Ruling for Access Leading court cases in developing countries on access to essential medicines as part of the fulfilment of the right to health Hans V. Hogerzeil Melanie Samson Jaume Vidal Casanova World Health Organization Department of Essential Drugs and Medicines Policy Geneva November 2004 Ruling for Access, version 9, 26 July 2004 Acknowledgements Jaume Vidal Casanova made the first inventory of 13 cases and collected relevant information and background references. Melanie Samson identified and analysed a further sevencases, prepared the summaries of all cases, completed the references and started the final ?? analysis. The study was conceived, planned and supervised by Hans V. Hogerzeil, who also wrote the introduction, completed and wrote the final analysis, and technically edited the document. Comments on the draft were received from Professor Sofia Gruskin, Simon Hogerzeil, Kath Hurst and Gian Luca Burci. EXPLAIN ASTERISKS done The final text was language edited and proofread by Kath Hurst. 2 Ruling for Access, version 9, 26 July 2004 Contents EXECUTIVE SUMMARY .................................................................................5 1. INTRODUCTION: ACCESS TO ESSENTIAL MEDICINES AS A HUMAN RIGHT..............................................................................................................8 The Universal Declaration of Human Rights and the WHO Constitution........................................8 The International Covenant on Economic, Social and Cultural Rights ............................................9 Essential medicines as part of the right to health ................................................................................9 Three levels of obligations .................................................................................................................10 International obligations.....................................................................................................................11 Core obligations under Article 12 ......................................................................................................11 Violations of the right to health..........................................................................................................11 Access to essential medicines as a human right: summary ...............................................................12 2. OBJECTIVES, METHODS ........................................................................13 Objectives of the study.......................................................................................................................13 Search methods, presentation of findings...........................................................................................13 3. RESULTS: THE CASES AND THE RULINGS..........................................14 General overview..................................................................................................................................14 Parties, types of cases.........................................................................................................................14 Diseases for which treatment is sought ..............................................................................................14 Human rights treaties ratified.............................................................................................................16 Constitutional framework...................................................................................................................16 Human rights treaties quoted..............................................................................................................16 Other aspects quoted ..........................................................................................................................16 Argentina...............................................................................................................................................17 Constitutional framework...................................................................................................................17 Arg-1: Viceconte Mariela Cecilia vs State of Argentina (Health Department)..................................18 Arg-2: Asociación Benghalensis et al. vs Ministerio de Salud y Acción Social ................................18 Arg-3: Campodonico de Beviacqua, Ana Carina vs Ministerio de Salud y Acción Social................19 Bolivia....................................................................................................................................................19 Constitutional framework...................................................................................................................19 Bol-1: N.N. vs la Corporación del Seguro Social Militar (COSSMIL)..............................................20 Colombia ...............................................................................................................................................21 Constitutional framework...................................................................................................................21 Col-1: Mr Alonso Muñoz Ceballos vs Instituto de Seguros Sociales (ISS) .......................................22 Col-2: Mr Diego Serna Gómez vs. Hospital Universitario del Valle.................................................23 Col-3: Mr Miguel Angel Ibarguen Rivas vs Instituto de Seguros Sociales (ISS) ..............................24 Col-4: Mr X vs. Instituto de Seguros Sociales (ISS)..........................................................................24 Col-5: Mr X vs. Secretaría de Salud Pública Municipal de Cali........................................................24 Col-6: Mrs Diana María Pinilla Sandoval vs Salud Colpatria EPS....................................................25 3 Ruling for Access, version 9, 26 July 2004 Costa Rica .............................................................................................................................................25 Constitutional framework...................................................................................................................25 Cos-1: Mrs Sidonia Vargas vs Hospital San Juan de Dios.................................................................26 Cos-2: Mr William García Álvarez vs Caja Costarricense de Seguro Social.....................................27 Cos-3: Ms Vera Salazar Navarro vs Caja Costarricense de Seguro Social ........................................27 Cos-4: Ombudsman for Mrs Ledi Orellana Martínez vs Caja Costarricense de Seguro Social (CCSS) ...........................................................................................................................................................28 El Salvador............................................................................................................................................28 Constitutional framework...................................................................................................................28 Sal-1: Mr Jorge Odir Miranda Cortez vs la Directora del Instituto Salvadoreño del Seguro Social ..29 South Africa ..........................................................................................................................................30 Constitutional framework...................................................................................................................30 Saf-1: Treatment Action Campaign, Dr Haron Sallojee and Children’s Rights Centre vs Republic of South Africa Ministry of Health.........................................................................................................31 Venezuela ..............................................................................................................................................32 Constitutional framework...................................................................................................................32 Ven-1: Mr J.R.B., et al. vs Ministerio de la Defensa .........................................................................34 Ven-2: Mr N.A., Y.F et al. vs Ministerio de Sanidad y Asistencia Social .........................................34 Ven-3: Cruz del Valle Bermúdez et al. vs Ministerio de Salud y Acción Social ...............................35 Ven-4: Mrs Glenda López et al. vs Instituto Venezolano de Seguros Sociales..................................35 4. DISCUSSION.............................................................................................36 Important conclusions in the rulings ..................................................................................................36 Most rulings have led to better access to life-saving medicines.........................................................36 International treaties create state obligations and individual rights....................................................36 Individual cases can create group rights.............................................................................................36 Government policies can be challenged in court................................................................................36 The right to health is not restricted by limitations in social security coverage, including the national list of essential medicines...................................................................................................................37 The State has special obligations towards the poor and disadvantaged