THE RESPONSIBILITY OF FEDERATIVE ENTITIES IN THE JUDICIAL ENFORCEMENT OF THE RIGHT TO HEALTH: AN ANALYSIS IN LIGHT OF COOPERATIVE FEDERALISM AND THE CASE LAW OF THE BRAZILIAN SUPREME FEDERAL COURT

Abstract

This article examines the responsibility of the federal government, states, the Federal District and municipalities in the judicial enforcement of the right to health, considering Brazil's cooperative federal structure and the evolving case law of the Brazilian Supreme Federal Court. The research adopts a qualitative, bibliographic and documentary approach, analyzing the 1988 Constitution, the legislation governing the Unified Health System and General Repercussion Themes 793, 500, 6 and 1,234, including the latter's 2026 update. It investigates how joint and several responsibility should coexist with the administrative allocation of duties, intergovernmental financing and technical criteria for access to medicines. The analysis indicates that constitutional solidarity protects citizens' access to judicial remedies but does not justify disregarding health system organization on a continuing basis. Recent precedents point toward coordination between individual protection, scientific evidence, judicial jurisdiction, reimbursement mechanisms and public planning. It concludes that judicial protection of the right to health is more consistent when it offers timely responses to demonstrated needs without indiscriminately shifting financial or administrative burdens to entities that are not primarily responsible for delivering the service. Institutional cooperation is essential to reconcile the effectiveness of rights with equitable collective access.