Implementation of the right to health in Brazil and India: a comparative study

• Author: Bárbara Mendonça Bertotti - Arati Ranade
• Position: LLM candidate at OP Jindal Global University (Sonipat, Haryana, India) - PhD student in Law at Pontifícia Universidade Católica do Paraná (Curitiba, Paraná, Brazil)
• Pages: 27-46

Licenciado bajo Licencia Creative Commons

Licensed under Creative Commons

Revista Eurolatinoamericana

de Derecho Administrativo

ISSN 2362-583X

27

Implementation of the right to health in Brazil and India:

a comparative study*

Concretização do direito à saúde no Brasil e na Índia:

um estudo comparado

ARATI RANADE I,**

I OP Jindal Global University (Sonipat, India)

aaranade@gmail.com

https://orcid.org/0000-0003-1753-1871

BÁRBARA MENDONÇA BERTOTTI II,***

II Pontifícia Universidade Católica do Paraná (Curitiba, Brasil)

barbarabmmab@gmail.com

https://orcid.org/0000-0001-6959-0481

Recibido el/Received: 11.09.2021 / September 11th, 2021

Aprobado el/Approved: 30.11.2021 / November 30th, 2021

Resumen:

Este artículo tiene como objetivo comparar los regíme-

nes jurídico-constitucionales de Brasil e India con res-

pecto a la realización del derecho a la salud. Por ello, en

primer lugar, se presentará información general sobre los

dos sistemas, en particular sobre aspectos de la funda-

mentalidad de este derecho, la garantía constitucional, la

titularidad del deber de garantizarlo, la participación de

los sistemas de salud público y privado (si los hubiere).

Posteriormente, se contrastarán los objetos de estudio

elegidos para identicar las proximidades. Se utilizará el

Abstract:

The purpose of this article is to compare the legal-constitu-

tional regimes of Brazil and India regarding the realization

of the right to health. To this end, rst, general information

about the two systems will be presented, notably on the as-

pects of the fundamental nature of this right, the constitu-

tional guarantee, the ownership of the duty to ensure it, the

participation of the private sector and public health systems

(if any). Then, the chosen objects of study will be contrast-

ed in order to identify their proximities. The comparative

method will be used, based on the thought disseminated by

DOI 10.14409/redoeda.v8i2.10652

Como citar este artículo | How to cite this article: RANADE, Arati; BERTOTTI, Bárbara Mendonça. Implementation of the right

to health in Brazil and India: a comparative study. Revista Eurolatinoamericana de Derecho Administrativo, Santa Fe, vol.

8, n. 2, p. 27-46, jul./dic. 2021. DOI 10.14409/redoeda.v8i2.10652.

* This study was nanced in part by the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - Brasil (CAPES) - Finance

Code 001.

** LLM candidate at OP Jindal Global University (Sonipat, Haryana - India). Bachelor in socio-legal studies and Bachelor in laws at

ILS Law College. E-mail: aaranade@gmail.com.

*** PhD student in Law at Pontifícia Universidade Católica do Paraná (Curitiba, Paraná - Brazil). Specialist in Public Law at Escola

da Magistratura Federal do Paraná and in Administrative Law at Instituto de Direito Romeu Felipe Bacellar. Bachelor of Laws at

Universidade Federal do Paraná. Vice-president of the Instituto Política por.de.para Mulheres. E-mail: barbarabmmab@gmail.com.

Rev. Eurol atin. de Derecho A dm., Santa Fe, vo l. 8, n. 2, p. 27-46, jul ./dic. 2021.

Arati Ranade

Bárbara Mendonça Bertotti

Rev. Eurol atin. de Derecho A dm., Santa Fe, vo l. 8, n. 2, p. 27-46, jul ./dic. 2021.

28

Contents:

1. Introduction; 2. The Legal-constitutional regime of the right to health in India; 3. In-

dia’s public healthcare system; 4. The Legal-constitutional regime of the right to health

in Brazil; 5. Brazilian public health system; 6. A comparison between general aspects of

the right to health in Brazil and India; 7. Conclusions. References.

1. INTRODUCTION

Martin Luther King Jr. once stated: ‘Of all the forms of inequality, inequality in health-

care is the most shocking and inhuman.’1 The Covid-19 pandemic has reinforced the rele-

vance of health issues around the world. But not only that. It also came as a litmus test

to test and reveal the real situation of the health systems in each country.

In Brazil, the Unied Health System (called “SUS”), the public structure that mate-

rializes the right to health, guarantees universality, integrality, and gratuity to all the

people who need it. About 75% of the Brazilian population depends entirely on SUS.

In the face of the pandemic scenario, it has become a protagonist and has shown itself

to be indispensable in the ght against the new Coronavirus. In reality, the way this

system was thought and organized already announced its protagonism since always.

And so it should be, were it not for the false ideas introduced by neoliberal thinking,

where the inecient State is opposed to the ecient private one. The dissemination

of this thought brings to the population the idea that the SUS “does not work”. In real-

ity, SUS faces many problems, mainly related to its underfunding, management,2 and

substantial inequalities (both in relation to the territorial distribution of health services,

1 Statement attributed toMartin Luther King Jr.

2 BECHARA, Fábio Ramazzini; COSTA, Fernanda Soraia Pacheco. Eciência na prestação de serviços de saúde:

experiência brasileira do modelo gerencial e comparativo com os países da common law. A&C – Revista de

Direito Administrativo & Constitucional, Belo Horizonte, ano 19, n. 75, p. 65-82, jan./mar. 2019.

método comparativo, desde el pensamiento difundido

por Pierre Legrand. Se concluye que en Brasil el derecho

a la salud tiene mayor protección y densidad normativa,

principalmente por ser un derecho fundamental garan-

tizado constitucionalmente y por tener el Sistema Único

de Salud como estructura pública de implementación. En

India, sin embargo, por no estar constitucionalmente ga-

rantizado y por no contar con un sistema público estruc-

turado a nivel nacional, el derecho a la salud se encuentra

en un nivel inferior, y aún queda mucho por desarrollar.

Palabras clave: derecho a la salud; Brasil; India; método

comparativo; derecho constitucional.

Pierre Legrand. The conclusion is that the right to health has

more excellent protection and normative density in Brazil,

mainly because it is a constitutionally guaranteed funda-

mental right and because it has the Unied Health System

as its public structure. In India, however, for not being con-

stitutionally assured and not having a nationally structured

public system, the right to health is at a lower level, and

there is still much to be developed.

Keywords: right to health; Brazil; India; comparative meth-

od; constitutional law.