Tuberculosis Eradication Drive Cannot Be Halted On Mere Apprehensions: Madhya Pradesh High Court

The Madhya Pradesh High Court has declined to interfere with a tuberculosis screening programme that deploys ultraportable handheld X-ray devices in community camps, holding that courts should exercise considerable restraint while reviewing public health policies framed in larger public interest.

Justice Jai Kumar Pillai dismissed a writ petition filed by Pragatisheel Radiographers Sangh, Madhya Pradesh, which had challenged the Centre’s operational guidelines for handheld X-ray devices and subsequent state and district-level orders directing radiographers to conduct large-scale TB screening under the TB Mukt Bharat Abhiyan.

The petitioner association, represented by Advocate Prathviraj Singh Parmar, argued that radiographers across the state were being compelled to perform between 100 and 150 chest X-rays daily in villages and temporary camps using handheld X-ray machines. According to the association, these camps were often conducted in Panchayat Bhawans, schools and Anganwadi centres that lacked lead-lined walls or other protective infrastructure.

The association further contended that radiographers were not being provided with mandatory Thermoluminescent Dosimeter (TLD) badges, adequate protective equipment or periodic health monitoring. It also highlighted that radiographers in Madhya Pradesh continue to receive a radiation allowance of only Rs. 50 per month, despite increased exposure risks associated with field deployment.

The challenge was directed against the August 2023 guidelines issued by the Central TB Division of the Ministry of Health and Family Welfare regarding the installation and operation of ultraportable handheld X-ray devices for tuberculosis screening. The petitioner questioned the scientific basis of the guidelines, pointing out that they relied on claims that radiation exposure from the devices was “almost zero/negligible” and “1/10th” that of conventional digital X-ray machines.

The association argued that such claims were based on manufacturers’ representations rather than independent scientific validation. It also asserted that requiring radiographers to perform a large number of daily X-rays without comprehensive protective measures violated Atomic Energy Regulatory Board safety norms and infringed their right to a safe working environment under Article 21 of the Constitution.

Additionally, the petitioner relied on medical literature and World Health Organization guidance to argue that indiscriminate screening of asymptomatic populations could result in unnecessary radiation exposure while providing only limited public health benefits.

Opposing the plea, Advocate Romesh Dave appeared for the Union of India, while Deputy Government Advocate Kushagra Singh represented the State authorities. They submitted that the impugned directions formed part of a national welfare policy aimed at eliminating tuberculosis and were issued under the National Health Mission in furtherance of a significant public health objective.

The respondents argued that the orders prescribing operational targets were merely administrative measures designed to implement the programme effectively at the grassroots level. They maintained that the petitioners had failed to produce any concrete evidence demonstrating actual harm or legal prejudice arising from the policy.

Accepting these submissions, the High Court observed that the scope of judicial review in matters relating to executive policy, especially public health initiatives, remains limited. The Court noted that the tuberculosis eradication programme was a welfare measure framed in the broader public interest and therefore warranted judicial deference.

“It is a trite law that courts must exercise profound restraint when invited to review state policies pertaining to public health initiatives,” the Court observed.

The Court further stated that it had “no occasion to interfere in the welfare policy meticulously developed by health experts and the executive under the National Health Mission.”

Addressing the challenge to daily screening targets, the Court held that administrative mechanisms prescribing operational targets of 100 to 150 X-rays per day could not be considered arbitrary merely because they imposed demanding work schedules. According to the Court, such measures were necessary to achieve the objectives of the TB Mukt Bharat Abhiyan.

On concerns relating to radiation hazards, the Court found that no material had been placed on record to conclusively establish any actual prejudice to radiographers. The Court remarked that “subjective apprehensions or informal experiments conducted by an association cannot substitute for formal administrative findings.”

Finding no violation of service rules or statutory provisions, the Court concluded that no writ of mandamus could be issued to halt or modify the implementation of the programme. Holding that the challenge lacked legal foundation, the Court dismissed the petition and all pending applications.

Case Title: Pragatisheel Radiographers Sangh, Madhya Pradesh Through President Virendra Kashyap v. The Union of India Through The Secretary Ministry of Health and Family Welfare and Others

Date of Order: June 3, 2026

Bench: Justice Jai Kumar Pillai