 the tuberculosis (prevention and control) bill, 2017 bydr kirit premjibhai solanki, mp——————arrangement of clauses——————clauses chapter i preliminary1 short title, extent and commencement 2 definitions chapter ii prohibition of discrimination3 prohibition of discrimination chapter iii molecular testing and daily dosage treatment4central and state governments to take measures5molecular testing and daily dose of multi-drug resistant (mdr-tb)tuberculosis6availability of latest anti-tuberculosis drugs7guidelines for testing centres chapter iv digital database  and tracking of tuberculosis treatment and care8mandatory notification of tuberculosis patients9enrolment under aadhaar for tuberculosis patients seeking treatment chapter v identification of vulnerable sections of the population10 identification of vulnerable section of the population 11 state government to present list of vulnerable sections to the central government chapter vi welfare measures by central and state government12 nutritional, financial and psycho-social support for tuberculosis patients 13 tuberculosis related awareness programs 14 guidelines for care, etc of children and hiv-positive persons affected bytuberculosisclauses chapter vii national and state tuberculosis elimination boards15 constitution of the national tuberculosis elimination board 16 functions of the national board 17 constitution of state tuberculosis elimination board chapter viii appointment of ombudsman18 appointment of ombudsman 19 powers of ombudsman 20 procedure of complaint 21 reasonable opportunity of being heard 22 authorities to assist ombudsman 23 report to state government chapter ix penalties24 penalty for failure to comply with orders of ombudsman 25 prohibition of victimization 26 court to try offences chapter x miscellaneous27 act to have overriding effect 28 protection of action taken in good faith29 delegation of powers 30 central government to make guidelines 31 power of central government to make rules 32 power of state governments to make rules 33 power to remove difficulties bill no 230 of 2017 the tuberculosis (prevention and control) bill, 2017 bydr kirit premjibhai solanki, mpa billto provide for the prevention, diagnosis, treatment and control of the spread of tuberculosis and for the protection of the rights of patients affected by the tuberculosis disease and for matters connected therewith or incidental theretowhereas  the continued spread of tuberculosis is a matter of grave concern to all and there is an urgent need for the prevention and control of the said disease;and whereas there is a need to protect and secure the rights of persons who are affected with tuberculosis and vulnerable to the said disease;and whereas there is a necessity for effective care, support and treatment for tuberculosis;and whereas the general assembly of the united nations has adopted the sustainable development goals, which call for a reduction in tuberculosis-related deaths and the world health organization has adopted the end tb strategy for a reduction in the incidence of tuberculosis by 2035 through collective global efforts;and whereas the republic of india, being a signatory to the aforementioned goals and strategy, it is expedient to give effect to the said goals and strategybe it enacted by parliament in the sixty-eighth year of the republic of india as follows:— chapter i preliminary51  (1) this act may be called the tuberculosis (prevention and control) act, 2017(2) it extends to the whole of indiashort title, extent and commencement(3) it shall come into force on such date as the central government, may,  by notification in the official gazette, appointdefinitions2 in this act, unless the context otherwise requires,—1018 of 2016(a) "aadhaar" means aadhaar number issued by the unique identificationauthority of india under sub-section (3) of section 3 of the aadhaar (targeted deliveryof financial and other subsidies benefits and services) act, 2016;(b) "discrimination" means any act or omission which directly or indirectly, expressly or by effect, immediately or over a period of time,—15(i) imposes any burden, obligation, liability, disability ordisadvantage on any person or category of persons, based on one or more tuberculosis-related grounds; or20(ii) denies or withholds any benefit, opportunity or advantage from anyperson or category of persons, based on one or more tuberculosis-related grounds,and the expression "discriminate" to be construed accordingly;25(c) "guidelines" means any statement or any other document issued by thecentral government indicating policy or procedure or course of action relating to tuberculosis to be followed by the central government, state governments, governmental and non-governmental organisations and establishments and individuals dealing with prevention, control and treatment of tuberculosis;(d) "hiv-positive person" means a person whose hiv test has been confirmedpositive;30(e) "multi-drug resistant tuberculosis (mdr-tb)" means a strain of thetuberculosis bacteria resistant to two of the most effective anti-tuberculosis drugs available, isoniazid and rifampicin;(f) "notification" means a notification published in the official gazette; (g) "nikshay" means a web based solution for monitoring of tuberculosis patients developed by the national informatics centre;35 40(h) "person" includes an individual, a hindu undivided family, a company, a firm, an association of persons or a body of individuals, whether incorporated or not, in india or outside india, any corporation established by or under any central or state act or any company including a government company incorporated under the companies act, 1956, any limited liability partnership under the limited liability partnership act, 2008, any body corporate incorporated by or under the laws of a country outside india, a co-operative society registered under any law relating to cooperative societies, a local authority and every other artificial juridical person;(i) "prescribed" means prescribed by rules made by the central government orthe state government, as the case may be;5(j) "revised national tuberculosis control program (rntcp)" means theprogram launched by the ministry of health and family welfare in 1997;(k) "state government" in relation to a union territory, means the administratorof that union territory appointed by the president under article 239 of the constitution;10(l) "tuberculosis" means an infectious disease caused by a bacterium,mycobacterium tuberculosis that is spread through the air; and(m) "tuberculosis-affected person" means an individual who is suffering fromany strain of the tuberculosis disease chapter ii prohibition of discrimination15prohibition of discrimination3 no person shall discriminate against the tuberculosis-affected person on any ground including any of the following, namely:—(a) the unfair treatment in, or in relation to employment or occupation; (b) the denial or discontinuation of, or unfair treatment in, healthcare services;20(c) the denial or discontinuation of, or unfair treatment in educationalestablishments and services thereof;(d) the denial or discontinuation of, or unfair treatment with regard to, the rightof movement;(e) the denial or discontinuation of, or unfair treatment with regard to the rightto reside, purchase, rent or otherwise occupy, any property;25(f) the denial of access to, removal from, or unfair treatment in, government orprivate establishment in whose care or custody a person may be;(g) the isolation or segregation of a tuberculosis-affected person chapter iii molecular testing and daily dosage treatment304 the central government and every state government, as the case may be, shalltake all measures as it deems necessary and expedient for the prevention of spread of tuberculosis, in accordance with the guidelinescentral and state governments to take measures355 (1) the measures to be taken by the central government or the state governmentunder section 4 shall include the measures for providing, as far as possible, molecular testing methods for diagnosis and daily dosage treatment for those living with multi-drug resistant (mdr-tb) tuberculosis, in particularmolecular testing and daily dose of multi-drug resistant (mdr-tb) tuberculosis(2) the central government shall issue necessary guidelines in respect of protocolsfor tuberculosis relating to molecular testing and daily dosage treatment, which shall be applicable to all persons and shall ensure their wide dissemination406 the central government shall take steps to ensure the introduction andavailability of the latest anti-tuberculosis drugs in all public hospitals and governmentrun pharmaciesavailability of latest antituberculosis drugsguidelines for testing centres7 no diagnostic centre or laboratory shall conduct a diagnostic test for tuberculosisor multi-drug resistant tuberculosis except in accordance with the guidelines laid down for such test under this act chapter iv5 digital database and tracking of tuberculosis treatment and care8 every public and private hospitals and clinics shall notify tuberculosis patients under their treatment and care on the web-based nikshay platform under the revised national tuberculosis control programme to facilitate real time tracking of treatment and care such patientsmandatory notification of tuberculosis patients109 the central government and every state government shall take measures to ensure that every tuberculosis-affected person is enrolled under aadhaar to ensure unique identification of patients seeking care and facilitate direct benefit transfers under the welfare measures mentioned under chapter vi of this actenrolmentunder aadhaarfor tuberculosis patients seeking treatment chapter v15 identification of vulnerable sections of the population10 (1) every state government shall, with the assistance from the central government, carry out identification of the poor and vulnerable sections of the population within the jurisdiction of each tuberculosis program in such manner as may be prescribedidentification of vulnerable sections of the population20(2) the identification under sub-section (1) shall include, but shall not be limited to women, children, below poverty line households and hiv-positive persons11 every state government shall, within six months of the act coming into force, present the central government with a list of vulnerable sections within every tuberculosis program and formulate a plan to create awareness and initiate preventive measures about disease among such vulnerable sectionsstate government to present list of vulnerable sections to the central government25 chapter vi welfare meaures by central and state government12 (1) the central government and every state government shall take measures to facilitate better access to welfare, access to persons infected or affected by tuberculosis, which shall include but will not be limited to:30nutritional, financial and psycho-social support for tuberculosis patients(a) nutritional support, if malnutrition or undernourishment is detected, underthe public distribution scheme or any other related food security scheme;(b) financial support, under a health insurance or coverage scheme, for belowpoverty line patients to reduce out of pocket expenditure;35(c) psychological and social support, through free counseling, for patients andtheir families(2) without prejudice to the provisions of sub-section (1), the central and state governments shall frame schemes to address the needs of tuberculosis-affected women and children as well those from vulnerable sections of society, including those who are hiv positive4013 the central government and state government shall formulate tuberculosis related information, education and communication programmes which are non-discriminatorytuberculosis related awareness programs14 the central government shall lay down guidelines for care, support and treatment of children affected with tuberculosis and hiv-positive persons affected by tuberculosisguidelines for care, etc of children and hiv-persons affected by tuberculosis chapter vii 5 national and state tuberculosis elimination boards15 (1) the central government shall, by notification in the official gazette, constitute a national tuberculosis elimination board, to facilitate the eradication of tuberculosis in the country(2) the national board shall include,—constitution of the national tuberculosis eliminationboard10(a) the union minister of health and family welfare— chairperson; (b) the secretary, union ministry of health and family welfare— member; (c) representatives from the indian council of medical research to be nominatedby the central government in such manner as may be prescribed— member;(d) representatives from health departments of every state government to benominated by the central government in such manner as may be prescribed—  member;15(e) medical practitioners from private medical hospitals and clinics to benominated by the central government in such manner as may be prescribed— member;(f) members from affected communities to be nominated by the centralgovernment in such manner as may be prescribed— member; and20(g) representatives from non-governmental organisations working in the fieldof prevention, control and treatment of tuberculosis to be nominated by the central government in such manner as may be prescribed— member(3) the salary and allowance payable to and other terms and conditions of service of members of the national board shall be such as may be prescribed2516 the national board shall,—functions of the national board(a) formulate a comprehensive strategy to ensure the elimination of the disease,with an aim to achieving national and international commitments;(b) keep track of new medical diagnostic technologies and anti-tuberculosisdrugs and ensuring their easy availability;30(c) provide incentives to the private sector to assist in the elimination oftuberculosis;(d) create awareness and prevention strategies on the basis of the mapping andidentification conducted by every state government under section 10;(e) track the activities of the ombudsman appointed under section 18;35(f) receive quarterly reports from the state tuberculosis elimination boards; (g) ensure that adequate financial, nutritional and psycho-social support isprovided to tuberculosis-affected patients under a variety of government schemes; and(h) take decisions regarding any other policy or scheme related to tuberculosisand the rights of the patients seeking treatment and care for the said disease4017 (1) every state government shall, by notification in the official gazette, constitute a state tuberculosis elimination board to carry out the functions of this actconstitution of state tuberculosis elimination boards5(2) the state tuberculosis elimination boards shall consist of a chairperson andsuch other number of members as may be determined by the state government in consultation with the national board(3) the salary and allowance payable to chairperson and other member of the state tuberculosis elimination board shall be such as may be prescribed appointment of ombudsman1018 (1) every state government shall appoint one or more ombudsman—(a) possessing such qualification and experience as may be prescribed, orappointmentofombudsman(b) designate such number of officers not below the rank of district magistrate,to exercise such powers and discharge such functions, as may be conferred on ombudsman under this act15(2) the terms and conditions of the service of an ombudsman appointed underclause (a) of sub-section (a) shall be such as may be prescribed by the state government(3) the ombudsman appointed under sub-section (1) shall have such jurisdiction inrespect of such are or areas as the state government may, by notification, specifypowers of ombudsman2019 (1) the ombudsman shall, upon a complaint made by any person, inquire into theviolation of the provisions of this act, in relation to healthcare services by any person, in such manner as may be prescribed by the state government(2) the ombudsman shall maintain records of complaints in such manner as may beprescribedprocedure of complaint20 the complaints shall be made to the ombudsman in such manner, as may beprescribed2521 the ombudsman shall, after giving an opportunity of being heard to the parties,pass such order, as he deems fit, giving reasons thereforreasonable opportunity of being heard authorities to assist ombudsman3022 all authorities including the civil authorities functioning in the area for which theombudsman has been appointed under section 18 shall assist in execution of orders passed by the ombudsmanreport to state government23 the ombudsman shall, after every six months, report to the state government, thenumber and nature of complaints received, the action taken and orders passed in relation to such complaints and such report shall be published on the website of the ombudsman and a copy thereof be forwarded to the central government penalties24 whoever fails to comply with any order given by an ombudsman within such time as may be specified in such order shall be liable to pay a fine which may extend upto ten thousand rupees and in case the failure continues, with an additional fine which may extend to five thousand rupees for every day during which the failure continuespenalty for failure to comply with orders of ombudsman25 no person shall subject any other person or persons to any detriment on the ground that such person or persons have taken any of the following actions namely:—prohibition of victimization(a) made complaint under this act;(b) brought proceedings under this act against any person; (c) furnished any information or produced any document to a person exercisingor performing any power or function under this act; or(d) appeared as a witness in a proceeding under this act5court to try offences26 no court other than the court of judicial magistrate first class shall take cognizanceof an offence under this act chapter x miscellaneous10act to have overridingeffect27 the provisions of this act shall have effect notwithstanding anything inconsistenttherewith contained in any other law for the time in force or in any instrument having effect by virtue of any law other than this actprotection of action taken in good faith1528 no suit, prosecution or other legal proceeding shall lie against the centralgovernment, the state government, the ombudsman or any member thereof or any officer or other employee or person acting under the direction either of the central government, the state government, or ombudsman in respect of anything which is in good faith done or intended to be done in pursuance of this act or any rules or guidelines made thereunder or in respect of the publication by or under the authority of the central government, the state government or ombudsmandelegation of powers2029 the central government or the state government, as the case may be, may, bygeneral or special order, direct that any power exercisable by it under this act shall, in such circumstances and under such conditions, if any, as may be mentioned in the order, be exercisable also by an officer subordinate to that government or the local authority30 the central government may, by notification, make guidelines consistent withthis act and any rules thereunder, generally to carry out the provisions of this actcentral government to make guidelines25power to remove difficulties31 (1) if any difficulty arises in giving effect to the provisions of this act, the centralgovernment may, by order published in the official gazette, make such provisions, notinconsistent with the provisions of this act, as may appear to be necessary for removing the difficulty:30provided that no order shall be made under this section after the expiry of the periodof two years from the date of commencement of this act(2) every order made under this section shall be laid, as soon as may be after it ismade, before each house of parliament32 (1) the central government may, by notification, make rules to carry out theprovisions of this act35power of central government to make rules40(2) every rule made under this act shall be laid, as soon as may be after it is made,before each house of parliament, while it is in session, for a total period of thirty days which may be comprised in one session or in two or more successive sessions, and if, before the expiry of the session immediately following the session or the successive sessions aforesaid, both houses agree in making any modification in the rule or both houses agree that the rule should not be made, the rule shall thereafter have effect only in such modified form or be of no effect, as the case may be; so, however, that any such modification or annulment shall be without prejudice to the validity of anything previously done under that rule33 (1) the state government may, by notification, make rules for carrying out theprovisions of this actpower of state governments to make rules45(2) every rule made by the state government under this act shall be laid, as soon asmay be, after it is made before the legislature of that state statement of objects and reasonsalthough tuberculosis is a preventable and treatable disease, yet it continues to be a serious public health epidemic in india india bears the highest tuberculosis burden in the world, accounting for 23 per cent of the global incidence of active tuberculosis patients it is estimated that 1,400 indians die every day due to tuberculosis since india is a signatory to the world health organization's 'end tb strategy' and the united nations' sustainable development goals, the ministry of health and family welfare has formulated the national strategic plan to eliminate tuberculosis by 2025to supplement the strategies outlined within this plan, the bill aims to address all aspects of the diagnosis, treatment, prevention and control of the spread of tuberculosis as well as the rights of the patients seeking care it mandates the creation of a national tuberculosis elimination board, which will be the apex body directing all efforts to combat the disease along with state-level boards it also provides for appointment of an ombudsman to address the grievances of patients and related stakeholdersthe bill prohibits certain discriminatory acts that stigmatize patients and their families and mandates the central government and state governments to undertake welfare measures to provide financial, nutritional and psycho-social support to patients from vulnerable sections of the population to facilitate the tracking of tuberculosis treatment and care, the bill makes it mandatory for both public and private hospitals and clinics to notify tuberculosis patients under their care on the web-based nikshay portal and encourage all patients seeking care to enroll under aadhaartuberculosis is india's most severe public health crisis and combating it will require the collective and sustained effort of all stakeholders the bill aims to ensure that india will achieve its goal to eliminate tuberculosis by 2025 and it seeks to achieve the above objectshence this billnew delhi;kirit premjibhai solankinovember 27, 2017 financial memorandumclause 4 of the bill provides that the central government and every state government, as the case may be, shall take all measures as it deems necessary and expedient for the prevention of spread of tuberculosis, in accordance with the guidelines clause 5 provides for measures to be taken by the central government or the state government for providing molecular testing methods for diagnosis and daily dosage treatment for those living with multi-drug resistant (mdr-tb) tuberculosis clause 10 provides for every state government to carry out identification of the poor and vulnerable sections of the population within the jurisdiction of each tuberculosis program clause 12 provides that the central government and every state government to take measures to facilitate better access to welfare, access to persons infected or affected by tuberculosis including nutritional support, financial support and social support clause 15 provides that the central government shall constitute a board to be known as the national tuberculosis elimination board clause 17 provides for constitution of the state tuberculosis elimination boards clause 18 provides for appointment of ombudsman the bill, therefore, if enacted, will involve expenditure from the consolidated fund of india it is likely to involve an annual recurring expenditure of about rupees one hundred crore from the consolidated fund of indiaa non-recurring expenditure of about rupees fifty crore is also likely to be involved memorandum regarding delegated legislationclause 4 of the bill empowers the central government to make guidelines consistent with the proposed legislation and rules thereunder to carry out its provisions clause 32 of the bill empowers the central government to make rules for carrying out the provisions of this act as matters in respect of which rules may be made under the aforesaid provisions are matters of procedure and administrative detail only, the delegation of legislative power is, therefore, of a normal character———— a billto provide for the prevention, diagnosis, treatment and control of the spread of tuberculosisand for the protection of the rights of patients affected by the tuberculosis disease and for matters connected therewith or incidental thereto————(dr kirit premjibhai solanki, mp)gmgipmrnd—2721ls(s3)—15-12-2017