On July 31, 2008, the Constitutional Court of Colombia (the Court) handed down a decision (T-760/2008) that ordered a dramatic restructuring of the country's health system. The judgment came as the culmination of a wave of litigation to enforce the right to health, with tens of thousands of health rights cases before the Colombian courts each year. Since 1992, the Court has staunchly upheld rights to access and treatment in the context of a highly neoliberal state, and has not shied away from decisions with considerable resource implications.

Colombia is a striking example of how broader regional and global trends can have an impact on judicial enforcement of claims for health goods and services. However, there is a wide-ranging debate in public health circles about the appropriateness and impact of such judicial interventions on health policy and health equity. Critics question, for example, whether judicial activism distorts priority-setting and undermines the role of administrative and legislative bodies.

Although it is too early to judge the implementation of the July 2008 decision, the sweeping 411-page judgment reaffirms that courts can enforce access to health goods and services as a matter of fundamental rights, even when there are substantial resource implications. It further indicates that courts can creatively define their role in health priority-setting.