Right to Health: UN Special Rapporteur Calls Access to Justice a Precondition for Health

Summary

On 22 October 2026, the United Nations Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health, Mariângela Simão, presented a report to the General Assembly's Third Committee (Social, Humanitarian and Cultural) on the justiciability of the right to health for justice and accountability. According to UN Meetings Coverage, she told the Committee that "justice is not external to health. Justice is a precondition for health", and stressed that the right to health is "not aspirational".

The report, prepared by her predecessor Tlaleng Mofokeng, examines how international, regional and national legal frameworks can either reinforce or dismantle barriers to health equity, and how judicial and non-judicial remedies can address violations of the right to health. This report summarises the findings, the statements made during the interactive dialogue, the recommendations and the relevant international standards.

Background: The Mandate and the Report

The report, "The justiciability of the right to health for justice and accountability" (A/81/169), is dated 13 July 2026 and was transmitted to the General Assembly's eighty first session by the Secretary-General in accordance with Human Rights Council resolution 60/10. It is the final report of Tlaleng Mofokeng as Special Rapporteur. Mariângela Simão of Brazil was appointed to the mandate by the Human Rights Council on 8 July 2026, at the close of its sixty second session, and took up her functions on 1 August 2026, according to the UN Office at Geneva and the Brazilian Ministry of Foreign Affairs.

According to the report, it was prepared following a call for inputs inviting rights holders and other stakeholders to share experiences of how laws, policies and practices intersect with the right to health, with emphasis on the impacts on marginalised groups. The report defines justiciability as the ability of everyone to claim a remedy before an independent and impartial body when a violation of a right has occurred or is likely to occur. In a statement released by the Office of the United Nations High Commissioner for Human Rights (OHCHR), Simão said: "When remedies are available, rights become meaningful; when accountability exists, obligations become real."

Key Findings of the Report

The report describes what it calls the dual role of the law. It states that while the law "has been weaponized to sustain socioeconomic, gender and racial segregation", it has also been used to tackle widespread health inequities, "often as a last resort for the most vulnerable individuals and communities".

Legal Obligations

The report states that, although the International Covenant on Economic, Social and Cultural Rights provides for the progressive realisation of the right to health, it also imposes obligations of immediate effect. It concludes that "legal remedies for health rights violations constitute an immediate duty, and are not subject to progressive realization." It adds that where non-judicial mechanisms exist, such as ombudspersons, national human rights institutions or patients' rights bodies, they must be reinforced or complemented by judicial remedies, and that any person must ultimately have access to an independent public authority able to determine a violation and order reparation.

Courts and Accountability in Practice

The report reviews how courts and other bodies have adjudicated health claims across three dimensions of the right: autonomy, prevention and healthcare. It cites cases in which judicial and administrative remedies protected persons living with HIV who were subjected to mandatory testing, involuntary disclosure of their status or sterilisation without consent, including a High Court ruling that the forced sterilisation of four women living with HIV violated their dignity and right to health. It also notes that courts have used proportionality tests to weigh public health measures, such as childhood vaccination policies, against other claimed freedoms.

Barriers to Remedies

The report finds that remedies are frequently obstructed by limited legal awareness, high legal costs, language barriers, inadequate legal assistance, distance from courts and institutional bias. Citing World Justice Project research, it states that an estimated 1.5 billion people are unable to access judicial or other accountability mechanisms to obtain effective remedies for violations of their rights, and that this gap disproportionately affects people from lower socioeconomic backgrounds, women, migrants and asylum seekers, persons with disabilities and other groups in situations of vulnerability.

Good Practices

Drawing on submissions from States, the report notes that, as of 2008, at least 115 Constitutions recognised an autonomous right to health or to healthcare. It highlights examples including Colombia's acción de tutela and the jurisdictional functions of its National Superintendency of Health, redress mechanisms reported by Portugal, Switzerland, Morocco, Montenegro and Georgia, and a 2024 judgment of the European Court of Human Rights finding that rigid limitation periods for asbestos victims violated the right to a fair hearing.

Statements During the Interactive Dialogue

According to UN Meetings Coverage, Simão told the Committee that individuals must have access to independent authorities empowered to determine violations and order remedies, and that "legal remedies for health rights violations can be a transformative driver for substantive equality". She called for constitutional recognition of the right to health and the empowerment of communities through participatory governance. UN Meetings Coverage also reported that she condemned United States sanctions against the International Criminal Court, its judges and the Special Rapporteur on the situation of human rights in the Palestinian territories occupied since 1967.

During the dialogue, Namibia's delegate, speaking for the African Group, said that mpox, hantavirus and the Ebola Bundibugyo emergency had exposed persistent weaknesses in global health systems. Cuba's representative reported that over 100,000 patients, including 12,000 children, were awaiting surgery, and attributed this to the United States embargo. Israel's representative described a profound mental health crisis following the 7 October attacks and subsequent hostilities. Iran's delegate stated that military attacks by the United States and Israel in February had destroyed 245 healthcare units, 70 hospitals and 69 ambulances. Brazil's speaker emphasised the impact of poverty and social exclusion on health, and the European Union, speaking as an observer, underscored the importance of legal remedies and non-discrimination. These figures and characterisations are those of the delegations as reported by UN Meetings Coverage and have not been independently verified by the Taskforce.

Recommendations

The report recommends that States recognise the right to health in full, and its enforceability, in their Constitutions and legal frameworks; ensure that all persons, without discrimination, have access to effective and expeditious remedies, including independent and impartial judicial bodies, with no reprisals against individuals, groups or civil society organisations; and expand legal aid while removing geographic, financial, linguistic and administrative hurdles to seeking justice.

It further recommends standing rules that allow national human rights institutions, non-governmental organisations, human rights defenders and public interest litigators to bring cases on behalf of marginalised populations; systemic, population-wide remedies where individual remedies are insufficient; reversing the burden of proof and applying reasonable causation standards, including epidemiological data, for health-related harms; specialised training for judges, prosecutors and lawyers; safeguards against conflicts of interest in judicial institutions; and the repeal of punitive frameworks that criminalise health-related decisions, behaviours, identities or conditions. It also calls on States and businesses to conduct human rights due diligence when digital technologies, telemedicine and artificial intelligence systems are acquired, developed and deployed.

Relevant International Standards

Article 12 of the International Covenant on Economic, Social and Cultural Rights recognises the right of everyone to the enjoyment of the highest attainable standard of physical and mental health, and General Comment No. 14 of the Committee on Economic, Social and Cultural Rights sets out its content, including the underlying determinants of health. Article 2 (3) of the International Covenant on Civil and Political Rights requires States to ensure an effective remedy for violations of recognised rights. The report also refers to General Comment No. 24 on State obligations in the context of business activities and to the third pillar of the Guiding Principles on Business and Human Rights, which concerns access to remedy. Target 16.3 of the Sustainable Development Goals calls for equal access to justice for all.

Taskforce Note

The Global HR Taskforce will continue to monitor the Third Committee's consideration of the report and any steps by States to adopt the constitutional, procedural and legal aid measures recommended in report A/81/169. Sources: Report of the Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health, "The justiciability of the right to health for justice and accountability", A/81/169, 13 July 2026; UN Meetings Coverage and Press Releases, Third Committee, 22 October 2026; OHCHR statement, "UN expert calls for stronger accountability to effectively realise right to health"; UN Office at Geneva, Human Rights Council sixty second session closing release, July 2026; International Covenant on Economic, Social and Cultural Rights.