Manual scavenging refers to the practice of manually cleaning, carrying, disposing or handling human excreta from dry latrines and sewers. It is one of the most dehumanizing and deplorable practices that violate basic human rights and dignity. This practice is linked to India’s caste system where so-called lower castes are expected to perform this job. Despite being outlawed in 1993, manual scavenging continues to exist in India due to socio-economic discrimination and lack of rehabilitation of manual scavengers. This paper attempts to provide an in-depth understanding. The harsh realities by qualitative systemic review of manual scavenging in India and how it negatively impacts human rights. It reviews relevant literature on the prevalence, causes, adverse effects, and laws against manual scavenging. The results indicate that manual scavenging is still practiced across many states in India. Manual scavengers face grave health hazards and socio-economic hardships. The laws against manual scavenging have failed to abolish this practice due to administrative apathy, lack of rehabilitation support for liberated scavengers, and continued prevalence of dry latrines necessitating manual disposal of excreta. The paper emphasizes the need for more concerted efforts by the government and civil society to end manual scavenging to uphold human rights, dignity, and justice for all. There is an urgent need for extensive awareness campaigns, social support, and proper rehabilitation of liberated scavengers into alternative professions.

Access to affordable and quality medicines plays a vital role for achieving Universal Health Coverage and in reducing out-of-pocket expenditures (OOPE) for households especially in developing nations such as India. Pradhan Mantri Bhartiya Janaushadhi Pariyojana (PMBJP), a Government of India initiative, aims to make low-cost and quality generic drugs and surgical equipment accessible to all segments of the population through its dedicated store outlets known as Pradhan Mantri Bhartiya Janaushadhi Kendra (PMBJK). In this study, a pilot survey comprising 20 stores/PMBJKs and 150 citizens was undertaken in the Bengaluru Urban District, India to understand various aspects of the PMBJKs including availability of drugs, stock-outs, accessibility to stores, perception and awareness levels along with challenges faced by store owners and citizens/beneficiaries. Based on the survey results, we capture the availability of drugs for 35 medicines and consumables belonging to 12 therapeutic categories across 20 store outlets. We also provide valuable insights and interdisciplinary recommendations on several facets including adopting technology-based measures for day-to-day functioning of stores, need for in-depth supply chain analysis for ensuring availability of drugs, encouraging prescription of generic medicines, increasing awareness levels in addition to promoting grassroot-level research, surveys and feedback mechanisms. These suggestions are expected to find their utility in policy-making, strengthen the implementation of the PMBJP scheme across Bengaluru and India as well as contribute towards achieving related Sustainable Development Goals.