Cancer deaths – a challenge for India’s economy – a legal analysis

By K. Divyadharshini, student pursuing 5-year B.Com.LLB (hons) law degree in SRM Institute of Science and Technology,

K. Divyadharshini,Pursuing a 5-year B.Com.LLB (hons) law degree in SRM Institute of Science and Technology, having active participation in moot court competitions and paper presentations. And also have an internship experience in Tamil Nadu State commission for women

Article 21 of the Indian Constitution guarantees the right to health as part of the fundamental right to life. A fundamental right is an essential component of the Indian Constitution, and it must not be violated. The Constitution, as the primary legislation of the country, gives its people the right to life. Despite the fact that everyone has the right to life and the right to health, many people are denied these basic rights. Their right to life and health were influenced by social, economic, and scientific reasons. This paper discusses the obstacles that cancer patients confront in India, where their right to life, health, and the right to live without disease cannot be exercised without difficulty. Their sole purpose is to survive another day. When a group of individuals is struggling to survive another day, it is clear that the world’s longest constitution fails to protect its citizens’ well-being. Despite the fact that the right to life is protected by various verdicts, the number of individuals dying from cancer is increasing year after year. Some foreign countries take the required steps and implement adequate legal reforms to reduce the number of cancer-related deaths.

Being mute towards the death of persons dying of cancer is something against constitutional morality, public morality, and committed injustice by neglecting to confer the guaranteed “right to life”

Children who have yet to see the world, such as those aged 5 to 10, are dying of cancer. Many people used to die from the most deadly diseases, the most of which were cancers.

If someone is diagnosed with cancer, his major purpose becomes to fight death in order to survive.

Social, economic, financial, and genetic factors all influence his prospects of survival.

Genetic reasons cannot be easily averted, but social, economic, and financial variables influencing cancer fatalities can be addressed.

The Supreme Court too in its Judgments enhanced the scope of  the right to health, which is an essential component of the right protected by Article 21 of the Indian Constitution. Where Supreme court issued directions to regulate Covid, resulting in 19 deaths during the Covid Pandemic

Thus, either the legislative or the judiciary can introduce new legal reforms to reduce cancer mortality.

Thus, this paper discusses legislation reforms proposed by numerous nations, as well as Supreme Court or High Court decisions that recognized or held that the right to health is an inherent aspect of the right to life guaranteed by Article 21 of the Indian Constitution. This paper will also illustrate the importance of enacting legal reforms to reduce cancer fatalities.

Though the Indian Constitution, High Court Judgements, and Supreme Court Decisions upheld the breadth of the Right to Health, which is a vital part of the Right to Life guaranteed by the Constitution, cancer fatalities continue to rise year after year.

In terms of cancer mortality rates, various other countries around the world have enacted legal reforms to control cancer deaths, and the death rate has successfully decreased.

The Indian Judiciary has the capacity to implement legal reform to limit the death rate in Covid-19 during the epidemic.

Thus, by enacting essential legislative amendments, the death rate among cancer patients can be reduced.

Thus, this study evaluates existing judicial observations, as well as legislation amendments enacted in other nations, which can clearly control cancer patient death rates.

According to a recent report by Apollo Hospitals^[1], India will be the world’s Cancer Capital by 2024. India, dubbed the “Cancer Capital of the World,” has a high number of cancer deaths, including young individuals. For some people, there are financial obstacles. Despite the fact that some people have no financial obstacles, they nonetheless die. Many young children lose their lives because they are unable to overcome cancer. Thus, on the one hand, some people have just one option: face cancer and struggle to survive; on the other hand, Article 21 of the Indian Constitution ensures the right to health which is an integral part of the right to life and personal liberty. It is the state’s primary duty to protect the lives of those who work extremely hard to survive

National Cancer Institute, (NCI), an official website of United States Government defines Cancer as follows:-

“A term for diseases in which abnormal cells divide without control and can invade nearby tissues. Cancer cells can also spread to other parts of the body through the blood and lymph systems. There are several main types of cancer. Carcinoma is a cancer that begins in the skin or in tissues that line or cover internal organs. Sarcoma is a cancer that begins in bone, cartilage, fat, muscle, blood vessels, or other connective or supportive tissue. Leukemia is a cancer that begins in blood-forming tissue, such as the bone marrow, and causes too many abnormal blood cells to be made. Lymphoma and multiple myeloma are cancers that begin in the cells of the immune system. Central nervous system cancers are cancers that begin in the tissues of the brain and spinal cord. Also called malignancy.”^[2]

Thus Cancer in general meaning is a disease which includes uncontrollable growth of body cells Usually a human brain signals the growth of cells . But cancer cells ignore those instructions from the brain.

Cancer cells are developed by mutation of cells. Most cancer cells are Mutated by Genetic Mutations. But even human or environmental interventions do promote growth of Mutated cancer cells.

As discussed earlier, mutation of cells lead to development of cancer cells. Following are the most prevalent causes of cancer:-

1. Genetic Mutations
2. Tobacco usage
3. Radiation exposure
4. Mal Nutrition

There exists some other miscellaneous causes too that lead to Cancer, but among the other causes the above mentioned causes dominates the majority.

Though genetic mutations too lead to cancer diagnosis, the people die with cancer out of Tobacco usage dominate the cancer deaths rate. Since ICMR – National Institute of Cancer Prevention and Research too reported that Oral Cancer and lung cancer contribute over 50% of the.cancer deaths.^[3]

Countries like the United States, Maldives, Mexico had implemented effective legal reforms to combat the above factors and shown a huge decline in cancer deaths in their countries.  

The well-known proverb “Prevention is better than cure” clearly states that it is always preferable to prevent rather than cure. The aforementioned aphorism applies to medical, criminal law, environmental law, and other domains.

The significance of the aforementioned proverb was first recognised by prominent jurists of the Classical school of criminology. Jurists from the Classical school of criminology, such as Jeremy Bentham ( in the year 1780–1789) and Cesare Beccaria ( in the year 1764), emphasise the significance of preventing harm through deterrence theory. They believe that rather than punishing offenders, preventing crime is preferable.

A well-known Latin maxim, “Principiis obsta: sero medicina paratur,” which translates as “resist the beginnings; the medicine is prepared too late,” also emphasised the significance of the adage.

In basic “Obsta Principiis” – means “resist the beginnings, thus prevention is better than cure.”

• WHO Framework convention on Tobacco control:-

World health assembly Adopted WHO Framework convention on tobacco control on 21, May, 2003, came into force on 27, February, 2005. The said convention was adopted to tackle the effects of Tobacco usage. It’s a known  fact that the regular usage of Tobacco leads to Throat cancer, Lung Cancer, etc.,. There are around 168 signatories including the European Union, and further there 181 parties to the convention.^[4]

Government of India ratified the said Convention in the year 2004. Thus India is a signatory to the said convention.^[5]

India did implement certain laws complying the provisions of the said convention.

• Core Provisions of WHO Framework convention on Tobacco Control:-

Article 8 –  mandating laws to protect people from exposure to Tobacco in Public Places.

Article 11 – mandating pictorial warnings on packaging and imposing bans on misleading or false labelling and advertising.

Article 16  – prohibiting sale of Tobacco to and by minors.

The United States of America once had reported huge cancer deaths before the year 1991, American Cancer Society in Cancer Statistics, 2019 reported that there was an overall drop of 27%, translating to 2.6 million fewer cancer deaths approximately.

The law hit four areas hard. Sales to anyone under 21 were out. Vending machines got restricted. And tobacco companies could no longer slap their brand on sports events or concerts. The logic is brutal but simple. Hook them young, lose them old. Most smokers start as teenagers. Stop the start, stop the cancer three decades later.

Smokeless tobacco had to put its warnings where people would actually see them. Every package needs one of four warnings. One says flat out: “WARNING: This product can cause mouth cancer.” Thirty percent of the two main panels. No hiding it.

The Act said prove it. File a modified risk tobacco product application with real science, or shut up. No more free rides.

Flavored cigarettes disappeared too. Except menthol and regular tobacco, everything else was gone. Fruit, candy, clove or whatever. Regulators knew these were gateway products. Teenagers don’t start with Marlboro Red. They start with something that tastes like cherry. And teenagers who start usually don’t quit.

Now, India. India’s COTPA from 2003 actually has bigger warning labels than the US. Eighty-five percent of the package covered in pictures. That beats America’s thirty percent hands down. But that’s where the good news ends. India still allows flavors. It still lets companies use words like “light” or “mild.” And it doesn’t have broad youth access restrictions. The US figured out that you need both supply control and demand reduction. India has the warning labels, but it’s missing the rest of the toolkit. Time to catch up. Ban flavors in all tobacco products. Kill the misleading descriptors. And fund state and local enforcement so the rules actually mean something.

Several Legal Reforms like Imposing restrictions on Tobacco usage, promoting Physical activity and Technical advancement in early detection of cancer do contributed towards the decline in Cancer Deaths in United states of America.       

The National Cancer Act, 1971 enacted to expand the scope of National Cancer Institute. The main purpose of the Act is to create a new Research centre for cancer.

Family Smoking Prevention and Tobacco Control Act,  2008 :–

Section 2 of the Act does include the findings of the congress. Following  were the findings under section 2 which are relevant to this subject matter.

• Usage of Tobacco products lead to cancer, heart disease and other health issues. (Section 2(2)
• Reduction in smoking among youths will result in premature deaths and a reduced health care costs. Further advertising, marketing and promotion of Tobacco Products resulted in increased usage of Tobacco products among youths as 80% of youths were influenced by Marketed brands ( Section 2(23) )
• The National Cancer Institute found that the “Light” or “Low Tar” cigarettes do promote false belief in people that those cigarettes are less harmful. As studies demonstrated that those Cigarettes promote the usage of Tobacco leading to disease and death

Section 4 of the Act mandates Labelling purposes, the label for Cigarettes should include “Cigarettes cause cancer” ( Section 4 (a) (1) ) . Section 4 (a) (2) deals with Placement, Typography for labels should display the warning by way of text and images.

Section 204 of the Act amended in compliance of Section 3 of the Comprehensive Smokeless Tobacco Health Education Act of 1986 ( 15 U.S.C. 4402)

Section 3(a) of Comprehensive Smokeless Tobacco Health Education Act of 1986 ( 15 U.S.C. 4402) may be read as follows:-

SEC. 3. SMOKELESS TOBACCO WARNING.

    “(a) General Rule.–

            “(1) It shall be unlawful for any person to manufacture,

        package, sell, offer to sell, distribute, or import for sale or

        distribution within the United States any smokeless tobacco

        product unless the product package bears, in accordance with

        the requirements of this Act, one of the following labels:

                    “WARNING: This product can cause mouth cancer.

                    “WARNING: This product can cause gum disease and

                tooth loss.

                    “WARNING: This product is not a safe alternative

                to cigarettes.

                    “WARNING: Smokeless tobacco is addictive.

Section 907, lay down Tobacco Product Standards an except tobacco or menthol, Tobacco Products shall not include a herb or spice, including strawberry, grape, orange, clove, cinnamon, pineapple, vanilla, coconut, licorice, cocoa, chocolate, cherry, or coffee, that is a characterizing flavor of the tobacco product or tobacco smoke

Section 911 deals with Modified Risk Tobacco Products where in general (Section 911 (a) ) a modified risk Tobacco Product cannot be introduced or delivered for introduction into Interstate commerce unless an order issued pursuant to subsection (g) of Section 911 is effective with respect to such product. Section 911 (2) deals with Definitions for the purpose of Section 911. Section 911(2) (A) (ii) is defines Tobacco products sold or distributed for use to reduce harm or the risk of tobacco-related disease associated with commercially marketed tobacco products, thus such products sold or distributed includes the label, labeling, or advertising which uses the descriptors `light’, `mild’, or `low’ or similar descriptors.

Promoting Physical Activity for Americans Act. 2025  – introduced as a bill into senate to promote physical activity for Americans.

Nancy Gardner Sewell Medicare Multi-Cancer Early Detection Screening Coverage Act (Bill, 31/1/2025)

Following is the extract of the purpose of the bill as stated in Congress.gov:-^[6]

This bill allows, beginning in 2028, for Medicare coverage and payment for multi-cancer early detection screening tests that are approved by the Food and Drug Administration and that are used to screen for cancer across many cancer types, if the Centers for Medicare & Medicaid Services determines such coverage is appropriate. Coverage is limited to those under a certain age (age 68 in 2028, increased by one year every year thereafter) and to one test every 11 months.

Thus by implementation of above legal reforms, US has shown a sharp decline of 27% in cancer rate. Further with bills introduced to detect cancer early, and to promote physical activity, in another 20 years, there will be a further decline in cancer death rate.

Maldives is the first country to ban younger people born after January 1, 2007 from Tobacco smoking, imposing a nationwide ban on Tobacco smoking.^[7]

Tobacco Control Act, Act No. 15/ 2010 prohibits growing tobacco and advertising tobacco products, to regulate import and export, sale by wholesale and retail, and packaging and labelling of tobacco products, and to set up a regulatory framework for taxation of tobacco products, protection of non tobacco users from environmental tobacco smoke, provision of requisite information and training to remain free from the hazards of tobacco, and the treatment of persons addicted to tobacco use, for the control of smoking in the Maldives.

Tobacco Ban was imposed in the year 2010, and in the year 2025, National Cancer Registry Data recorded a sharp decline in new cancer cases over 6 years^[8]. Thus Tobacco ban do promotes decline in Cancer rate

General Law on Tobacco Control :-

Article 39 bans all forms of Promotions on all tobacco products including labels and packaging, even promoting them as less harmful or “low in tar”, “light”, “ultra-light”, “smooth”, “extra”, “lights”, “mild”, “soft”. 

Article 60 allows smoking only in areas located outdoors or in isolated interior spaces and have the specific characteristics

Article 61 states compliance required for Isolated interior spaces.

Article 65 forbids smoking in places people were lodged provided that people are allowed to smoke in rooms specifically designed for smoking.

Ley General de Cultura Física y Deporte  (General Law on Physical Culture and Sport) do promote and mandate physical activity among its citizens.

Mexico has the second – lowest cancer death rate globally. As the country is recognised with low risk factors like tobacco usage and other factors that contribute to cancer. ^[9]

• LOW QUALITY PRODUCTS THAT CAUSE CANCER SOLD AT AFFORDABLE RANGE:-

It is pertinent to note that European Union Safety Authorities found 527 cancer causing chemicals which were found from Renowned Indian Spice Brands like MDH and Everest. The chemicals used in those products were banned in several countries.^[10] Further, the EU rejected 87 consignments. Out of 527 items, 332 items were tagged as Indian origin.

Once around in the year 2025, two Famous cricket brothers admitted openly that they ate Just Maggi for 3 years, not for taste but minimal money; they had no other food options at an affordable range except a maggi in their childhood days. It is a well known fact that around June, 2015, Maggi instant noodles had been banned in India having excessive lead chemicals in it. An official website in California listed Lead Chemicals in Proposition 65 list as they cause cancer affirming that such Lead chemicals increase cancer risk.^[11] Pandya Boys had Maggi instant noodles for only financial reasons before 2015, being exposed to cancer risks. The voice of economically weaker sections had come out from an open admission of two celebrities.

• TOBACCO IS ONLY HALF THE STORY, THE REST IS THE MONTHLY GROCERY:-

In the timeframe between September 2020 and April 2024, European regulators tested nearly 527 Indian food products and as a result, ethylene oxide was found in all of them. International Agency for Research on Cancer (IARC) calls it a Group 1 carcinogen. They’re certain it causes cancer in people. Three hundred and thirty-two of those products had India as the only source. The EU turned away 87 shipments.

Ethylene oxide is a Colourless gas. Farmers and processors use it to kill bugs and sterilize gear. Works great. Also gives you cancer. Lymphoma. Leukemia. The contamination came from big Indian spice brands like MDH, Everest. After the EU findings, Hong Kong and Singapore banned them too.

527 products. Four years. That’s not a mistake. That’s a system failing. FSSAI has rules on paper. But if export goods which get checked more carefully than what we eat at home are still contaminated, what does that say about the food on Indian plates?

Article 21. Article 47. Right to life. State duty to improve health. These aren’t abstract ideas. When carcinogens show up in spices, nuts, sesame seeds, staples those constitutional promises are broken. The EU acts. Rejects, recalls, investigates. India waits until someone else complains. Poor people eat this food. They can’t afford labs. They trust the label. The label lies. Fix the law. Enforce it.

In Rachana Gangu & Anr Vs. Union of India & Ors (2026 INSC 218), the Supreme Court upheld and imposed “No-Fault Liability” in a case involving the harmful effects and deaths that resulted. As with the Covid-19 pandemic, many deaths occurred after manufacturers produced vaccines to regulate and battle Covid-19 deaths. Since the government required its citizens to get vaccinated in order to participate in public activities, the majority of people received Covid-19 vaccinations. However, because some deaths were reported as a result of such vaccination, many applications including the harmful consequences of vaccination were decided together by the Supreme Court.

While deciding the same the Supreme court highlighted Article 47 of the Indian Constitution from Directive Principles of state Policy.  Which impose duty of the state to raise the level of nutrition and the standard of living and to improve Public Health and observed as follows :-

“24. The Constitution does not conceive of the State as a distant spectator to human suffering, but as an active guardian of welfare and dignity. The Directive Principles of State Policy illuminate this vision with clarity. Article 41 speaks of public assistance in cases of sickness and disablement, within the limits of State’s capacity. Article 47 declares the improvement of public health to be among the State’s primary duties.”

Thus by observing the above other interpretations, court imposed No- fault liability on the state.

IN RE: DISTRIBUTION OF ESSENTIAL SUPPLIES AND SERVICES DURING PANDEMIC. (LL 2021 SC 236 ), The Supreme Court, while  issuing directions for the supply of essential services during the Covid-19 pandemic, emphasized the importance of the right to life under Article 21 of the Indian Constitution, which includes the right to health, and purported to promote a rational approach under Article 14 of the Indian Constitution.       Where the Supreme court observed as follows:-

“69.   ……

(ii) The Central Government shall, in collaboration with the States, prepare a buffer stock of oxygen for emergency purposes and decentralize the location of the emergency stocks. The emergency stocks shall be created within the next four days and is to be replenished on a day to day basis, in addition to the existing allocation of oxygen supply to the States;

…….

(iv). The Central Government shall, within two weeks, formulate a national policy on admissions to hospitals which shall be followed by all State Governments. Till the formulation of such a policy by the Central Government, no patient shall be denied hospitalization or essential drugs in any State/UT for lack of local residential proof of that State/UT or even in the absence of identity proof;”

In Murli S. Deora v. Union of India (2001), the Supreme Court faced a simple questions does public smoking violate non-smokers’ right to life? The Court said yes. Read the language:

“2. Fundamental right guaranteed under Article 21 of Constitution of India, inter alia, provides that none shall be deprived of his life without due process of law. Then – why a non-smoker should be afflicted by various diseases including lung cancer or of heart, only because he is required to go to public places? Is it not indirectly depriving of his life without any process of law? The answer is obviously – ‘yes’. Undisputedly, smoking is injurious to health and may affect the health of smokers but there is no reason that health of passive smokers should also be injuriously affected. In any case, there is no reason to compel non-smokers to be helpless victims of air pollution.”

The Court also noted tobacco smoke has “harmful contents including nicotine, tar, potential carcinogens, carbon monoxide irritants, asphyxiates and smoke particles which are the cause of many diseases including the cancer.” Then it banned public smoking nationwide.

Why does this matter? Three things. One, the Court linked tobacco to cancer with medical evidence, not just moralizing. Two, it said passive exposure violates Article 21 not just active smoking. Three, it established that when the State knows about a preventable hazard and ignores it, that’s a constitutional violation.

The logic travels. If public smoking had to go because it causes lung cancer, then chemical contaminants in food and weak tobacco enforcement must go too. Known carcinogens don’t care where they come from.

But let’s be real. Courts can’t legislate. Murli S. Deora forced a smoking ban. It did not and cannot ban flavors, set chemical limits in food, or build a cancer screening programme. Parliament does that. State legislatures do that. What Murli S. Deora gives us is the principle. When the State knows people are exposed to preventable cancer risks and does nothing, Article 21 is breached. The rest is up to lawmakers.

Thus for a country like India being labeled as the Cancer capital of the world with highest cancer deaths reported per year, it is just and necessary to implement new laws and legal reforms to control cancer deaths. Once the United States of America was reported to have the highest cancer deaths in the world but over the years, the United States of America showed a sharp decline in cancer deaths. This was possible not just because of technical advancement but also out of implementation of proper laws.

Understanding the root cause of cancer, foreign countries do implement proper laws restricting tobacco usage and promoting physical activity. And they do succeed in showing a sharp decline in cancer deaths by imposing restrictions on Tobacco usage and further promoting physical activity among its citizens.

Thus, cancer deaths in India can be controlled by implementing laws restricting tobacco usage and promoting physical activity. Further restricting harmful chemicals in food products sold in India like European Union rejected 87 consignments and 332 food items from India is very much crucial for Indian People’s future health. It is proven fact that restricting Tobacco usage, Harmful chemicals in food do promote cancer risk and improving physical activity do reduce the cancer risk.

Thus implementing necessary laws is crucial to control cancer death rate in India.

Right to health which is an integral part of Right to Life guaranteed by Indian Constitution cannot be denied. The Indian Constitution can’t stay silent towards the deaths of millions of people. India being labelled as the Cancer Capital of the world, bringing necessary legal reform needs consideration to control cancer deaths .

REFERENCES :-

1. Bare Text of Family Smoking Prevention and Tobacco Control Act,  2008, United States of America – https://www.congress.gov/bill/110th-congress/house-bill/1108/text –
2. Bare Text of General Law on Tobacco Control, Mexico https://assets.tobaccocontrollaws.org/uploads/legislation/Mexico/Mexico-RGLTC.pdf  –
3. WHO FRAMEWORK CONVENTION ON TOBACCO CONTROL – PARTIES https://fctc.who.int/who-fctc/overview/parties
4. Ministry of Health and Family Welfare,  WHO Framework Convention on Tobacco Control (WHO FCTC) https://nhm.gov.in/index1.php?lang=1&level=3&sublinkid=1126&lid=636
5. Indian Judgements referred from https://indiankanoon.org

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^[1]PTI, India is the ‘cancer capital’ of the world: Apollo Hospitals’ report, The Economic Times, April 8, 2024,  https://economictimes.indiatimes.com/news/india/health-report-indicates-significant-growth-in-non-communicable-diseases-across-india/articleshow/109056998.cms?from=mdr

^[2] National Cancer Institute, Cancer  –  https://www.cancer.gov/publications/dictionaries/cancer-terms/def/cancer

^[3]Ministry of Health and family welfare, Government of India, ICMR – National Institute of Cancer Prevention and Research, https://cancerindia.org.in/statistics/

^[4] FCTC, WHO FRAMEWORK CONVENTION ON TOBACCO CONTROL, HOME / CONVENTION / PARTIES, WHO FRAMEWORK CONVENTION ON TOBACCO CONTROL – PARTIES https://fctc.who.int/who-fctc/overview/parties

^[5] Ministry of Health and Family Welfare,  WHO Framework Convention on Tobacco Control (WHO FCTC) https://nhm.gov.in/index1.php?lang=1&level=3&sublinkid=1126&lid=636

^[6]H.R.842 – Nancy Gardner Sewell Medicare Multi-Cancer Early Detection Screening Coverage Act, Congrss.gov ,  https://www.congress.gov/bill/119th-congress/house-bill/842

^[7] Malu Cursino, Maldives bans smoking for younger generations, BBC,  November 3, 2025 https://www.bbc.com/news/articles/crex3154l8jo

^[8] Muslim Network TV,   Maldives records lowest cancer registrations in six years, February 4, 2026 https://www.muslimnetwork.tv/maldives-records-lowest-cancer-registrations-in-six-years/

^[9]Zia Sherrel, MPH, Medically reviewed by Christina Chun, MPH,  What to know about cancer survival, incidence, and death rates, Medical News Today, July 29, 2021,   https://www.medicalnewstoday.com/articles/cancer-rates-by-country

^[10] TOI Lifestyle Desk,TIMES ENTERTAINMENT, BY THE TIMES OF INDIA,  Cancer-causing chemicals found in 527 Indian food items by EU food safety authorities, May 3, 2024

https://timesofindia.indiatimes.com/life-style/food-news/cancer-causing-chemicals-found-in-527-indian-food-items-by-eu-food-safety-authorities/articleshow/109598657.cms

^[11]Proposition 65, Your sight to know (Official Website of the State California),  Lead and Lead Compounds https://www.p65warnings.ca.gov/fact-sheets/lead-and-lead-compounds