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Volumn 33, Issue 4, 2005, Pages 711-724

Ensuring reasonable health: Health rights, the judiciary, and South African HIV/AIDS policy

Author keywords

[No Author keywords available]

Indexed keywords

CONFERENCE PAPER; HEALTH CARE AND PUBLIC HEALTH; HEALTH CARE DELIVERY; HEALTH CARE POLICY; HEALTH CARE QUALITY; HUMAN; HUMAN IMMUNODEFICIENCY VIRUS INFECTION; INFECTION CONTROL; LEGAL APPROACH; LEGAL ASPECT; ORGANIZATION AND MANAGEMENT; PATIENT RIGHT; POLITICS; SOUTH AFRICA;

EID: 32144435929     PISSN: 10731105     EISSN: None     Source Type: Journal    
DOI: 10.1111/j.1748-720X.2005.tb00538.x     Document Type: Conference Paper
Times cited : (17)

References (174)
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    • Dandridge v. Williams 397 U.S. 471 (1970), where the U.S. Supreme Court refused to review the way that social grants were formulated or administered, reasoning that "[t]he intractable economic, social and even philosophical problems presented by public welfare assistance program are not the business of this Court."
    • See for instance, Dandridge v. Williams 397 U.S. 471 (1970), where the U.S. Supreme Court refused to review the way that social grants were formulated or administered, reasoning that "[t]he intractable economic, social and even philosophical problems presented by public welfare assistance program are not the business of this Court."
  • 2
    • 32144461419 scopus 로고    scopus 로고
    • Andrews v. Law Society of British Columbia (1989) 1 S.C.R 123, at paragraph 194, where Justice La Forest states: "much economic and social policy making is simply beyond the institutional competence of the courts: their role is to protect against incursions on fundamental values, not to second guess policy decisions."
    • See for example, Andrews v. Law Society of British Columbia (1989) 1 S.C.R 123, at paragraph 194, where Justice La Forest states: "much economic and social policy making is simply beyond the institutional competence of the courts: their role is to protect against incursions on fundamental values, not to second guess policy decisions."
  • 3
    • 32144451023 scopus 로고    scopus 로고
    • Gosselin v. Québec (Attorney General), 2002 4 S.C.R. 429, where the Canadian Supreme Court refused to recognize that the right to security of the body places positive obligations on the government to provide social welfare
    • See for example, Gosselin v. Québec (Attorney General), 2002 4 S.C.R. 429, where the Canadian Supreme Court refused to recognize that the right to security of the body places positive obligations on the government to provide social welfare.
  • 4
    • 32144458628 scopus 로고    scopus 로고
    • Universal Declaration of Human Rights, G.A. Res. 217 A (III), U.N. Doc. A/810 (1948): article 25; Constitution of the World Health Organization, opened for signature July 22, 1946, 62 Stat. 2679, 14 U.N.T.S. 186
    • See for instance, Universal Declaration of Human Rights, G.A. Res. 217 A (III), U.N. Doc. A/810 (1948): article 25; Constitution of the World Health Organization, opened for signature July 22, 1946, 62 Stat. 2679, 14 U.N.T.S. 186;
  • 5
    • 32144445273 scopus 로고    scopus 로고
    • International Covenant on Economic, Social and Cultural Rights opened for signature December 16, 1966, 993 U.N.T.S. 3, article 12
    • International Covenant on Economic, Social and Cultural Rights opened for signature December 16, 1966, 993 U.N.T.S. 3, article 12;
  • 6
    • 32144450667 scopus 로고    scopus 로고
    • International Convention on the Rights of the Child, opened for signature November 20 1989, U.K.T.S. 1992 No. 44, 28 I.L.M. 1448 1989, article 24(1)
    • International Convention on the Rights of the Child, opened for signature November 20 1989, U.K.T.S. 1992 No. 44, 28 I.L.M. 1448 1989, article 24(1);
  • 7
    • 32144440322 scopus 로고    scopus 로고
    • International Convention on the Elimination of Racial Discrimination, opened for signature December 21, 1965, 660 U.N.T.S. 195, 5 I.L.M. 352 1966, article 5(e)(iv)
    • International Convention on the Elimination of Racial Discrimination, opened for signature December 21, 1965, 660 U.N.T.S. 195, 5 I.L.M. 352 1966, article 5(e)(iv);
  • 8
    • 32144463377 scopus 로고    scopus 로고
    • Convention on the Elimination of All Forms of Discrimination Against Women, opened for signature December 18, 1979, U.K.T.S. 1989 No. 2, 19 I.L.M. 33 1980, articles 11(1)(f) and 12
    • Convention on the Elimination of All Forms of Discrimination Against Women, opened for signature December 18, 1979, U.K.T.S. 1989 No. 2, 19 I.L.M. 33 1980, articles 11(1)(f) and 12;
  • 9
    • 32144455923 scopus 로고    scopus 로고
    • International Convention on the Protection of the Rights of All Migrant Workers and Members of Their Families, opened for signature December 18, 1990, article 28
    • International Convention on the Protection of the Rights of All Migrant Workers and Members of Their Families, opened for signature December 18, 1990, article 28;
  • 10
    • 32144443694 scopus 로고    scopus 로고
    • The European Social Charter, opened for signature, October 18, 1961, 529 U.N.T.S. 89, article 11
    • The European Social Charter, opened for signature, October 18, 1961, 529 U.N.T.S. 89, article 11;
  • 11
    • 32144444025 scopus 로고    scopus 로고
    • the African Charter on Human and People's Rights, opened for signature June 27, 1981, O.A.U. Doc. CAB/LEG/67/3 rev. 5, 21 I.L.M. 58 (1982), article 16
    • the African Charter on Human and People's Rights, opened for signature June 27, 1981, O.A.U. Doc. CAB/LEG/67/3 rev. 5, 21 I.L.M. 58 (1982), article 16;
  • 16
    • 32144437993 scopus 로고    scopus 로고
    • (article 12 of the International Covenant on Economic, Social and Cultural Rights)" E/C.12/2000/4, August 11
    • On the right to health specifically, see Committee on Economic, Social and Cultural Rights, "General Comment No. 14 (2000): The Right to the Highest Attainable Standard of Health (article 12 of the International Covenant on Economic, Social and Cultural Rights)" E/C.12/2000/4, August 11, 2000.
    • (2000) General Comment No. 14 (2000): The Right to the Highest Attainable Standard of Health
  • 17
    • 14544287672 scopus 로고    scopus 로고
    • Provisions for health and health-care in the constitutions of the countries of the world
    • E. D. Kinney and B. A. Clark, "Provisions for Health and Health-Care in the Constitutions of the Countries of the World," Cornell International Law Journal 37 (2004): 285-355, at 287.
    • (2004) Cornell International Law Journal , vol.37 , pp. 285-355
    • Kinney, E.D.1    Clark, B.A.2
  • 18
    • 32144436928 scopus 로고    scopus 로고
    • There are examples of both direct judicial enforcement of health rights, and judicial protection of health through civil rights protections. For example in Viceconti v. Ministry of Health and Social Welfare (Argentina, Poder Judicial de la Nación, Causa no. 31.777/96, June 2, 1998), international human rights treaties on health were recognized, and government's positive obligations to provide health care were confirmed;
    • There are examples of both direct judicial enforcement of health rights, and judicial protection of health through civil rights protections. For example in Viceconti v. Ministry of Health and Social Welfare (Argentina, Poder Judicial de la Nación, Causa no. 31.777/96, June 2, 1998), international human rights treaties on health were recognized, and government's positive obligations to provide health care were confirmed;
  • 19
    • 32144460870 scopus 로고    scopus 로고
    • and in Cruz Bermudez et al v. Ministerio de Sanidad y Asistencia Social (Supreme Court of Justice of Venezuela, Case No. 15.789, Decision No. 916 July 15, 1999), the court found that constitutional rights to health and life required the Ministry of Health to provide antiretroviral medicines; develop national treatment policies and programs
    • and in Cruz Bermudez et al v. Ministerio de Sanidad y Asistencia Social (Supreme Court of Justice of Venezuela, Case No. 15.789, Decision No. 916 July 15, 1999), the court found that constitutional rights to health and life required the Ministry of Health to provide antiretroviral medicines; develop national treatment policies and programs;
  • 20
    • 32144449453 scopus 로고    scopus 로고
    • and reallocate budget necessary to carry out the Court's decision. For indirect protection of health, see for example, Paschim Banga Khet Mazdoor Samity v. State of West Bengal (1996) 4 S.C.C. 37, where the denial of emergency medical treatment for serious head injuries was deemed to be a breach of the right to life contained in the Indian Constitution
    • and reallocate budget necessary to carry out the Court's decision. For indirect protection of health, see for example, Paschim Banga Khet Mazdoor Samity v. State of West Bengal (1996) 4 S.C.C. 37, where the denial of emergency medical treatment for serious head injuries was deemed to be a breach of the right to life contained in the Indian Constitution;
  • 21
    • 32144445785 scopus 로고    scopus 로고
    • and Eldridge v. British Columbia (Attorney General) 1997 3 S.C.R. 624, where the Canadian Supreme Court ordered the provision of health care benefits under the constitutional right to equality and non-discrimination
    • and Eldridge v. British Columbia (Attorney General) 1997 3 S.C.R. 624, where the Canadian Supreme Court ordered the provision of health care benefits under the constitutional right to equality and non-discrimination.
  • 22
    • 85055300897 scopus 로고    scopus 로고
    • From wickedness to equality: The moral transformation of South African Law
    • A. Chaskalson, "From Wickedness to Equality: The Moral Transformation of South African Law," International Journal of Constitutional Law 1, no. 4 (2003): 590-609, at 601.
    • (2003) International Journal of Constitutional Law , vol.1 , Issue.4 , pp. 590-609
    • Chaskalson, A.1
  • 23
    • 84870936730 scopus 로고    scopus 로고
    • adopted May 8, 1996, amended October 11, 1996, (last visited October 4, 2004)
    • Constitution of the Republic of South Africa (adopted May 8, 1996, amended October 11, 1996), available at 〈http://www.polity.org. za/govdocs/constitution/saconst.html〉 (last visited October 4, 2004).
    • Constitution of the Republic of South Africa
  • 24
    • 32144441017 scopus 로고    scopus 로고
    • Id, Preamble
    • Id, Preamble.
  • 25
    • 32144442912 scopus 로고    scopus 로고
    • Id, sections 1(a), 7(1), 36(1) and 39(1)(a)
    • Id, sections 1(a), 7(1), 36(1) and 39(1)(a).
  • 26
    • 32144456069 scopus 로고    scopus 로고
    • Id, Preamble
    • Id, Preamble.
  • 27
    • 32144450126 scopus 로고    scopus 로고
    • A constitutional confluence: American 'state action' law and the application of South Africa's socio-economic rights guarantees to private actors
    • P. Andrews and S. Ellmann eds., Johannesburg: Witwatersrand University Press
    • For instance, in addition to prohibiting discrimination on the grounds of sexual orientation and gender in section 9(3) on equality, in sections 8(2) and 239, the Constitution provides for horizontal application of the constitution as between individuals and juristic persons. See in this respect, S. Ellmann, "A Constitutional Confluence: American 'State Action' Law and the Application of South Africa's Socio-Economic Rights Guarantees to Private Actors," in P. Andrews and S. Ellmann eds., The Post-Apartheid Constitutions: Perspectives on South Africa's Basic Law (Johannesburg: Witwatersrand University Press, 2001): at 444.
    • (2001) The Post-Apartheid Constitutions: Perspectives on South Africa's Basic Law , pp. 444
    • Ellmann, S.1
  • 28
    • 32144433398 scopus 로고    scopus 로고
    • These rights include section 27 (food, health care, water and social security), 26 (housing), 29 (education), and 28 (children's rights to basic social amenities)
    • These rights include section 27 (food, health care, water and social security), 26 (housing), 29 (education), and 28 (children's rights to basic social amenities).
  • 29
    • 32144437672 scopus 로고    scopus 로고
    • Under apartheid, approximately 87 percent of South African land was reserved for white ownership, and what limited black ownership remained was effectively eroded through forced removals. Skilled jobs and economic opportunities were predominantly limited for whites
    • Under apartheid, approximately 87 percent of South African land was reserved for white ownership, and what limited black ownership remained was effectively eroded through forced removals. Skilled jobs and economic opportunities were predominantly limited for whites.
  • 30
    • 11144317039 scopus 로고    scopus 로고
    • New York: UNDP
    • South Africa is ranked 119th on the United Nations Development Program's [UNDP] human development index (in the lower two thirds of countries classified as having medium human development). However it has a gross domestic product per capita (US $10,070,00) comparable to at least 60 percent of countries classified as having high human development. See UNDP, Human Development Report 2004 (New York: UNDP, 2004): at 138-139.
    • (2004) Human Development Report 2004 , pp. 138-139
  • 31
    • 32144450842 scopus 로고    scopus 로고
    • Overview on poverty in South Africa
    • D. Bradshaw and K. Steyn, eds. (Tygerberg: Medical Research Council)
    • K. Steyn and M. Schneider, "Overview on Poverty in South Africa" in D. Bradshaw and K. Steyn, eds., Poverty and Chronic Diseases in South Africa: Technical Report 2001 (Tygerberg: Medical Research Council, 2001): 1-14, at 6. S.A. records one of the highest Gini Coefficient indexes in the world, measured in 2003 at 59.3. The Gini coefficient is used to compare inequality among nations. It measures the distribution of income (or consumption) among individuals or households within a country between 0 (perfect equality) and 100 (perfect inequality).
    • (2001) Poverty and Chronic Diseases in South Africa: Technical Report 2001 , pp. 1-14
    • Steyn, K.1    Schneider, M.2
  • 33
    • 32144445784 scopus 로고    scopus 로고
    • Steyn and Schneider, supra note 17, at 12
    • See Steyn and Schneider, supra note 17, at 12.
  • 34
    • 32144464933 scopus 로고    scopus 로고
    • supra note 14
    • See supra note 14.
  • 35
    • 32144444024 scopus 로고    scopus 로고
    • Constitution, supra note 9, at sections 28(1)(c), 35(2)(e) and section 24(a) respectively
    • Constitution, supra note 9, at sections 28(1)(c), 35(2)(e) and section 24(a) respectively.
  • 36
    • 32144457935 scopus 로고    scopus 로고
    • WHO Constitution and ICESCR, supra note 4
    • See for example, WHO Constitution and ICESCR, supra note 4.
  • 39
    • 0031039751 scopus 로고    scopus 로고
    • Socioeconomic determinants of health: Health inequalities: Relative or absolute material standards?
    • and R. G. Wilkinson, "Socioeconomic Determinants of Health: Health Inequalities: Relative or Absolute Material Standards?" British Medical Journal 314 (1997): 591-595, at 591.
    • (1997) British Medical Journal , vol.314 , pp. 591-595
    • Wilkinson, R.G.1
  • 40
    • 32144458108 scopus 로고    scopus 로고
    • note
    • There is however an important proviso to this limited scope, since certain health care services (such as AIDS medicines in high prevalence countries) may hold far broader public health benefits. Moreover, given the correlation between poverty and health, the realization of the constitutional provisions regarding basic needs could also contribute to improved population health.
  • 41
    • 32144439240 scopus 로고    scopus 로고
    • Constitution, supra note 9, at section 7(2)
    • Constitution, supra note 9, at section 7(2).
  • 42
    • 0003754159 scopus 로고
    • (Princeton, NJ: Princeton University Press). It is applied in the context of health in General Comment 14, supra note 5
    • The duty to respect imposes a negative obligation to desist from interfering with people's enjoyment of rights; the duty to protect requires the state to prevent third party interference with people's rights; and the duty to promote and fulfil describes the state's positive obligation to realize access. The notion of a typology of rights is widely acknowledged to have been developed by Henry Shue, see H. Shue, Basic Rights, Subsistence, Affluence and US Foreign Policy (Princeton, NJ: Princeton University Press, 1980). It is applied in the context of health in General Comment 14, supra note 5.
    • (1980) Basic Rights, Subsistence, Affluence and US Foreign Policy
    • Shue, H.1
  • 44
    • 32144455421 scopus 로고    scopus 로고
    • Id.
    • Id.
  • 45
    • 32144462673 scopus 로고    scopus 로고
    • Id, at paragraph 78
    • Id, at paragraph 78.
  • 46
    • 32144449599 scopus 로고    scopus 로고
    • Social and economic rights: Can they be made justiciable?
    • These concerns are apparent in Justice Albie Sach's ex curia assertion, prior to the Court's seminal decision in Grootboom, that judicial lack of expertise regarding the technical complexities of socioeconomic policy required "corresponding judicial modesty." In Sachs' eyes, judges could not "be philosopher kings and queens who go around telling government how to function." Where Sachs saw an appropriate judicial function, was when situations of socioeconomic deprivation went "to the core of a person's life and dignity" - here he argued that courts were better equipped to balance competing interests than governments whose bureaucratic and operational concerns demanded compromise. See A. Sachs, "Social and Economic Rights: Can they be Made Justiciable?" Southern Methodist University Law Review 53 (2000): 1381-1391, at 1388-1389.
    • (2000) Southern Methodist University Law Review , vol.53 , pp. 1381-1391
    • Sachs, A.1
  • 47
    • 32144435276 scopus 로고    scopus 로고
    • Two additional socioeconomic rights-related cases have been heard - Minister of Public Works and Others v. Kyalami Ridge Environmental Association, Case CCT 55/00, which addressed private challenges to state policy designed to provide housing to the poor, and Louis Khosa and Others v. The Minister of Social Development and others; Saleta Mahluale and Another v. The Minister of Social Development, Case CCT 12/03, which dealt with a challenge to state policy that limited social security assistance to citizens. Relevant holdings of the latter case are included below
    • Two additional socioeconomic rights-related cases have been heard - Minister of Public Works and Others v. Kyalami Ridge Environmental Association, Case CCT 55/00, which addressed private challenges to state policy designed to provide housing to the poor, and Louis Khosa and Others v. The Minister of Social Development and others; Saleta Mahluale and Another v. The Minister of Social Development, Case CCT 12/03, which dealt with a challenge to state policy that limited social security assistance to citizens. Relevant holdings of the latter case are included below.
  • 48
    • 32144432693 scopus 로고    scopus 로고
    • Soobramoney v. Minister of Health (Kwa-Zulu Natal) (1998) 1 S.Afr.L.R. 765 (S. Afr. Const. Ct.)
    • Soobramoney v. Minister of Health (Kwa-Zulu Natal) (1998) 1 S.Afr.L.R. 765 (S. Afr. Const. Ct.).
  • 49
    • 32144464767 scopus 로고    scopus 로고
    • Government of the Republic of South Africa and Others v. Irene Grootboom and Others (2000) 11 B.Const. L.R. 1169 (S. Afr. Const. Ct.)
    • Government of the Republic of South Africa and Others v. Irene Grootboom and Others (2000) 11 B.Const. L.R. 1169 (S. Afr. Const. Ct.).
  • 50
    • 32144456809 scopus 로고    scopus 로고
    • Minister of Health and Other v. Treatment Action Campaign and Others (2002) 5 S.Afr.L.R. 721 (S.Afr.Const.Ct)
    • Minister of Health and Other v. Treatment Action Campaign and Others (2002) 5 S.Afr.L.R. 721 (S.Afr.Const.Ct).
  • 51
    • 0006008676 scopus 로고    scopus 로고
    • Reasoning about resources: Soobramoney and the future of socio-economic rights claims
    • See for example, D. Moellendorf, "Reasoning about Resources: Soobramoney and the Future of Socio-Economic Rights Claims," South African Journal on Human Rights 14 (1998): 327-333, at 327;
    • (1998) South African Journal on Human Rights , vol.14 , pp. 327-333
    • Moellendorf, D.1
  • 52
    • 0034472627 scopus 로고    scopus 로고
    • The recognition of access to health care as a human right in South Africa: Is it enough?
    • and C. Ngwenya, "The Recognition of Access to Health Care as a Human Right in South Africa: Is it Enough?" Health and Human Rights 5, no. 1 (2000): 27-44, at 33.
    • (2000) Health and Human Rights , vol.5 , Issue.1 , pp. 27-44
    • Ngwenya, C.1
  • 53
    • 32144460527 scopus 로고    scopus 로고
    • note
    • Soobramoney never contested the lower court's finding that "the [state] has conclusively proved that there are no funds available to provide patients such as the applicant with the necessary treatment." Instead Soobramoney argued that the state could make additional funds available to the provincial hospital, and that it was obliged to do under section 27. Soobramoney, supra note 33, at paragraph 23.
  • 55
    • 32144463188 scopus 로고    scopus 로고
    • Soobramoney, supra note 33, at paragraphs 24-25
    • Soobramoney, supra note 33, at paragraphs 24-25.
  • 56
    • 32144456070 scopus 로고    scopus 로고
    • Id, at paragraph 42
    • See Id, at paragraph 42.
  • 57
    • 32144461048 scopus 로고    scopus 로고
    • Id, at paragraph 29 states that "a court would be slow to interfere with rational decisions taken in good faith by the political organs and medical authorities whose responsibility it is to deal with such matters." Rationality is a low standard of review, requiring only that the government purpose is legitimate, and that there is a rational and not arbitrary connection between the law and the government purpose.
    • Id, at paragraph 29 states that "a court would be slow to interfere with rational decisions taken in good faith by the political organs and medical authorities whose responsibility it is to deal with such matters." Rationality is a low standard of review, requiring only that the government purpose is legitimate, and that there is a rational and not arbitrary connection between the law and the government purpose.
  • 58
    • 32144455922 scopus 로고    scopus 로고
    • Khosa, supra note 32, at paragraph 67
    • See also Khosa, supra note 32, at paragraph 67.
  • 59
    • 32144463375 scopus 로고    scopus 로고
    • Grootboom, supra note 34, at paragraphs 24 and 44
    • Grootboom, supra note 34, at paragraphs 24 and 44.
  • 60
    • 32144464934 scopus 로고    scopus 로고
    • TAC, supra note 35, at paragraphs 35 and 36
    • TAC, supra note 35, at paragraphs 35 and 36.
  • 61
    • 32144451548 scopus 로고    scopus 로고
    • Grootboom, supra note 34, at paragraph 83
    • Grootboom, supra note 34, at paragraph 83.
  • 62
    • 32144444559 scopus 로고    scopus 로고
    • Id.
    • Id.
  • 63
    • 32144444191 scopus 로고    scopus 로고
    • Id, at paragraphs 38, 40, 42 and 43
    • Id, at paragraphs 38, 40, 42 and 43.
  • 64
    • 32144440320 scopus 로고    scopus 로고
    • Id, at paragraph 44, cited with approval in TAC, supra note 35, at paragraph 68
    • Id, at paragraph 44, cited with approval in TAC, supra note 35, at paragraph 68.
  • 65
    • 32144445271 scopus 로고    scopus 로고
    • Grootboom, supra note 34, at paragraphs 35 and 43, the latter paragraph cited with approval in TAC, supra note 35, at paragraph 68
    • Grootboom, supra note 34, at paragraphs 35 and 43, the latter paragraph cited with approval in TAC, supra note 35, at paragraph 68.
  • 66
    • 32144451383 scopus 로고    scopus 로고
    • Grootboom, supra note 34, at paragraph 44
    • Grootboom, supra note 34, at paragraph 44.
  • 67
    • 32144438893 scopus 로고    scopus 로고
    • Id, at paragraph 44
    • Id, at paragraph 44.
  • 68
    • 32144446818 scopus 로고    scopus 로고
    • Id, at paragraph 42
    • Id, at paragraph 42.
  • 69
    • 32144457933 scopus 로고    scopus 로고
    • Id, at paragraphs 40 and 43
    • Id, at paragraphs 40 and 43;
  • 70
    • 32144445272 scopus 로고    scopus 로고
    • cited with approval in TAC, supra note 35, at paragraph 68
    • cited with approval in TAC, supra note 35, at paragraph 68.
  • 71
    • 32144448532 scopus 로고    scopus 로고
    • Grootboom, supra note 34, at paragraph 41
    • Grootboom, supra note 34, at paragraph 41.
  • 72
    • 32144431624 scopus 로고    scopus 로고
    • Id, at paragraph 45
    • Id, at paragraph 45.
  • 73
    • 32144445461 scopus 로고    scopus 로고
    • Id.
    • Id.
  • 74
    • 32144461591 scopus 로고
    • U.N. Doc. HRI\GEN\1\Rev.1 at 45 paragraph 9, cited with approval in Grootboom, supra note 34, at paragraph 45
    • UN Committee on Economic, Social and Cultural Rights, General Comment 3: The Nature of State Party Obligations, U.N. Doc. HRI\GEN\1\Rev.1 at 45 (1994), at paragraph 9, cited with approval in Grootboom, supra note 34, at paragraph 45.
    • (1994) General Comment 3: The Nature of State Party Obligations
  • 75
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    • TAC, supra note 35, at paragraph 131
    • TAC, supra note 35, at paragraph 131.
  • 76
    • 32144447829 scopus 로고    scopus 로고
    • Id, at paragraph 32
    • Id, at paragraph 32.
  • 77
    • 32144440852 scopus 로고    scopus 로고
    • Grootboom, supra note 34, at paragraph 46
    • Grootboom, supra note 34, at paragraph 46.
  • 78
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    • Id, at paragraph 68
    • Id, at paragraph 68.
  • 79
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    • Soobramoney, supra note 33, at paragraphs 8-11; TAC, supra note 35, at paragraphs 31 and 34; Khosa, supra note 32, at paragraph 43
    • Soobramoney, supra note 33, at paragraphs 8-11; TAC, supra note 35, at paragraphs 31 and 34; Khosa, supra note 32, at paragraph 43.
  • 80
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    • Soobramoney, supra note 33, at paragraphs 8, 28 and 31
    • Soobramoney, supra note 33, at paragraphs 8, 28 and 31.
  • 81
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    • Id, at paragraph 53
    • Id, at paragraph 53.
  • 82
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    • Id, at paragraph 54
    • Id, at paragraph 54.
  • 83
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    • Id. 65. Id, at paragraph 32
    • Id. 65. Id, at paragraph 32.
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    • This is not a unique feature of the current administration however, and from the earliest appearance of AIDS in South Africa in 1983, government's response has been inadequate. See V. van der Vliet, "South Africa Divided against AIDS: A Crisis of Leadership," in K. D. Kauffman and D. L. Lindauer, eds., AIDS and South Africa: The Social Expression of a Pandemic (Hampshire: Palgrave Macmillan, 2004): 48.
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    • This legislative authority is primarily held in the Medicines and Related Substances Control Amendment Act No. 59 of 2002, as well as the Patents Act No. 57 of 1978 as revised
    • This legislative authority is primarily held in the Medicines and Related Substances Control Amendment Act No. 59 of 2002, as well as the Patents Act No. 57 of 1978 as revised.
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    • Id, at paragraph 123.
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    • The minimum core focuses on state obligations to ensure equitable distribution of health care facilities, goods and services; essential drugs; non-discriminatory access to health care; access to food, water, housing and sanitation, and a comprehensive plan to provide health care for all. Id, at paragraph 43.
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    • The only specific minimum core obligation not explicit in the reasonableness standard or the Constitution itself is the necessity of ensuring access to essential drugs, although the holding in the TAC case would certainly support such an interpretation. This is not to downplay this absence - given the crucial role of essential drugs within national health care systems, this deficit alone could found the objections to the Court's refusal to more fully elaborate a substantive content for section 27.
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    • The task of defining a nationally appropriate minimum core is probably best addressed by a government institution like the Human Rights Commission, which is constitutionally mandated to monitor state compliance with the Constitution's socioeconomic guarantees, to promote the protection, development and attainment of human rights, and to carry out research.
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    • In his outgoing speech as Chief Justice, Arthur Chaskalson articulated this balance in the following way: [T]he independence of the judiciary and the separation of powers are foundational principles of constitutionalism. The delicate balance called for to give effect to this separation requires the three arms of government to pay attention to the inter-relationship between them mandated by the Constitution, and to the deference that each owes to the other. How this is done is of particular importance to the standing of the courts, their efficacy, and the respect that their judgments command. It is crucial to constitutionalism. Chief Justice A. Chaskalson. "Farewell Speech on Stepping Down as Chief Justice of South Africa and the Constitutional Court," June 2, 2005, available at 〈http://www.constitutionalcourt. org.za/site/farewell.htm〉 (last visited July 10, 2005).
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