Sahara House v. Union of India

Petitioner, Sahara House, was a center for residential care and rehabilitation. The Petitioner filed a public interest litigation in the Supreme Court under Article 32 of the Constitution of India (original writ jurisdiction of the Supreme Court). The Petitioner sought directions from the Court to the effect that denial of treatment to persons living with HIV/AIDS (PLHIV) would be in violation of, inter alia, article 14 (right to equality), article 21 (right to life) and article 47 (duty of the state to improve public health.) of the Constitution of India.

Another petition (W.P. No. (C) 513 of 1999) filed by Sankalp Rehabilitation Trust, Petitioner No. 2, also sought directions from the Court regarding discrimination against PLHIV in health care settings. Other petitions were filed by Voluntary Health Association of Punjab (W.P. No. (C) No. 311 of 2003) and Common Cause (W.P. No. (C) 61/2003). During the pendency of the petition, Petitioner No. 2 also brought to the Court’s notice problems in the 2004 National Antiretroviral Rollout Programme (the Programme). The Court asked Petitioner No. 2 to file the directions, along with justifications, they sought for remedying the defects in the Programme. In one of the applications filed by Petitioner No. 2, it was argued that the criteria set by the National AIDS Control Organization (NACO) restricting the provision of second line antiretroviral treatment (ART) to certain categories of persons was unconstitutional. Petitioner No. 2 argued that ART should be made available to everyone requiring the treatment irrespective of any other criteria.

Please note that this case is unusual as there is no judgment and only a series of orders. The most significant orders have been compiled here into a single PDF document. For a list of all orders, please see Additional Documents.

As to the issues surrounding access to treatment, the Court endorsed the points agreed to by NACO, lawyers for the respective parties, PLHIV and the Government. The points were issued by NACO through an office memorandum. The Court, inter alia, ordered the upscaling of antiretroviral treatment centers, including provision and maintenance of adequate infrastructure and CD4 testing machines, provision of redressal mechanisms for PLHIV, free treatment of opportunistic infections, and nondiscrimination of PLHIV in health care settings

Taking note of the irrational prescription of treatment and medicines by private doctors, the Court ordered the Medical Council of India to ensure that all private sector health care facilities followed NACO protocol guidelines. It also ordered all health care providers to submit quarterly reports on the treatment provided to PLHIV, in a format that could be made available by NACO on its website.

Regarding the provision of second line antiretroviral treatment to all those who required such treatment, the Court held that second line treatment should be universally available to people needing it, regardless of any additional criteria. Taking into consideration capacity constraints, the Court held that such treatment should initially be made available in four centers. The Court clarified that persons from all over the country could be referred to these centers. It further held that the pilot initiative was to be studied for three months, during which capacity would be increased and the number of people in need of treatment could be determined. The Court held that NACO should make second line antiretroviral treatment universally available as quickly as possible.

“It is submitted that persons from anywhere in the country (in need of second line treatment) may be referred to these four Centers of Excellence presently.” Order dated 16/12/2010, Para. 6.

“NACO shall make its best efforts to ensure that such treatment is universally available at the earliest.” Order dated 16/12/2010, Para. 8.