144. In this judgment (supra paras. 118 to 127), the Court has already found that the
State violated the right to health of 49 victims by failing to ensure them adequate medical
treatment as people living with HIV. The Court will now examine the allegation that the
State violated the commitment established in Article 26 concerning compliance with its
obligation of progressivity. This obligation consists in the adoption of provisions, especially
of an economic and technical nature – to the extent of available resources and by either
legislative or other appropriate means – to achieve progressively the full realization of
certain economic, social, cultural and environmental rights. In addition, the Court recalls
that the progressive realization of the ESCER means that the States Parties have the specific
and constant obligation to advance as rapidly and effectively as possible towards the full
realization of the ESCER.172 In this regard, the Court reiterates that the obligation of
progressivity:
(…) should not be interpreted to mean that, during their implementation, these
obligations become deprived of specific content, which also does not mean that
States may postpone indefinitely the adoption of measures to make the rights in
question effective, especially almost forty years after the entry into force of the interAmerican treaty. Therefore, the obligation of non-retrogressivity applies with regard
to any realization of the rights that has been achieved.”173
145. Bearing in mind that the matter analyzed refers to the specific measures that, in the
opinion of the Commission and of the representatives, were retrogressive for the prevention
and combat of HIV in Guatemala, the Court clarifies that, in this case, it does not have to
assess whether the State’s current public policy for combating HIV is insufficient in relation
to the obligations established in Article 26 of the Convention. Indeed, the Court notes that
the State has promoted a series of actions to combat the HIV epidemic in Guatemala. The
State has described these actions to the Court on different occasions and they include the
promulgation of laws and decrees, government decisions, care protocols, cooperation
agreements and manuals (supra paras. 41 to 54). Further, the Court notes that, from 2004
to 2017, the State progressively increased the budget allocated to combat HIV, and that it
has adopted other public policy measures aimed at achieving a greater protection for the
population.
146. Nevertheless, the Court reiterates that the obligations regarding the progressive
realization of the ESCER require the continual execution of actions to achieve the full
enjoyment of these rights. Thus, the progressive dimension of the protection of ESCER,
although acknowledging the gradual nature of their realization, also includes a sense of
progress, which calls for an effective improvement of the enjoyment and exercise of these
rights, so that social inequalities are corrected and the inclusion of vulnerable groups is
facilitated. Accordingly, the obligation of progressive realization prohibits State inactivity in
the task of implementing actions to achieve the comprehensive protection of these rights,
especially when the total absence of State protection places the individual at risk of
suffering harm to his or her life or personal integrity. This risk occurs for people living with
HIV who do not receive adequate medical care. Consequently, the Court considers that the
State failed to comply with its treaty-based obligation to ensure progressive realization
because it did not have public policies or programs that de facto – and not only de jure –
allowed it to make progress in complying with its obligation to achieve the full realization of
the right to health.
Cf. Poblete Vilches et al. v. Chile. Merits, reparations and costs. Judgment of March 8, 2018. Series C No.
349, para. 104 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. 31.
172
Cf. Poblete Vilches et al. v. Chile. Merits, reparations and costs. Judgment of March 8, 2018. Series C No.
349, para. 104.
173
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