147. Indeed, determination of when a State has failed to comply with the obligation
should be made on the basis of the particularities of its laws and the available resources.
However, the Court recognizes that the leeway enjoyed by States for the effective
realization of the ESCER does not justify inaction in protecting them. Thus, in this case, the
Court recalls that it has been demonstrated that the State, despite having a series of laws
and programs aimed at caring for people living with HIV, failed to provide medical treatment
before 2004 to ensure the right to health of these individuals, with the exception of treating
a limited number of them; rather it entrusted this task to non-governmental organizations.
The State acknowledged this situation before the Court on several occasions and sought to
justify the lack of progressive medical care before 2004 despite the existence of domestic
laws that established an obligation of protection for different authorities. Consequently, the
Court considers that the State’s inaction, prior to 2004, constituted non-compliance with the
State obligations in relation to progressive protection of the right to health, in violation of
Article 26 of the American Convention.
148. Consequently, owing to the State inaction with regard to protection of the right to
health of the population of people living with HIV, despite the existence of an international
obligation and State regulations, the Court concludes that the State is responsible for
violating the principle of progressivity contained in Article 26 of the Convention, in relation
to Article 1(1) of this instrument.
B.4.1.3. Analysis of compliance with the obligations of progressivity
in relation to the alleged legal barriers concerning intellectual property and
administrative contracting
149. The Court notes that the representatives’ petition refers specifically to the legal
barriers concerning intellectual property and administrative contracting practices that
allegedly constituted retrogressive measures because they had prevented the health system
from having a permanent supply of antiretroviral drugs. In the representatives’ opinion,
these barriers had prevented the State from using the maximum resources available to
prevent the propagation of the virus and to ensure the right to health. In this regard, the
Court notes that the Commission did not refer directly to the Law on Industrial Property in
its Merits Report as an obstacle to compliance with the State’s obligation to respond to HIV,
but it did mention some commitments made by the Government during a meeting held by
the President of Guatemala, the Ministry of Public Health, the Executive Director of the AIDS
Prevention Foundation, and the Director of the Asociación de Salud Integral (ASI).174 The
meeting was held following the Constitutional Court’s ruling of January 29, 2003.
150. The Court considers that the facts contained in the Merits Report concerning the
commitments made by the President following the ruling of the Constitutional Court;
namely, those related to the adoption of various measures: (i) to annul Decree No. 9-2003,
(ii) to promulgate Decree No. 34-2004, and (iii) to promulgate Decree 30-2005, are of a
contextual nature for the effects of this case. In other words, these facts are relevant “to
provide a framework for the facts that are alleged to have led to violations [of human
rights] in the context of the specific circumstances in which they took place.”175 Thus, the
facts mentioned by the Commission as some of the commitments made by the Government
Cf. IACHR, Merits Report No. 2/16, Luis Ronaldo Cuscul Pivaral and other persons living with HIV/AIDS,
Guatemala, April 13, 2016 (merits file, folio 30).
174
Cf. Case of J. v. Peru. Preliminary objection, merits, reparations and costs. Judgment of November 27,
2013. Series C No. 275, para. 53, and Case of the Dismissed Employees of PetroPeru et al. v. Peru. Preliminary
objections, merits, reparations and costs. Judgment of November 23, 2017. Series C No. 344, para. 67.
175
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