ABSTRACT
The recognition of the right to health as a justiciable and enforceable fundamental right remains one of the most pressing legal and constitutional imperatives in India. Although the Indian Constitution does not explicitly enshrine the right to health as a fundamental right, its judicial interpretation, most notably under Article 21, has significantly expanded the contours of the “right to life” to encompass the right to health. This research examines the constitutional mandates and practical realities surrounding this right, interrogating the dynamic interplay between Directive Principles of State Policy and fundamental rights, & transformative role of judicial activism in bridging the normative gap. Through judicial analysis, this research delves into how jurisprudence has progressively infused substantive content into the right to health. It also contextualizes the operational challenges posed by India’s quasi-federal structure, where health is constitutionally situated as a State’s subject, thereby complicating uniform implementation and accountability. Further, this research juxtaposes India’s legal approach with comparative constitutional frameworks that explicitly guarantee the right to health, highlighting the normative advantages of textual incorporation. The policy dimensions, particularly the efficacy of the National Health Policy, 2017 and flagship schemes like Ayushman Bharat, are critically assessed against persistent systemic deficiencies in infrastructure, access, and equity. This research argues for the explicit constitutional recognition of the right to health as a fundamental right, necessitating robust institutional reforms, enhanced public expenditure, and judicial accountability to render health justice a lived constitutional reality.
Keywords: Right to Health, Fundamental Rights, Judicial Activism, Public Health, Ayushman Bharat, Healthcare Access.
INTRODUCTION
Health occupies a central locus in the architecture of human development, functioning not merely as a physiological necessity but as an enabler of individual freedom, socio-economic mobility, and collective well-being. The Human Development Index (HDI), pioneered by UNDP, embeds health, measured through life expectancy, as a core determinant, underscoring its symbiotic relationship with education and income. In the Indian context, where socio-economic stratification and vast demographic diversity shape public policy outcomes, health assumes an even more pronounced significance. A citizen’s ability to participate in civic life, pursue educational or economic goals, and enjoy the full spectrum of constitutionally guaranteed freedoms is inextricably linked to their physical and mental well-being. Hence, a robust public health framework transcends the paradigm of welfare to become an essential component of justice, substantive, distributive, and procedural.[1]
In constitutional democracies, rights are not merely rhetorical constructs but normative benchmarks against which state action, and inaction, is measured. The recognition of health as a right in such societies is predicated on the understanding that human dignity, which lies at the normative core of constitutionalism, is unattainable in the absence of adequate health care. The evolution of rights jurisprudence globally has increasingly embraced a justiciable right to health, either through explicit textual incorporation (as seen in the Constitutions of South Africa and Brazil) or through progressive judicial interpretation of broader rights such as the right to life or dignity. In India, although the Constitution does not explicitly codify the right to health as a fundamental right, a rights-based approach is discernible through the expansive interpretation of Article 21 by the higher judiciary.[2] The convergence of constitutional morality, international obligations under instruments like the ICESCR, and grassroots advocacy collectively reinforces the imperative of acknowledging health as a non-negotiable entitlement intrinsic to a functional, egalitarian democracy.
According to the National Health Profile, India has only one government hospital bed per 1,844 people, far below the WHO’s recommended ratio of one per 1,000.[3] The Rural Health Statistics 2021-22 by the Ministry of Health and Family Welfare highlight that 75% of healthcare infrastructure is concentrated in urban areas, while 73% of the population resides in rural areas with limited access to basic medical facilities.[4] India’s public health expenditure remains low at 2.1% of GDP in FY23, compared to the 5.2% average for lower- and middle-income countries, as per a Frontiers in Public Health report.[5] High out-of-pocket expenditure (2.3% of GDP, per OECD) exacerbates healthcare inequities, with over 33% of the ailing population suffering from infectious diseases and women facing significant disparities, as noted in the World Economic Forum 2021 report, which ranks India among the worst for female health and survival.[6] Despite initiatives like Ayushman Bharat, covering over 40 crore people by 2025, and 15,000+ Jan AushadhiKendras for low-cost medicines, the lack of a comprehensive public health law and inadequate infrastructure continue to hinder the effective realization of the right to health.[7]
[1] Ramakanta Satapathy & Bikram Kumar Das, RIGHT TO HEALTH IN INDIA, 6 Int’l Multidisciplinary Rsch. J. 6, (2016), https://doi.org/10.19071/imrj.2016.v6.3038.
[2] INDIA CONST., art. 21.
[3]Just 1 Doctor To Treat 11,000 Patients: Govt Report Details India’s Health Crisis, ThePrint, https://theprint.in/india/governance/just-1-doctor-to-treat-11000-patients-govt-report-details-indias-health-crisis/74013/ (last visited June 16, 2025).
[4]Rural Health Statistics, 2021-22, People’s Archive of Rural Health, https://ruralindiaonline.org/en/library/resource/rural-health-statistics-2021-22/ (last visited June 16, 2025).
[5]Health expenditure at 2.1% of GDP in FY23: Economic Survey, mint, https://www.livemint.com/news/india/health-expenditure-at-2-1-of-gdp-in-fy23-economic-survey-11675160463795.html (last visited June 16, 2025).
[6]Health expenditure in relation to GDP, OECD, https://www.oecd.org/en/publications/2023/11/health-at-a-glance-2023_e04f8239/full-report/health-expenditure-in-relation-to-gdp_e3566919.html (last visited June 16, 2025).
[7] Jan Aushadhi Scheme To Provide Best And Affordable Medicines, Says Pm, Press Information Bureau, https://www.pib.gov.in/newsite/PrintRelease.aspx?relid=200008 (last visited June 16, 2025).