We are not determining the quantum of fees. We hope that
            the State will fix the quantum, regard being had to the experience
G           of the 5 members of the Committee at the Bar. The visits of the
            Committee shall be coordinate by Mr. Rao after holding discussions
            with Mr. Ashok Gupta, learned senior counsel.”
             8. It is worthy to note here that during the pendency of this writ
      petition, another Writ Petition (Civil) No. 1151 of 2017 was filed seeking
H     the relief that number of legislations be declared as unconstitutional
      PANKAJ SINHA v. UNION OF INDIA AND OTHERS                              341
                  [DIPAK MISRA, CJI]

being violative of Articles 14, 19(1)(d), 19(1) (g) and 21 of the            A
Constitution of India. In the course of hearing of the said writ petition,
our attention had been drawn to the 256 th Report of the Law
Commission. The said report had been submitted on the basis of the
initiative taken by the Union of India titled “Legal Enactments
Simplification and Streamlining”. The Law Commission had referred to
                                                                             B
the provisions of the Leprosy Act and adverted to the Second Interim
Report No.249 wherein it had been mentioned that India is a member of
the U.N. General Assembly which unanimously passed a resolution on
the elimination of discrimination against persons affected by leprosy and
their family members. As per the Law Commission Report, the Leprosy
Act was against the spirit of the Resolution and, therefore, required        C
immediate repeal in consultation with the States. Paragraphs 2.2.1, 2.2.2
and 2.2.3 were reproduced by this Court when the said writ petition was
taken up on 5th July, 2018. We think it appropriate to reproduce the said
paragraphs and other paragraphs that had been adverted to for proper
appreciation:-
                                                                             D
      “In paragraphs 2.2.1 to 2.2.3, there has been a reference to the
      facts and myths surrounding leprosy. We think it appropriate to
      reproduce the said paragraphs:
         “2.2.1 There are several myths and distortions surrounding
         Leprosy that are sought to be clarified in this Chapter. Such       E
         myths consider Leprosy as a hereditary and infectious disease
         that is caused due to impure blood and poverty. Many also
         believe that the infection of Leprosy spreads through food and
         water and is difficult to detect. However, all such beliefs are
         not based on evidence and therefore without merit.
                                                                             F
         2.2.2 Leprosy is not a hereditary disease and is not caused
         due to impure blood or poverty, but due to the causative agent
         Mycobacterium Leprae as mentioned above. Further, even
         though Leprosy is a chronic infectious disease, it is neither
         difficult to diagnose nor hard to treat. The main consideration
         for an effective Leprosy treatment is early detection and           G
         regularity in treatment.
         2.2.3 All persons are not susceptible to Leprosy, although
         insanitary conditions, malnutrition and lack of personal hygiene
         may increase the chances of getting infected by the Leprosy
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342     SUPREME COURT REPORTS                               [2018] 13 S.C.R.


A       bacillus or a host of other diseases and infections caused on
        account of such conditions. Further, Leprosy is not a fatal
        disease, even though on account of the stigma and discrimination,
        it may cause permanent psychological and social damage to
        the victims.”
B     In paragraph 2.4.2., it has been mentioned that leprosy is a
      completely curable disease. We think it relevant to reproduce
      paragraph 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 Leprosy
C       treatment during the last three decades, it is now a completely
        curable disease that can be rendered non-infectious in the initial
        stages of the treatment itself. The treatment that has made it
        possible to cure Leprosy is the process of Multi-Drug Therapy
        (“MDT”), which was first recommended by the WHO in early
        1980s after over 40 years of research and testing. Under MDT,
D       powerful drugs such as Rifamipicin, Clofazimine and others in
        combination with Dapsone, are administered to the affected
        person to effectively fight the Leprosy bacillus. Over the past
        two decades, more than 15 million Persons affected by Leprosy
        are said to have been cured under MDT.”
E     Eventually, after analysing various aspects, the Law Commission
      recommended as follows:
        “7.13 This statute should be titled as the “Elimination of
        Discrimination against Persons affected by Leprosy Bill, 2015”.
        This stand-alone law, apart from comprehensively covering the
F       repeal/modification of the specified statutes, shall contain
        principles of nondiscrimination and equal protection before law.
        These principles shall specify that (1) No person, or public or
        private establishment shall discriminate against any person
        affected by Leprosy, or members of his family on any ground
G       in relation to their affliction of Leprosy, or their disability, physical
        attributes or any other form of their association with Leprosy;
        and (2) All persons affected by Leprosy and members of their
        family shall be entitled to the recognition, enjoyment and
        exercise, on an equal basis, of all human rights including
        freedoms guaranteed by the Constitution of India. Further, the
H
         PANKAJ SINHA v. UNION OF INDIA AND OTHERS                              343
                     [DIPAK MISRA, CJI]

            law shall also contain enabling provisions regarding affirmative    A
            action and repeal and amend discriminatory provisions listed
            above.
            7.14 A model Bill is provided in the Annexure for the
            consideration of the Government of India. The Law Commission
            of India believes that the fact that India is home to the most      B
            number of Persons affected by Leprosy in the world is a matter
            of deep shame. Further, despite clear scientific evidence and
            pioneering social efforts, the stigma associated with leprosy
            still continues unabated. The proposed Bill is an important step
            in eliminating the social discrimination faced by such persons, a
            necessary precursor to their reintegration into society. As a       C
            humane society that believes in human rights for all, especially
            its poorest, the Law Commission believes that the Bill should
            be converted into a law as expeditiously as possible by the
            Government of India.”
         9. After referring to the same, the Court observed:-                   D

         “The annexure contains a draft Bill, namely, Eliminating
         Discrimination Against Persons Affected by Leprosy (EDPAL)
         Bill, 2015. The Law Commission recommended the repeal of the
         Lepers Act and other laws, which create any kind of stigma,
         disability or discrimination against persons suffering from leprosy.   E
         Despite the recommendations made by the Law Commission, it is
         submitted by Mr.Raju Ramachandran, learned senior counsel for
         the petitioner, no steps have been taken to repeal those obsolete
         laws, except for the Lepers Act which has been repealed.”
      10. In the said order, a reference was made to a two-Judge Bench          F
decision rendered in Dhirendra Pandua vs. State of Orissa and
Others1 wherein the learned Judges had taken note of the progress
made 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 may      G
         be fully cured of the disease, yet the Legislature in its wisdom has
         thought it fit to retain such provisions in the statute in order to
         eliminate the danger of its being transmitted to other people from
         the person affected by the disease. Having regard to these
1
    (2008) 17 SCC 311                                                           H
344            SUPREME COURT REPORTS                          [2018] 13 S.C.R.


A           circumstances, we are convinced that the said classification does
            bear a reasonable and just relation with the object sought to be
            achieved by the statute in question and cannot be said to be
            unreasonable or arbitrary. Accordingly, we hold that Sections
            16(l)(iv) and 17 (l)(b) of the Act are not violative of Article 14 of
            the Constitution.
B
            30. Before parting with this case, we deem it appropriate to point
            out that having regard to the changed concept and knowledge
            gained about the disease of leprosy, on the recommendation of
            the Working Group on Eradication of Leprosy, appointed by the
            Government of India, many State Governments and Union
C           Territories have repealed the antiquated Lepers Act, 1898 and
            subsequent similar State Acts, providing for the segregation and
            medical treatment of pauper lepers suffering from infectious type
            of disease. Therefore, keeping in view the present thinking and
            researches carried on leprosy as also on tuberculosis, and with
D           professional input, the Legislature may seriously consider whether
            it 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 the
      same and the social stigma that still remains attached to the said disease.
E     The directions issued by the Court in the said case are to the following
      effect:-
            “(i) The Union of India and the Department of Health and other
            concerned Departments shall carry out awareness campaigns at
            various levels so that people come to know about the curability of
F           the disease and of its not being contagious.
            (ii) Some responsible authorities, at least two, shall be exclusively
            nominated for the said duty.
            (iii) There should be specific programmes on All India Radio
            and Doordarshan, both at the Central and the State level, as also
G           on the regional channels, for educating people about the fact that
            leprosy is not a communicable disease and not to treat any person
            suffering from that disease with any kind of stigma or
            discrimination.

H
      PANKAJ SINHA v. UNION OF INDIA AND OTHERS                               345
                  [DIPAK MISRA, CJI]

      (iv) The programmes shall be shown on Doordarshan, both on              A
      the national and the regional channels, to the extent feasible on
      prime time so that the people can see them.
      (v) Hospitals should not decline to treat such patients suffering
      from leprosy for administering the first dosage and thereafter
      provide treatment if they suffer from any other disease. It has to      B
      be remembered that a person has a right to avail the treatment in
      the government hospitals.
      (vi) The awareness campaign must cover all areas from urban
      areas to the panchayat level so that there will be a concrete and
      holistic approach with regard to awareness.                             C
      (vii) The Union of India and the States shall take steps to
      rehabilitate persons suffering from leprosy to bring them in the
      main-stream. It should be the primary duty of the State to see that
      this category of persons does not suffer from any kind of stigma.
      (viii) We would commend to the Union of India and the State             D
      Governments to apprise us about the steps taken with regard to
      the repeal of the provisions where leprosy has been treated as a
      stigmatic disability. A report of compliance shall be filed by the
      Union of India as well as all the States.”
      12. The said writ petition was adjourned to 20th August, 2018,          E
seeking due compliance. On 20th August, 2018, after hearing the learned
Attorney General for India and learned counsel for the parties, the Court
passed the following order:-
      “In the course of hearing of the petition, we sought the assistance
      of Mr. K.K. Venugopal, learned Attorney General for India.              F
      According to Mr. Venugopal, apart from positive law and repeal
      of statutes which relate to the stigma attached to leprosy patients,
      there has to be awareness campaign at various levels so that the
      people come to know that the disease is not incurable and further,
      after administration of the first dosage, it ceases to be contagious.
                                                                              G
      Learned Attorney General would also submit that the patients
      suffering from leprosy, who have lost their limbs, can be brought
      to the mainstream of society if certain treatments are given by
      plastic surgery.

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346           SUPREME COURT REPORTS                           [2018] 13 S.C.R.


A          Mr. Raju Ramachandran, learned senior counsel for the petitioner
           submitted that pending repeal of the enactments, this Court should
           issue directions so that the patients suffering from leprosy live a
           life of dignity with decency. Regard being had to the
           non-adversarial submissions at the Bar, we would ask the learned
           Attorney General as well as Mr.Raju Ramachandran, learned
B
           senior counsel for the petitioner to give their suggestions in
           writing so that this Court will be in a position to issue appropriate
           directions.
           Let the matter be listed on 10.09.2018.
C          In the meantime, learned Attorney General shall apprise us whether
           a recommendation can be made to the legislature to pass an
           affirmative law conferring certain rights and benefits on the
           persons suffering from leprosy and any statute, rule, regulation
           orenactment, running counter to the affirmative law, shall be
           treated to have been repealed.”
D
            13. On 10th September, 2018, the following order came to be
      passed:-
           “Mr. Raju Ramachandran, learned senior counsel has filed
           certain ‘Suggestions’ as part of his submissions. He has given 11
E          suggestions.
           Out of the 11 suggestions, suggestion nos.10 and 11 pertain to the
           legislative realm. Mr. Venugopal, learned Attorney General would
           pray for six weeks’ time in respect of these two aspects.
           As far as the other 9 suggestions are concerned, prima facie we
F          are of the view that they would fall within the executive sphere.
           The said suggestions are - (i) Awareness, Sensitisation and
           Dissemination 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;
G
           and (ix) Language and Expression.
           We would request Mr. Venugopal, learned Attorney General to
           assist with regard to the aforesaid 9 aspects by filing his suggestions
           within four weeks hence.
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      PANKAJ SINHA v. UNION OF INDIA AND OTHERS                                   347
                  [DIPAK MISRA, CJI]

       All the States shall file their response with regard to the steps          A
       taken and to be taken, keeping in view the constitutional goal.”
       14. In the instant writ petition, the petitioner has drawn the attention
of the Court to the fact that although leprosy as a disease has been
scientifically and medically proven to be curable and manageable with
MDT, yet the fact remains that millions of people and their family                B
members still suffer from leprosy and the social, economic and cultural
stigma attached to the said disease. This fact reveals the lack of
awareness and the prevailing misguided notions in the society pertaining
to leprosy. Further, the miserable plight of the persons afflicted with
leprosy does not end here. It has been highlighted that due to the disability
that entails as a result of the disease, the people affected by leprosy           C
suffer additional discrimination in the form of denial of access to health
services, education and livelihood options. At present, majority of the
populace which is afflicted with leprosy live as a marginalized section in
the society deprived of even basic human rights which manifestly results
in violation of the fundamental right to equality and right to live with          D
dignity.
        15. It has been further brought to the attention of the Court that
as per the requirements of the World Health Organization (WHO), all
countries are required to achieve a prevalence of less than one leprosy
case per 10,000 persons and although India had declared way back in               E
31.12.2005 that it has achieved the said goal of elimination of leprosy,
yet the progress reports of NLEP which have been reporting prevalence
rate in certain States of the Ministry of Health and Family Welfare exposit
an entirely different reality. As per the said reports, out of 642 districts in
India, only 543 districts have achieved a prevalence rate of less than one
case of leprosy for 10,000 persons. The underestimation of the cases of           F
leprosy and the declaration of elimination of leprosy has resulted in the
integration of leprosy in general health services thereby leading to
diversion of funds which would have otherwise been dedicated to
eliminating leprosy.
       16. The petitioners have expressed deep concern over the fact              G
that although a National Sample Survey of Leprosy was conducted by
the respondent No. 1, Union of India, yet the said survey has never been
brought out in the public domain. The desired results have not been
achieved due to improper dispensation of the MDT drugs through the
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348             SUPREME COURT REPORTS                          [2018] 13 S.C.R.


A     PHCs established for the said purpose. It is urged that the staff of
      PHCs display sheer lack of sensitivity while dealing with patients affected
      with leprosy as a consequence of which the level of stigma and isolation
      still prevails amongst the said patients. Several incidents have also been
      reported which have brought to light the discriminatory treatment meted
      out by the Government hospitals to leprosy affected pregnant women
B
      and cases wherein women have been refused treatment solely on account
      of being affected by leprosy. Another aspect, that is, the area of education
      has also been brought forth by the petitioners. It has been urged that
      lack of adequate education facilities would further magnify the sense of
      insecurity and stigma prevailing amongst the persons affected with
C     leprosy. For any development to take place, the first step would be in the
      direction of ensuring quality education for the children who are the wards
      of people affected with leprosy.
             17. It has been pointed out that several instances have come to
      fore highlighting that the persons affected with leprosy are being provided
D     with APL cards and not BPL cards which prevented these people from
      claiming benefits under various schemes brought out by the Government,
      such as the Antyodaya Anna Yojana (AAY), which again deprives this
      section of the populace from claiming their right to food. Deprivation of
      housing and other basic civic amenities, adequate sanitary facilities and
      rehabilitation programmes are yet other serious concerns which, if not
E     addressed, would lead to the entire reformatory process taking a huge
      setback.
             18. Keeping in view the factual matrix in entirety and the
      submissions advanced, we think it appropriate to issue the following
      directions :-
F
         (i) The Union and the States are to undertake periodical national
             surveys for determining the prevalence rate and new cases
             detection rate of leprosy and, at the same time, publish and bring
             the reports of the National Sample Survey of Leprosy conducted
             in 2010-11 and subsequent thereto into the public domain. That
G            apart, the activities of the National Leprosy Eradication
             Programme (NLEP) must be given wide publicity;
         (ii) On leprosy day which is internationally observed every year on
              the last Sunday of January, the Union of India along with all State
              Governments should organize massive awareness campaigns to
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   PANKAJ SINHA v. UNION OF INDIA AND OTHERS                               349
               [DIPAK MISRA, CJI]

    increase public awareness about the signs and symptoms of              A
    leprosy and the fact that it is perfectly curable by the Multi Drug
    Therapy (MDT). Awareness should also be spread about the free
    availability of MDT at all government health care facilities in the
    country, the prescribed course for MDT treatment and all other
    relevant information related to MDT. The content and
                                                                           B
    information contained in the awareness programmes should
    discontinue to use frightening images of people disabled with
    leprosy and instead use positive images of cured persons sharing
    their experiences of being cured of leprosy;
(iii) The Union and the States are to ensure that drugs for management
     of leprosy and its complications including the MDT drugs are          C
     available free of cost and do not go out of stock at all Primary
     Health Centres (PHCs) or, as the case may be, public health
     facilities in the country;
(iv) All-year awareness campaigns should also be run, by the Union
    as well as the States, to inform the citizenry that under the          D
    National Leprosy Eradication Programme (NLEP), treatment is
    provided free of cost to all leprosy cases diagnosed through general
    health care system including NGOs;
(v) The Union and the States must organize seminars at all levels
   which serve as platforms to hear the views and experiences              E
   directly from the former patients and their families as well as
   doctors, social workers, experts, NGOs and Government officials;
(vi) The awareness campaigns must include information that a person
    affected by leprosy is not required to be sent to any special clinic
    or hospital or sanatorium and should not be isolated from the          F
    family members or the community. The awareness campaigns
    should also inform that a person affected with leprosy can lead a
    normal married life, can have children, can take part in social
    events and go to work or school as normal. Acceptability of leprosy
    patients in the society would go a long way in reducing the stigma     G
    attached to the disease;
 (vii) Health care to leprosy patients, at both Government as well as
      private run medical institutions, must be such that medical
      officials and representatives desist from any discriminatory
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350        SUPREME COURT REPORTS                          [2018] 13 S.C.R.


A         behaviour while examining and treating leprosy patients.
          Treatment of leprosy should be integrated into general health
          care which will usher in a no-isolation method in general wards
          and OPD services. In particular, it must be ensured that there
          is no discrimination against women suffering from leprosy and
          they are given equal and adequate opportunities for treatment
B
          in any hospital of their choice. To this effect, proactive measures
          must be taken for sensitization of hospital personnel;
      (viii) Patients affected with leprosy, for whom partial deformity can
           be corrected by surgery, should be advised and provided
           adequate facility and opportunity to undergo such surgeries;
C
      (ix) The possibility of including leprosy education in school curricula
           so as to give correct information about leprosy and leprosy
           patients and prevent discrimination against them should be
           explored;
D     (x) The Union and the State Governments must ensure that both
          private and public schools do not discriminate against children
          hailing from leprosy affected families. Such children should not
          be turned away and attempt should be made to provide them
          free education;

E     (xi) Due attention must be paid to ensure that the persons affected
           with leprosy are issued BPL cards so that they can avail the
           benefits under AAY scheme and other similar schemes which
           would enable them to secure their right to food;
      (xii) The Union and the States should endeavour to provide MCR
F          footwear free of cost to all leprosy affected persons in the
           country;
      (xiii) The States together with the Union of India should consider
           formulating and implementing a scheme for providing at least a
           minimum assistance, preferably on a monthly basis, to all leprosy
           affected persons for rehabilitation;
G
      (xiv) The Union and the State Governments must pro-actively plan
          and formulate a comprehensive community based rehabilitation
          scheme which shall cater to all basic facilities and needs of the
          leprosy affected persons and their families. The scheme shall
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      PANKAJ SINHA v. UNION OF INDIA AND OTHERS                                    351
                  [DIPAK MISRA, CJI]

         be aimed at eliminating the stigma that is associated with persons        A
         afflicted with leprosy.
    (xv) The Union Government may consider framing separate rules
        for assessing the disability quotient of the leprosy affected
        persons for the purpose of issuing disability certificate in exercise
        of the power granted under the Rights of Persons with                      B
        Disabilities Act, 2016 (No. 49 of 2016).


      19. The writ petition is, accordingly, disposed of. There shall be
no order as to costs.
                                                                                   C

Ankit Gyan                                                 Petition disposed of.




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