de Barcellos Ana Paula
Constitutional Law Professor at the State University of Rio de Janeiro, 2012-2013 Takemi Fellow at the Harvard School of Public Health, Boston, MA, USA.
Health Hum Rights. 2014 Dec 11;16(2):E35-46.
Public law litigation has been used in many places to advance human rights related to health. In Brazil, such lawsuits usually request that the government pay for pharmaceuticals to individuals. But could litigation play a role in shaping public health policies to benefit communities? To explore this question, this paper focuses on lawsuits involving determinants of health, namely water and sanitation public policies. This paper discusses the results of an empirical study of 258 Brazilian court orders, issued in a 10-year period, that address requests for sewage collection and treatment. The data show that the Brazilian judiciary is willing to improve access to sanitation services. However, litigation has addressed fewer than 177 out of the 2,495 Brazilian municipalities that lack both sewage collection and treatment systems, and lawsuits are concentrated in the richer cities, not in the poorest ones. This paper suggests that public law litigation can be used to foster public health policies similar to the way in which structural reform litigation and the experimentalism approach between courts and defendants have influenced public policies and achieved institutional reform in schools and prisons. However, greater effort is needed to target initiatives that would reach the most disenfranchised communities.
公法诉讼在许多地方被用于推进与健康相关的人权。在巴西，此类诉讼通常要求政府为个人支付药品费用。但诉讼能否在塑造有益于社区的公共卫生政策方面发挥作用呢？为探讨这个问题，本文聚焦于涉及健康决定因素的诉讼，即水和环境卫生公共政策。本文讨论了对10年间发布的258项巴西法院命令进行实证研究的结果，这些命令涉及污水收集和处理的请求。数据显示，巴西司法机构愿意改善卫生服务的可及性。然而，在巴西缺乏污水收集和处理系统的2495个城市中，诉讼涉及的城市不到177个，而且诉讼集中在较富裕的城市，而非最贫困的城市。本文表明，公法诉讼可用于促进公共卫生政策，其方式类似于结构改革诉讼以及法院与被告之间的实验主义方法对公共政策产生影响并在学校和监狱实现制度改革的方式。然而，需要做出更大努力，以使倡议能够惠及最被剥夺权利的社区。
