## Facts

- Glenda Lopez and other people living with HIV/AIDS (the patients) were affiliated with the Venezuelan Institute of Social Welfare (the institute), the public entity responsible for certain social-security health benefits.
- The patients filed a writ of constitutional protection (acción de amparo) against the institute alleging it failed to provide the medications and laboratory testing needed to treat and manage HIV/AIDS.
- The requested treatment included antiretroviral drugs (described as “triple therapy”), medicines for opportunistic infections, and the diagnostic and monitoring tests required to prescribe and follow that treatment.
- The patients alleged that the institute’s failure to provide these medicines and tests jeopardized effective treatment and put their health and lives at risk.
- They claimed the omission violated constitutional rights, including (1) liberty, (2) equality and nondiscrimination, and (3) health and life, along with access to science and technology.
- The case was decided shortly after the adoption of Venezuela’s new constitution and the creation of a restructured Supreme Court, in a context where the court was asked to treat access to essential HIV/AIDS treatment as a justiciable constitutional matter.
- The patients also sought relief that would not be limited to the named claimants, but would reach other HIV-positive people insured by the institute who needed the same medicines and tests.

## Issues

1. Whether the institute’s failure to provide necessary HIV/AIDS medications and related testing violated the patients’ constitutional rights to health and life (and related guarantees such as liberty, equality, and nondiscrimination).
2. Whether constitutional protection of access to science and technology supports an enforceable duty to provide medically indicated, modern HIV/AIDS treatment and monitoring.
3. Whether the court could grant amparo relief with effects reaching similarly situated HIV-positive beneficiaries affiliated with the institute, rather than limiting relief to the named patients.

## Decision

- The court granted the writ of protection (amparo) against the institute.
- The court held that the institute had a duty to provide HIV/AIDS patients covered by the social-security scheme with the necessary medications and medical testing required for treatment and disease management.
- The court treated the institute’s failure to supply those medicines and tests as an unconstitutional omission that violated the right to health and threatened the right to life, and that also conflicted with guarantees tied to equality and nondiscrimination and access to science and technology.
- The court ordered the institute to supply the required HIV/AIDS medications and to provide or cover the necessary testing on a regular and consistent basis for eligible beneficiaries.
- The court extended the operative effects of the decision beyond the named patients to other HIV-positive people covered by the institute who legally qualified for benefits and requested the same medicines and tests, so they could rely on the judgment without filing separate actions.

## Legal Principles

- When a public social-security health institution fails to provide medically necessary treatment for a life-threatening condition, that omission can constitute a constitutional violation subject to amparo relief.
- The right to health is enforceable through constitutional protection when denial of essential care places individuals at serious risk, including risk to life.
- Guarantees related to equality and nondiscrimination apply to access to public health benefits; public entities may not withhold or interrupt essential treatment in a way that effectively denies covered patients access to care.
- Constitutional protection of access to science and technology can support requiring public benefit institutions to provide recognized, medically indicated therapies and the testing needed to use them safely and effectively.
- Effective judicial protection may permit relief that reaches a defined group of similarly situated beneficiaries where the violation and requested remedy are common to the group, avoiding repetitive litigation and enabling consistent treatment.

## Conclusion

The court held that the Venezuelan Institute of Social Welfare’s failure to provide HIV/AIDS medications and necessary testing violated constitutional protections tied to health and life (and related guarantees), ordered the institute to provide the treatment and testing on a regular basis, and allowed similarly covered HIV-positive beneficiaries who qualify for benefits to invoke the ruling without bringing separate lawsuits.


Glenda Lopez et. al. v. Venezuelan Institute of Social Welfare, Exped. No. 1343 (2001)