(i) Non-discrimination: health facilities, goods and services must be accessible
to all, especially the most vulnerable or marginalized sections of the
population, in law and in fact, without discrimination on any of the prohibited
grounds.
(ii) Physical accessibility: health facilities, goods and services must be within
safe physical reach for all sections of the population, especially vulnerable or
marginalized groups, such as ethnic minorities and indigenous populations,
women, children, adolescents, older persons, persons with disabilities and
persons with HIV/AIDS. Accessibility also implies that medical services and
underlying determinants of health, such as safe and potable water and
adequate sanitation facilities, are within safe physical reach, including in rural
areas. Accessibility further includes adequate access to buildings for persons
with disabilities.
(iii) Economic accessibility (affordability): health facilities, goods and services
must be affordable for all. Payment for health-care services, as well as
services related to the underlying determinants of health, has to be based on
the principle of equity, ensuring that these services, whether privately or
publicly provided, are affordable for all, including socially disadvantaged
groups. Equity demands that poorer family units should not be
disproportionately burdened with health expenses as compared to richer family
units.
(iv) Information accessibility: accessibility includes the right to seek, receive
and impart information and ideas concerning health issues. However,
accessibility of information should not impair the right to have personal health
data treated with confidentiality.
(c) Acceptability. All health facilities, goods and services must be respectful of medical
ethics and culturally appropriate, i.e. respectful of the culture of individuals,
minorities, peoples and communities, sensitive to gender and life-cycle requirements,
as well as being designed to respect confidentiality and improve the health status of
those concerned.
(d) Quality. As well as being culturally acceptable, health facilities, goods and services
must also be scientifically and medically appropriate and of good quality. This requires,
inter alia, skilled medical personnel, scientifically approved and unexpired drugs and
hospital equipment, safe and potable water, and adequate sanitation.114
107. Based on the foregoing, the Court concludes that the right to health refers to the
right of every human being to enjoy the highest attainable standard of physical, mental and
social well-being. This right encompasses prompt and appropriate health care provided in
keeping with the principles of availability, accessibility, acceptability and quality. The State’s
compliance with its obligation to respect and ensure this right should include special care for
vulnerable and marginalized groups, and should be provided progressively in accordance
with available resources and applicable domestic law. The Court will now refer to the specific
obligations that arise in the case of health care for people living with HIV.
Cf. Case of Suárez Peralta v. Ecuador. Preliminary objections, merits, reparations and costs. Judgment of
May 21. 2013. Series C No. 261, para. 152; Case of Poblete Vilches et al. v. Chile. Merits, reparations and costs.
Judgment of March 8, 2018. Series C No. 349, paras. 120 and 121, and Committee on Economic, Social and
Cultural Rights, General Comment No. 14: The Right to the Highest Attainable Standard of Health, August 11,
2000. U.N. Doc. E/C.12/2000/4, para. 12.
114
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