Introduction:

In Guntha Venkata Sai Kumar v. The State of Andhra Pradesh and Others, WP PIL No 12 of 2026, the Andhra Pradesh High Court comprising Chief Justice Dhiraj Singh Thakur and Justice Challa Gunaranjan considered a Public Interest Litigation drawing attention to the alarming absence of Bone Marrow Transplantation facilities in Government hospitals and medical colleges across the State. The petitioner highlighted that while several private hospitals provide Bone Marrow Transplant services, the cost of such procedures is prohibitively expensive, rendering them inaccessible to economically weaker sections. The PIL asserted that despite inclusion of Bone Marrow Transplant under the erstwhile Dr Y S R Aarogyasri Scheme now Dr N T R Vaidya Seva with financial caps of ₹11,00,000 for patients above 14 years and ₹10,00,000 for those below 14 years, Government run hospitals in the State lack infrastructure to perform the procedure. The Court was therefore called upon to examine whether the State had fulfilled its obligation to ensure accessible healthcare for life threatening conditions requiring highly specialised and expensive treatment.

Arguments on Behalf of the Petitioner:

The petitioner submitted that Bone Marrow Transplantation is a critical and often life saving procedure required for patients suffering from serious blood disorders, cancers, and other life threatening illnesses. It was contended that the absence of such facilities in Government hospitals places an enormous burden on patients who must seek treatment in private hospitals at exorbitant costs. The PIL pointed out that although the State Government had included Bone Marrow Transplant under its flagship health insurance scheme in 2020, the financial ceiling fixed under the scheme was inadequate given the actual cost of the procedure and post operative care. The petitioner emphasized that Bone Marrow Transplant is not a one time intervention but a prolonged medical process involving pre transplant evaluation, transplantation, and extended follow up with trained specialists and advanced infrastructure. The petition further highlighted that many patients, particularly from economically weaker backgrounds, had reportedly lost their lives due to inability to afford treatment in private hospitals once the capped reimbursement amount was exhausted. It was argued that the right to health forms an integral part of the right to life under Article 21 of the Constitution, and the State has a constitutional obligation to create adequate medical infrastructure to ensure that life saving treatment is accessible and affordable. The petitioner also brought to the Court’s notice that several neighbouring States had established Government run Bone Marrow Transplant Units and were providing treatment either free of cost or at substantially subsidised rates. In this context, it was contended that a progressive State like Andhra Pradesh ought to possess the administrative and financial capacity to establish similar facilities. The absence of such infrastructure, according to the petitioner, reflected a significant gap in public healthcare policy and warranted judicial intervention to ensure time bound implementation of Bone Marrow Transplant facilities in Government institutions.

Response and Submissions on Behalf of the State:

The State informed the Court that the Government was contemplating the introduction of specialised treatment including Bone Marrow Transplantation in Government hospitals. It was submitted that establishment of such facilities requires substantial infrastructure, highly trained faculty, specialised equipment, and compliance with stringent medical protocols. The State indicated that policy level discussions were underway to assess feasibility and resource allocation. While not disputing the importance of Bone Marrow Transplantation as a life saving intervention, the State emphasized that implementation involves logistical planning and financial commitments. The Government also relied on the existence of the Dr N T R Vaidya Seva scheme under which financial assistance is provided for Bone Marrow Transplant procedures in empanelled hospitals. It was suggested that the reimbursement mechanism was intended to ensure that eligible patients receive treatment without immediate financial burden. However, the State did not provide specific timelines for operationalising Bone Marrow Transplant Units in Government hospitals. The absence of a concrete roadmap or detailed affidavit explaining existing constraints and projected timelines prompted the Court to seek further clarity.

Court’s Observations and Judgment:

The Division Bench observed that the issue raised in the Public Interest Litigation was important and relevant, particularly in light of the fact that Bone Marrow Transplantation is a highly expensive and prolonged medical procedure. The Court noted with concern that there was no provision for conducting Bone Marrow Transplant in any Government hospital or medical college in the State. The Bench remarked that if other States in the country had been able to establish Government run Bone Marrow Transplant Units and provide treatment at minimal or no cost, there was no reason to believe that Andhra Pradesh lacked the capacity to conceive and implement a similar programme. The Court underscored that access to healthcare, especially for life threatening conditions, is a matter of serious public importance. While acknowledging the State’s submission that specialised treatment facilities were under consideration, the Bench emphasized the need for concrete action rather than mere contemplation. Accordingly, the Court directed the State to file a detailed affidavit addressing the issues raised in the petition, including the steps proposed to establish Bone Marrow Transplant facilities in Government hospitals and the timelines within which such procedures could be undertaken with trained faculty and requisite infrastructure. The Court also suggested that in the interim, the Government may consider increasing the upper limit of financial reimbursement under the health scheme for patients requiring Bone Marrow Transplantation, so as to mitigate the financial hardship faced by affected families. By doing so, the Court signalled that while long term infrastructure development is essential, immediate relief measures must also be strengthened to prevent avoidable loss of life. The matter was thus kept under judicial scrutiny with directions aimed at ensuring policy clarity, accountability, and time bound action.