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Epidemic diseases act 1897, India: Whether sufficient to address the current
challenges?

Article · January 2013

DOI: 10.4103/0971-9903.117796

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 ISSN 0971-9903

Journal of
Mahatma Gandhi
Institute of Medical Sciences
Official Publication of Mahatma Gandhi Institute of Medical Sciences
September 2013 / Volume 18 / Issue 2
www.jmgims.co.in
JMGIMS

Medknow
 Short Review

Epidemic diseases act 1897, India: Whether

sufficient to address the current challenges?
Binod K. Patro, Jaya Prasad Tripathy1, Rashmi Kashyap1

Abstract
In this age of noncommunicable diseases, communicable diseases still contribute 30% of disease burden in India.
Hundreds of epidemics occur each year and we fail to respond and contain most of them. Apart from various
biological and behavioral public health interventions, we need to closely look at the structural intervention, that
is, the legal framework to review health system preparedness. Although India has a number of legal mechanisms
to support public health measures in an epidemic situation, they are not being addressed under a single legislation.
The Epidemic Act 1897 is a century old blunt act which needs a substantial overhaul to counter the rising burden
of infectious diseases both new and old. Issues like definition of epidemic disease, territorial boundaries, ethics
and human rights principles, empowerment of officials, punishment, etc., need more deliberations and warrant a
relook.

Keywords: Epidemic diseases act, outbreak control, public health interventions

Introduction A total of 1,584 disease outbreaks were reported and

India is witnessing epidemiological transition. In the 21st
century, the country is facing dual burden of diseases.
While struggling to combat the burden of communicable
diseases, our health system is challenged to address
chronic noncommunicable diseases. The burden and
spectrum of infectious diseases are enormous in India.
They still contribute about 30% of disease burden in India.
[1]
Epidemics of communicable diseases impose a heavy
economic burden on individuals, families, communities,
and nation at large. We still are clueless while handling
influenza pandemics and struggle to contain them.
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DOI:
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responded during the year of 2012 in India.[2] This is just
the tip of the iceberg as many outbreaks go unnoticed
and unreported. The rise in the number, geographic
extent, severity of outbreaks, threat of bioterrorism,
emergence of emerging and reemerging infections,
volume of air travel, globalization, and the complex
lifestyle behaviors of the people has stressed the need
for devising new public health interventions to respond
to the epidemics effectively and swiftly.
Public health interventions can be broadly divided
into four categories: Biological, behavioral, political,
and structural. The biological interventions are most
commonly used for containing communicable diseases.
They are the ones based on classical biomedical model
of health. Behavioral interventions rely upon bringing
upon a change in the behavior of an individual or the
community which is based upon social determinants
model of health promotion. Political interventions are
in the form of prescribing policies related to health.

Department of Community Medicine and Family Medicine, All India Institute of Medical Sciences, Bhubaneswar, Odisha,
1
Department of Community Medicine, Post Graduate Institute of Medical Education and Research School of Public Health,
Chandigarh, India

Address for correspondence:

Dr. Binod K Patro, Associate Professor, Department of Community Medicine and Family Medicine, All India Institute
of Medical Sciences, Bhubaneswar – 751 019, Odisha, India. E-mail: patrobinod@gmail.com

September 2013 | Vol 18| Issue 2 Journal of Mahatma Gandhi Institute of Medical Sciences
110
The last category of public health interventions is
structural which is the end result of political process,
that is, passage of laws and regulations.[3]
Two pronged strategy is employed by Government
of India to control infectious diseases. First, we have
selective vertical diseases control program which
focuses on one disease at a time. This approach is
suitable for endemic diseases. Cost and nonintegration
with general health services of this approach makes
it nonreplicable and inefficient in the containment of
infectious diseases. The second approach is based on
investigation and control of outbreaks and epidemics.
This approach is suitable for short-term containment
of epidemics, but inappropriate for endemic diseases.
Both approaches operate with within a legal and
administrative framework and require community
participation to be effective. A recent review on
challenge of infectious diseases in India have concluded
the inadequacy of our health system in tackling the
infectious diseases and recommended overhauling
of our health system.[4] Review of health systems
preparedness will not be complete without reviewing
the legal frameworks available. Regulatory options
available in India are namely Epidemic Act 1897
and Internal Health Regulations. International Health
Regulations is an instrument designed and implemented
by World Health Organization for diseases of national,
regional, and global health security. Epidemic Act
1897 is the only act which provides legal interventions
in case of a subnational epidemic.
Epidemic Diseases Act 1897
The Epidemic Diseases Act came into force on
February 4, 1897 as a response to the plague epidemic
in Bombay. This act confined plague to Bombay by
a series of tough measures which prevented crowds
from gathering.[5] This Act has four sections, the first
section describes the title and the extent, the second
section empowers state and central government to
take special measures and prescribe regulations that
are to be observed by public to contain the spread of
disease. The third section defines penalty for violating
the regulations, whereas the fourth section gives legal
protection to persons acting under the act.
Section 1 says that the act may be called as Epidemic
Diseases Act, 1897 and it extends to the whole of India
except the territories which immediately before the 1st
November, 1956 were comprised in Part B states.
Journal of Mahatma Gandhi Institute of Medical Sciences September 2013 | Vol 18| Issue 2
Patro, et al.: Epidemic act in India
Section 2 states that when 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; and if it thinks that the ordinary
provisions of the law are insufficient for the purpose
then the state may take, or require or empower any
person to take some measures and by public notice
prescribe such temporary regulations to be observed
by the public. The state government may prescribe
regulations for 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.
Section 2A empowers the central government for
inspection of any ship or vessel leaving or arriving at
any port and for detention thereof, or of any person
intending to sail therein, or arriving thereby.
Section 3 prescribes penalty for disobeying any
regulation or order made under the Act in accordance
with section 188 of the Indian Penal Code. Under this
provision, a punishment of 6 months imprisonment or
1,000 rupees fine or both shall be meted out to the person
who disobeys any order under the Act.
Section 4 clearly mentions that no suit or other legal
proceeding shall lie against any person for anything
done or in good faith intended to be done under this
Act.[5]
Major Limitations of the Act
Epidemic Act 1897 is an archaic framework, 113-year-
old. The century old Act over the years has accumulated
quite a number of flaws which can be attributed to
the changing priorities in public health emergency
management. Epidemic Act 1897 is silent on the
definition of dangerous epidemic disease. Moreover, it
being a century old act, the territorial boundaries of the
act needs a relook. Apart from the isolation or quarantine
measure the act is mum on the legal framework of
availability and distribution of vaccine and drugs
and implementation of response measures. There is
no explicit reference pertaining to the ethical aspects
or human rights principles during a response to an
epidemic. The punishment for violation of regulations
under section 188 of Indian Penal Code also warrants
a revision. Can section 188 IPC guarantee justice to
all those who suffered from the plague epidemic which
cost the Indian economy over $600 million and took
 Patro, et al.: Epidemic act in India
the toll of hundreds of lives is a big question, and we
certainly have no answers to that.[6]
Although India has a number of legal mechanisms to
support public health measures in an epidemic situation,
they are not being addressed under a single legislation.
There is an urgent need to assemble all the provisions
in one over-arching public health legislation, so that
the implementation of the responses to an epidemic can
be effectively monitored. Without a comprehensive
public health Act, we are dependent upon old
blunt instruments like Epidemic Act 1897 which is
nonfunctional in itself. Constant efforts are underway
to strengthen public health legislation in India. In 1955
and again in 1987 the central government developed a
Model Public Health Act, but could not advocate states
to adopt them. The latest revision done by NICD in
2003 is still pending for approval by central authorities.
The National Health Bill 2009 seeks to ensure broad
legal framework for providing essential public health
services and functions and powers to respond to public
health emergencies through effective collaboration
between center and the states. Some states like Gujarat
and Karnataka have a gone a long way in drafting the
Public Health Bill.[7]
Integrated Disease Surveillance Project (IDSP) was
another initiative launched in 2004 which collects
routine disease surveillance data to detect and respond
to disease epidemics quickly. On an average, IDSP
reports 30-40 outbreaks every week by the states.[2] But
these provisions seem to be adequate to deal with small
scale emergencies but do not appear to be sufficient for
large scale health crisis during pandemics. With the
advent of emerging and reemerging infectious diseases
and widespread global movement, the legal frameworks
need to be strengthened under a sound public health law
infrastructure under areas like isolation or quarantine
of infected or suspected patients, travel or movement
restrictions, prohibition of mass gatherings, closure
September 2013 | Vol 18| Issue 2 Journal of Mahatma Gandhi Institute of Medical Sciences
View publication stats
111
of educational and other institutions, compulsory
vaccination, etc.
Conclusion
Thus it is far beyond doubt that this century old Act
needs a complete overhaul to cater to the changing
public health priorities. Undeniably, the role of public
health specialists in this regard cannot be ruled out. The
lawmakers can draw a leaf out of the National Disaster
Management Act 2005[8] (deals with public emergency)
as it clearly defines all the terms and has an explicit
description of all the implementing measures and
agencies to be instituted in the event of any emergency.
References
1. WHO. The global burden of disease: 2004 update. Geneva:
World Health Organization, 2008.
2. Integrated Disease Surveillance Project. Ministry of Health
and Family Welfare, Government of India. Available from:
http://www.idsp.nic.in/ [Last accessed on 2012 Jun 24].
3. Nutbeam D, Wise M. Structures and strategies for public
health intervention. In: Detels R, McEwen J, Beaglehole R,
Tanaka H, editors. Oxford Textbook of Public Health. 4th ed.
London: Oxford University Press; 2002.
4. John TJ, Dandona L, Sharma VP, Kakkar M. Continuing challenge
of infectious diseases in India. Lancet 2011;377:252-69.
5. Epidemic Diseases Act 1897. Available from: www.mohfw.
nic.in [Last accessed on 2012 Dec 24].
6. Dennis DT. Plague in India. BMJ 1994;309:89.
7. Kakkar M, Hazarika S, Zodpey S, Reddy KS. Influenza
pandemic preparedness and response: A review of legal
frameworks in India. Indian J Public Health 2010;54:11-7.
8. National Disaster Management Act 2005. Available from: http://
www.ndmindia.nic.in/acts-rules/DisasterManagementAct2005.
pdf [Last accessed on 2012 Dec 24].
How to cite this article: Patro BK, Tripathy JP, Kashyap
R. Epidemic diseases act 1897, India: Whether sufficient to
address the current challenges?. J Mahatma Gandhi Inst Med Sci
2013;18:109-11.
Source of Support: Nil, Conflict of Interest: None declared.