a treaty-based hierarchy to norms contained in other national and international instruments
related to the ESCER.106 To the contrary, the Court is making an interpretation pursuant to
the standards established by Article 29, and in keeping with its judicial practice, that allows
it to update the meaning of the rights derived from the OAS Charter that are recognized by
Article 26 of the Convention. Determination of the right to health will give special emphasis
to the American Declaration, because, as this Court has established:
[…] [T]he Member States of the Organization have signaled their agreement that the
Declaration contains and defines the fundamental human rights referred to in the
Charter. Thus the Charter of the Organization cannot be interpreted and applied as
far as human rights are concerned without relating its norms, consistent with the
practice of the organs of the OAS, to the corresponding provisions of the
Declaration.107
102. Moreover, the Court has indicated on other occasions that human rights treaties are
living instruments, and their interpretation must evolve over time in line with current
conditions. This evolutive interpretation is consequent with the general rules of
interpretation established in Article 29 of the American Convention, as well as in the Vienna
Convention.108 In addition, the third paragraph of Article 31 of the Vienna Convention
authorizes the use of means of interpretation such as agreements or practices or relevant
rules of international law indicated by the States regarding the subject matter of the treaty,
which are some of the means that relate to an evolutive vision of the treaty. In this way, in
order to determine the scope of the right to health for people living with HIV, as derived
from the economic, social, education, scientific and cultural standards of the OAS Charter,
the Court will refer to the relevant instrument of the international corpus juris.
B.3. The content of the right to health
103. Based on the foregoing, the Court notes, first, that Article XI of the American
Declaration recognizes that “[e]very person has the right to the preservation of his health
through sanitary and social measures relating to medical care, to the extent permitted by
public and community resources.” Similarly, Article 10 of the Protocol of San Salvador
establishes that “everyone shall have the right to health, understood to mean the
enjoyment of the highest level of physical, mental and social well-being” and indicates that
health is a “public good.”109 The same article establishes that, among other measures to
ensure the right to health, States must ensure “[u]niversal immunization against the
principal infectious diseases,” “[p]revention and treatment of endemic, occupational and
Cf. Case of the Pacheco Tineo family v. Bolivia. Preliminary objections, merits, reparations and costs.
Judgment of November 25, 2013. Series C No. 272, para.143.
106
Cf. Interpretation of the American Declaration of the Rights and Duties of Man within the Framework of
Article 64 of the American Convention on Human Rights. Advisory Opinion OC-10/89 of July 14,1989. Series A No.
10. para. 43, and Case of Poblete Vilches et al. v. Chile. Merits, reparations and costs. Judgment of March 8, 2018.
Series C No. 349, para. 107.
107
Cf. The Right to Information on Consular Assistance in the Framework of the Guarantees of the Due
Process of Law. Advisory Opinion OC-16/99 of October 1, 1999. Series A No. 16, para. 114, and The institution of
asylum, and its recognition as a human right under the Inter-American System of Protection (interpretation and
scope of Articles 5, 22(7) and 22(8) in relation to Article 1(1) of the American Convention on Human Rights).
Advisory Opinion OC-25/18 of May 30, 2018. Series A No. 25, para. 137.
108
Article 10(1) of the Protocol of San Salvador establishes: “[e]veryone shall have the right to health,
understood to mean the enjoyment of the highest level of physical, mental and social well-being. 2. In order to
ensure the exercise of the right to health, the States Parties agree to recognize health as a public good and,
particularly, to adopt the following measures to ensure that right: a. Primary health care, that is, essential health
care made available to all individuals and families in the community; [and] b. Extension of the benefits of health
services to all individuals subject to the State's jurisdiction.”
109
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