Despicable - government wants TB patients to show Aadhaar first, then claim benefits
The Aadhaar debate is still raging, and the Supreme Court had only a few days back held that those without Aadhaar need not obtain it for linking it with PAN in order to file their tax returns. While the
While the judgement is still interpreted among legal and jurisprudential circles, we have one more ruling from the government that makes it mandatory for patients suffering from tuberculosis to show their Aadhaar cards to avail benefits. Under the Revised National Tuberculosis Control Programme (RNTCP), Aadhaar is now compulsory, as per a notification, dated June 16, from the ministry of health and family welfare.
It says: “An individual eligible to receive the benefit under the Scheme, is hereby, required to furnish proof of possession of Aadhaar number or undergo Aadhaar authentication.” In fact, the notification goes against its own aim to provide “universal access to tuberculosis care” by discriminating between those who have Aadhaar and those who don’t, including TB patients, healthcare workers and others assisting in the treatment.
This is only the latest in a long line of rulings which the government has issued at regular but frequent intervals, making Aadhaar, which is voluntary in the Aadhaar Act of 2016, mandatory for various schemes. Last week, after the SC judgment left many befuddled over whether or not Aadhaar must be linked to PAN for income tax filing, we were notified that bank accounts must be linked to Aadhaar, new accounts cannot be opened without Aadhaar, and transactions over Rs 50,000 must have Aadhaar.
Before that, we had Aadhaar made compulsory for a host of social services and government schemes, for availing rations via PDS, for mid-day meal schemes at schools, for skills and jobs training, for booking train tickets. Those with Aadhaar are being given preferential treatment at hospitals, schools.
States like Haryana are making Aadhaar compulsory for issuing birth certificates. In Jharkhand, women are returning empty-handed as their rations are being denied to them as Aadhaar fails to accurately match their fingerprints with the data. The discriminatory onslaught continues with the latest ruling making Aadhaar mandatory for TB patients and in the related healthcare.
For direct cash assistance, TB patients must be registered via a web-based application called Nikshay, and the authentication must now happen via Aadhaar. The last date for providing Aadhaar enrolment number via Nikshay is August 31.
Millions of TB patients
According to tbfacts.org, each year about 2.2 million people develop tuberculosis, and about 10 per cent, or 220,000 die from the disease. In 2015 alone, 6.1 million new TB cases came to light, even though the World Health Organisation says that India reports only 59 per cent of its total TB cases.
The incidence of TB is staggeringly high at 217 per 100,000 population. When compared to Canada, where there are just 1,600 hundred TB cases every year, this is indeed a staggering number. Every third AIDS patient dies of tuberculosis in India, and it’s one of India’s major public health issues. According to tbfacts.org, “In 2015 the RNTCP covered a population of 1.28 billion.
A total of 9,132,306 cases of suspected TB were examined by sputum smear microscopy and 1,423,181 people were diagnosed and registered for TB treatment”. According to the National Strategic Plan (NSP) of 2012-2017, the then UPA government envisioned a TB-free India, achieving universal access for all TB affected persons by improving quality and quantity of services.
The RNTCP included even those with drug-resistant TB, and the aim early detection and treatment, expanding the ambit of RNTCP to include even the HIV-related TB patients.
Aadhaar-driven exclusions
Much like in other government services in which Aadhaar has been made mandatory despite it being legally voluntary as per the Aadhaar Act, those without Aadhaar will be left without a choice to get the UID or forego treatment. Given that TB mostly affects those living in abject poverty, with lung infections caused by inadequate sanitation, poor hygiene, malnutrition, this is the exclusion that TB patients are simply too poor to afford.
However, we need to ask what kind of a government is willing to see TB patients wither and drop dead because they don’t have an ID, the legality of which itself is under the scanner. Most of those afflicted with TB in the urban areas are the migrant workers without an address, no rent agreements, and documents that are a must to obtain Aadhaar. In addition, the “conditional cash assistance” is a big hurdle for TB patients who’d be bogged down with the extra bureaucratic burden.
Instead of universalising access, this is the kind of digital hurdle erected to discourage many from availing the benefits of the NTCP, and realise its one-time noble goals. Moreover, the leaky government websites leeching Aadhaar and other private data online are hardly capable of guarding sensitive and confidential medical data.
Registering and authenticating every TB patient through the web app Nikshay presents the additional security issue, and the government notification says nothing of what all precaution has been taken to prevent the same. The imposition of Aadhaar on the citizens, especially the most vulnerable, at in order to avail basic government services is going on even as the legality of Aadhaar itself is under question.
We need to ask what is it about this government that it would let a person with tuberculosis suffer and die than let him/her get treatment, in case he/she is missing an Aadhaar card.