Karnataka High Court Quashes Order Closing Jan Aushadhi Kendras in Govt Hospitals

Bengaluru, December 11, 2025 – In a significant ruling that underscores the judiciary's role in safeguarding public health and fundamental rights, the Dharwad Bench of the Karnataka High Court has quashed a controversial government order directing the closure of Jan Aushadhi Kendras (JAKs) operating within government hospital premises. The decision, delivered by Justice M Nagaprasanna on December 10, 2025, marks a major setback for the Siddaramaiah-led Congress administration and reaffirms the importance of affordable generic medicines in India's healthcare ecosystem.

The court allowed a batch of writ petitions, including the lead case filed by Rakesh Mahalingappa L and others (WP No. 103827/2025), effectively nullifying the May 14, 2025, government order (GO). While a detailed written judgment is awaited, the oral observations from the bench were unequivocal: "We will not allow one wing of the government to tinker with the medicines being given to the poor whether it is free of cost or for nominal price." This ruling not only preserves the operational continuity of these kendras but also highlights the tension between state policy goals and constitutional protections.

Background: The Genesis of the Controversy

The Pradhan Mantri Bhartiya Janaushadhi Pariyojana (PMBJP), a flagship initiative of the central government launched in 2008 and revitalized under Prime Minister Narendra Modi, aims to provide high-quality generic medicines at prices 50-90% lower than branded equivalents. Jan Aushadhi Kendras serve as dedicated outlets for these drugs, targeting vulnerable populations such as below-poverty-line (BPL) families, senior citizens on fixed incomes, daily wage workers, and chronic patients requiring ongoing medication.

In Karnataka, several such kendras had been established within government hospital premises to enhance accessibility, allowing patients to obtain affordable alternatives without leaving the facility. However, on May 14, 2025, the state health department issued an order mandating their closure, arguing that it conflicted with the policy of providing free medicines directly through hospital pharmacies. The rationale was to streamline free drug distribution and avoid "directing patients to external sources," as per the department's stance.

This move drew immediate backlash. On July 8, 2025, the Karnataka High Court stayed the order, recognizing potential harm to public interest. The controversy escalated when Union Health Minister JP Nadda wrote to Chief Minister Siddaramaiah in August 2025, expressing concerns over the closures and their impact on the national scheme. Karnataka Health Minister Dinesh Gundu Rao defended the decision, stating it was intended to ensure "free and assured supply of essential medicines" and reduce out-of-pocket expenses for patients. Despite this, the petitioners pressed forward, culminating in the December ruling.

The case title, Rakesh M S/o Mahalingappa L & Ors. v. State of Karnataka , encapsulates a broader narrative of federalism, where state-level policies intersect with centrally sponsored welfare programs. Legal experts note that this episode reflects ongoing friction between the Congress-ruled state and the BJP-led center, with political undertones amplified by BJP MP Tejasvi Surya's post-ruling statement on X (formerly Twitter): "This setback to the Congress Govt should serve as a lesson that political vendetta must never come in the way of advancing public interest."

Petitioners' Arguments: Constitutional Infringements and Public Interest

The petitioners, represented by advocates Anirudh A Kulkarni, Vasista Ramprasad, and Shreyas S, mounted a multi-pronged attack on the GO. Central to their case was the assertion that the order was promulgated "in haste, without consulting them or even giving a warning," violating principles of natural justice and legitimate expectation.

They highlighted substantial investments already made in the kendras—covering infrastructure development, medicine inventory, equipment, furniture, staff salaries, and necessary licenses. This created a "legitimate expectation" that the state would not arbitrarily disrupt operations, especially since the kendras complemented rather than competed with free medicine distribution.

On the constitutional front, the plea invoked Article 19(1)(g), which guarantees the right to practice any profession or carry on any occupation, trade, or business, subject to reasonable restrictions under Article 19(6). The abrupt closure, they argued, infringed upon this right to livelihood, as the kendras were viable enterprises serving a social purpose. More profoundly, it encroached on Article 21, the right to life and personal liberty, which the Supreme Court has expansively interpreted to include the right to health in landmark judgments like Bandhua Mukti Morcha v. Union of India (1984) and State of Punjab v. Mohinder Singh Chawla (1997).

The petitioners emphasized that JAKs do not hinder the state's free medicine policy; instead, they extend its reach by offering nominal-priced generics to those who might otherwise forgo treatment due to cost. "It cannot be the submission of the state that a small Kendra is coming in its way of distributing free medicine," their counsel argued. "We both are working towards public interest." Data from the PMBJP underscores this: over the past decade, the scheme has saved the poor more than Rs 30,000 crore in medical expenses, with over 12,000 kendras operational nationwide.

Furthermore, the closure was portrayed as antithetical to public interest, disproportionately affecting marginalized groups. By limiting access to affordable drugs, the GO undermined citizens' right to health, a facet of Article 21 reinforced in Consumer Education and Research Centre v. Union of India (1995), where the apex court held that health is integral to a dignified life.

State's Defense and Judicial Scrutiny

The state, represented by Additional Advocate General Gangadhar JM, countered that free medicines were already being supplied in government hospitals, rendering JAKs redundant within those premises. The kendras were free to operate outside, on non-government land, ensuring no blanket prohibition on the scheme. This, the state contended, aligned with its sovereign right to regulate public health resources without constitutional violation.

However, Justice Nagaprasanna's bench appeared unconvinced by this narrow framing. The oral remarks suggest a judicial aversion to fragmented government actions that undermine welfare initiatives. The court recognized that JAKs enhance, rather than obstruct, healthcare delivery, particularly for chronic and low-income patients who may not qualify for or access free supplies seamlessly.

This ruling aligns with precedents where courts have struck down executive actions for failing the proportionality test under Article 19. In Modern Dental College and Research Centre v. State of Madhya Pradesh (2016), the Supreme Court emphasized that restrictions must be reasonable and not excessive. Here, the GO's blanket closure failed this threshold, especially given the lack of consultation or transitional measures.

Legal Implications: A Win for Federal Harmony and Health Rights

For legal practitioners, this judgment offers rich terrain for analysis in constitutional litigation, particularly in balancing state autonomy with national welfare schemes. It reinforces the judiciary's role as a bulwark against hasty executive decisions, echoing Kesavananda Bharati v. State of Kerala (1973) by protecting the basic structure of rights-based governance.

The decision has immediate implications for administrative law. Petitioners' success in invoking legitimate expectation—a doctrine rooted in Union of India v. Hindustan Development Corporation (1993)—signals that states must honor investments in public-private partnerships, especially in social sectors. Failure to do so risks judicial intervention, potentially setting a precedent for similar challenges in other states.

On the health rights front, the ruling bolsters the evolving jurisprudence under Article 21. Courts increasingly view access to affordable medicines as a positive obligation on the state, as seen in Paschim Banga Khet Mazdoor Samity v. State of West Bengal (1996). By quashing the order, the Karnataka HC has indirectly affirmed the PMBJP's role in realizing the right to health, potentially influencing policy in other Congress-ruled states like Himachal Pradesh or Telangana, where similar tensions exist.

Politically, the verdict is a embarrassment for the Siddaramaiah government, especially amid accusations of "vengeance" by BJP leaders like Tejasvi Surya. It may prompt legislative amendments to clarify the operational space for JAKs, ensuring alignment with both state and central objectives. Nationally, it could accelerate the expansion of kendras, with the PMBJP targeting 10,500 outlets by 2025—a goal now fortified by judicial endorsement.

Broader Impacts on Legal Practice and Society

For lawyers specializing in public interest litigation (PIL), this case exemplifies strategic use of constitutional provisions to advocate for the underprivileged. The Dharwad Bench's efficiency—interim stay in July followed by final disposal in December—highlights the high courts' accessibility for regional grievances, contrasting with the Supreme Court's overburdened docket.

In practice areas like health law and regulatory compliance, firms advising pharmaceutical entities or NGOs may see increased demand for guidance on kendra licensing and constitutional challenges. The ruling also underscores the need for impact assessments in policy-making; the absence of one here was a fatal flaw, as per the court's implied critique.

Societally, the decision ensures continuity of affordable healthcare, vital in a state like Karnataka with high out-of-pocket expenditure (over 60% of health costs, per National Health Accounts). It protects livelihoods for kendra operators—often small entrepreneurs from local communities—and sustains savings for millions. As BJP MP Surya noted, the scheme's decade-long impact (Rs 30,000 crore saved) cannot be undermined lightly.

Looking ahead, stakeholders anticipate the detailed order, which may elaborate on remedies like costs or directives for kendra relocation support. Union intervention, via Nadda's letter, could lead to central guidelines mandating state cooperation with PMBJP.

In sum, this judgment is more than a policy reversal; it is a testament to the Constitution's commitment to equity in healthcare. As India grapples with universal health coverage under Ayushman Bharat, such rulings remind policymakers that public interest is not served by silos but by synergy.