Recent studies of the Brazilian case suggest that successful litigation can have regressive effects and negatively impact the health care system. While the data to support this claim is not conclusive, this paper assumes that such immediate regressive effects are indeed taking place, but asks if these are the only consequences that should be analyzed in assessing the impact of right to health litigation in Brazil. The answer is no. The current perspective adopted to assess right to health litigation in (...) Brazil is too narrow. Other consequences can and should be considered in analyzing the overall impact of litigation. To go beyond the set of questions asked by the existing experts on the topic, this paper analyzes whether the right to health litigation in Brazil has the potential, and could be generating: (i) policy changes within the health care system; (ii) institutional changes within the health care system; and (iii) institutional changes outside the health care system. After presenting anecdotal evidence that suggests these three types of changes may be happening in Brazil, I conclude the paper by discussing what would be required to assess them, and how these changes may affect our overall assessment of the more immediate and supposedly negative impact that litigation has had on the system. (shrink)

The 1988 Brazilian Constitution establishes a right to health in two of its provisions. The first provision provides a relatively long list of social rights, which includes not only the right to health, but also the right to the determinants of health such as education, food, employment, and shelter. The second provision recognizes the two components of the right to health, namely: factors that are likely to affect a person’s health, such as access to clean water, sanitation and nutrition; and (...) medical care or health services. This second provision establishes that the right to health “shall be guaranteed by means of social and economic policies aimed at reducing the risk of illness and other hazards and by the universal and equal access to actions and services for its promotion, protection and recovery.” It also enumerates state obligations, the first and most important one being the duty of the Brazilian state to guarantee the right to health to every citizen. (shrink)

Domestic litigation has become a principal strategy for realizing international treaty obligations for the human right to health, providing causes of action for the public’s health and empowering individuals to raise human rights claims for HIV prevention, treatment, and care. In the past 15 years, advocates have laid the groundwork on which a rapidly expanding enforcement paradigm has arisen at the intersection of human rights litigation and HIV/AIDS policy. As this enforcement develops across multiple countries, human rights are translated from (...) principle to practice in the global response to HIV/AIDS, transforming aspirational declarations into justiciable obligations and implementing human rights through national policies and programs. (shrink)

Domestic litigation has become a principal strategy for realizing international treaty obligations for the human right to health, providing causes of action for the public’s health and empowering individuals to raise human rights claims for HIV prevention, treatment, and care. In the past 15 years, advocates have laid the groundwork on which a rapidly expanding enforcement paradigm has arisen at the intersection of human rights litigation and HIV/AIDS policy. As this enforcement develops across multiple countries, human rights are translated from (...) principle to practice in the global response to HIV/AIDS, transforming aspirational declarations into justiciable obligations and implementing human rights through national policies and programs. (shrink)

Why does #RepealedThe8th matter for feminist legal studies? The answers seem obvious in one sense. Feminism has long constituted itself through the struggle for sexual and reproductive justice, and Irish feminism has contributed a significant ‘legal win’ with the landslide vote of approval for lifting abortion restrictions in the referendum on the 25th May 2018. That win comes at a global moment when populist legal engagement is doing significant damage in countries that regard themselves as world leaders, and beyond. #RepealedThe8th (...) offers Ireland, and the world, the actuality that the popular vote, and everything that contributes to it, could be something else. Repeal shows how legal tools like the vote may be made into an expression of care for reproductive lives. This expression is important in recognizing pregnant people as knowing agents who are best placed to decide, and in seeking to do justice to those who contribute to everyday reproductive life. But repeal, like the many who brought it into being, has multiple meanings. #RepealedThe8th matters because it is a moving process of socio-legal translation, which draws on a collective energy, ‘repeal energy’, to turn the travesty that was the Eighth Amendment and all it represents into a search for the rest of reproductive life. In opening up the meaning of the vote, much like feminists elsewhere have opened up the meaning of the strike, Irish feminists have turned public mourning over past mistreatment into a series of reproductive connections. This is not a strategy that can be rolled out. Figuring out #RepealedThe8th will take many tellings. Rather we need to give repeal, and repealers, room to breathe and rest. We need to feel our way through repeal’s production of legal change so that this success is not reduced to some generic transferable set of legal instructions. I begin by reflecting on repeal as a process of feminist socio-legal translation, which shows us how legal change comes about through the motivation of collective joy, the mourning of damaged and lost lives, the sharing of legal knowledge, and the claiming of the rest of reproductive life. (shrink)

This article explores the effectiveness of the decision of the Committee on the Elimination of Discrimination against Women in the case of Alyne da Silva Pimentel Teixeira (deceased) v. Brazil, concerning a poor, Afro-Brazilian woman. This is the first decision of an international human rights treaty body to hold a state accountable for its failure to prevent an avoidable death in childbirth. Assessing the future effectiveness of this decision might be undertaken concretely by determining the degree of Brazil's actual compliance (...) with the Committee's recommendations, and how this decision influences pending domestic litigation arising from the maternal death. Alternative approaches include: determining whether, over time, the decision leads to the elimination of discrimination against women of poor, minority racial status in the health sector, and if it narrows the wide gap between rates of maternal mortality of poor, Afro-Brazilian women and the country's general female population. Determining the effectiveness of this decision will guide whether to pursue a more general strategy of judicializing maternal mortality. (shrink)

Alyne da Silva Pimentel Teixeira died of postpartum hemorrhage following the stillbirth of a 27-week-old fetus on November 16, 2002 in Rio de Janeiro, Brazil. Her death led in 2011 to the first decision of an international treaty body holding a government accountable for a preventable maternal death. The decision, Alyne da Silva Pimentel Teixeira v. Brazil, was given by the Committee on the Elimination of Discrimination against Women, established to monitor compliance by member states with the UN Convention on (...) the Elimination of All Forms of Discrimination against Women. The decision upheld a complaint, filed in 2007 against the state and government of Brazil, finding discrimination in the field of health care for Alyne’s avoidable maternal death, in breach of the Women’s Convention. (shrink)