The Kerala Public Health Ordinance, 2021 was promulgated by the Governor of Kerala on February 23, 2021 and in October 2021 a Bill to replace the ordinance was presented in the Assembly, to be referred to a select committee. The Kerala Public Health Bill 2021, unifying the provisions in the Madras Public Health Act, 1939 and the Travancore-Cochin Public Health Act, 1955 was passed by the Kerala Legislative Assembly in March 2023. It aims to align these laws with the Kerala Municipality Act, 1994 and the Kerala Panchayat Raj Act, 1994, which were enacted in line with the provisions of Part IX and Part IX A inserted by the 73rd and 74th amendments of the Constitution of India. It is after several rounds of discussions with SHSRC and other experts from other department, various public health fora and after gathering public opinion on various aspects of the proposed law that the select committee drafted the final Bill.

The new Bill has been drafted based on a much broader premise that beyond mere diagnosis and curative services, public health should focus on improving the social determinants of health such as clean water and environment, sanitation, and waste management. The Bill also stresses the fact that the scope of a new public health law should encompass the threats posed by climate change, new and emerging viruses, non- communicable diseases and the need for special care and attention for the vulnerable, including the elderly, chronically bedridden and the disabled, welfare of migrant labourers, food safety, blood banks and blood safety, biomedical waste management, tackling antimicrobial resistance and even ensuring adequate toilet facilities in public spaces.

The Director of Health Services will be the State Public Health Authority, under whom there shall be district and local health authorities. They will prepare annual action plans before the commencement of every financial year, charting out the activities that need to be taken up in advance to prevent seasonal epidemics and manage their impact on public health. The Act also requires local bodies to earmark a portion of the health budget for implementing programmes for the prevention and control of NCDs.