India is home to approximately 4.95 million blind individuals and 70 million people with vision impairments, including 0.24 million blind children. Many of them also face chronic conditions like diabetes, cancer, cardiovascular diseases, mental health disorders, etc making the management of such medical conditions even more challenging with their dependence on others. For the persons with visual disabilities, daily tasks such as buying or managing medications often require reliance on others in a world that has overlooked their needs. Industries and policymakers have long marginalized this community, assuming they will always need assistance. This struggle is especially acute for those living independently.
Introducing braille-embossed packaging on medicines and making it a compulsion could significantly enhance the ability of visually impaired individuals to manage their health and foster a more inclusive society. Braille is more than just a medium of communication- it is a source of empowerment and self-reliance. While technological advancements and apps like ‘Talkback’ have made accessing information somewhat easier for the visually impaired, these solutions are not without flaws. Apps can face limitations such as software malfunctions or connectivity issues. More importantly, technology cannot yet fully replace the reliability and simplicity of braille scripts for reading medication details. Braille remains the most secure and independent method for visually impaired individuals to access critical information.
Small actions, big impact: paving the way for braille accessibility
Medhansh Soni, a 12-year-old who is completely visually impaired, filed a Public Interest Litigation (PIL) with the support of his mother. The goal of the PIL is to push for better integration of braille in medicine prescriptions, consumer products, and currency notes. The PIL brings attention to the daily struggles of visually impaired individuals, such as reading labels, managing medications, and identifying currency. In response, the Supreme Court, led by Chief Justice DY Chandrachud, has sought answers from the Central Government and all states, emphasizing the pressing need for braille in pharmaceutical products. Medhansh’s statement that the real issue isn’t blindness, but society’s blindness to the needs of the visually impaired strikes a chord, underlining the importance of inclusivity.
There are other instances in which small steps were being taken prior to this legal action. Dr. Shalini Shetty, a senior ophthalmologist, has become a pioneer by offering braille prescriptions at no cost to her visually impaired patients. She covers the printing expenses herself, demonstrating a deep commitment to providing accessibility. Her initiative has proven remarkably effective, with 93% of patients successfully managing their medications independently, significantly reducing errors. While this effort has received a 100% “excellent” rating from patients, there is still work to be done in developing a scalable, cost-efficient solution.
Beyond individual efforts, companies like Pravesha are also contributing by incorporating braille labelling on pharmaceutical packaging. Such effort reflects their commitment to acknowledging and supporting individuals with disabilities.
Global standards for braille on pharmaceutical packaging: A comparative overview
United Kingdom (UK): Countries like the UK have been at the forefront of accessibility in pharmaceutical packaging and have implemented accommodating practices, such as the Medicines and Healthcare products Regulatory Agency (MHRA) guidelines introduced in 2005. These guidelines, following Article 56(a) of Directive 2001/83/EC, mandate that medicinal product names and strengths be clearly labelled in braille on the packaging. For smaller packages, approved abbreviations from the European Pharmacopoeia can be used, and the Marburg Medium Braille font is recommended for readability. This legislation sets a vital benchmark, allowing visually impaired individuals to independently access critical information about their medications, thus promoting both accessibility and patient safety. However, challenges like limited space on packaging for long product names remain, which may affect clarity.
European Union (EU): In 2004, the European Commission emphasized the importance of braille on pharmaceutical packaging with an amendment to Directive 2001/83/EC, which required all medicinal products authorized after October 30, 2005, to comply with braille labelling. This directive also obliges companies to provide alternative formats, such as braille or audio leaflets, upon request.
United States of America (USA): In contrast to the UK and EU, in the USA the mandate of braille labelling on pharmaceutical packaging remains optional.
Pharmaceutical companies have a crucial role in promoting accessibility and showing respect for visually impaired individuals. However, in India, the adoption of such measures is still limited, despite the growing importance of corporate social responsibility.
Cost concerns should not deter countries from adopting such progressive practices. Health is invaluable, and accessibility should be a priority. For instance, a small café named ‘Om’ in Koramangala, Bengaluru, prints its menu in braille to accommodate visually impaired customers. If a local business can take such steps, large pharmaceutical companies in India, whose products are essential to human life, should certainly do the same.
Currently, Indian companies emboss braille mainly to meet export demands for markets like Europe and the USA, where it is required. For example, Yamir Packaging Private Limited embossed braille on cartons for medicines exported to Europe. However, India still lacks regulations mandating such practices, reflecting a long journey toward becoming truly accommodating across sectors.
Ensuring accessibility through law: The need for braille labelling in India
India’s laws have been inclusive in their intent, but violations of these provisions continue. The growing use of braille in countries like the UK should be mirrored in India to ensure the country recognizes and addresses the needs of its vulnerable populations. Any fundamental change in society has to be brought by law, and setting clear mandates for the pharmaceutical industry, along with strict penalties for non-compliance, is crucial for driving meaningful change. Precedents set by the Supreme Court and High Courts can reinforce these mandates and lead to substantial improvements.
Denying visually impaired individuals the ability to access information about their medications infringes upon their rights under Article 21 of the Constitution of India, which guarantees the right to live with dignity. This includes access to essential health and safety information, and the absence of braille labelling violates these fundamental rights.
Furthermore, the lack of braille-embossed medicine packaging directly contravenes the Rights of Persons with Disabilities (RPWD) Act, 2016 which requires that printed content be made available in accessible formats, a responsibility that lies with the appropriate government. The Act also mandates that goods and services must be accessible to disabled persons, including braille-embossed materials for the visually impaired. The Act further aims to protect the rights of visually challenged individuals by ensuring equality, non-discrimination, and access to information. It requires that information, including braille, be made available to ensure their full participation in society and emphasizes their legal capacity and right to access justice. However, the absence of braille on essential products continues to undermine these provisions.
The absence of braille labelling on medicines could potentially lead to tragic incidents, such as the case of 86-year-old Douglas Lamond, a blind pensioner who died in May 2012 after receiving incorrect medication from a busy Boots pharmacy due to a label mix-up. Such scenarios highlight the urgent need for accessible labelling to prevent medication errors and ensure safety for the visually impaired.
In conclusion, the lack of accessible packaging for the visually impaired is a pressing social issue that needs immediate attention. The Union Ministry of Health and Family Welfare must take decisive steps to amend existing laws and mandate braille-embossed scripts on all pharmaceutical packaging. Regular audits and stricter penalties for non-compliance are crucial to ensure that companies meet these standards. Public awareness also plays a key role in driving change, as individuals with visual impairments deserve the same independence and dignity as everyone else. Addressing this issue is vital for creating a truly inclusive society, where basic rights are upheld for all. The ongoing PIL, if successful, could pave the way for broader reforms, transforming accessibility across various sectors in India.