Bolivian Court Orders State to Guarantee Dialysis for Kidney Patients Amid Crisis

Historic Ruling Mandates State Action

In a landmark decision on Tuesday, September 30, 2025, the Sixth Sentencing Court of Santa Cruz, Bolivia, granted an 'acción de libertad' (freedom action) against the government, ordering the immediate and continuous guarantee of dialysis treatments for kidney patients. This ruling comes after weeks of protests and a severe crisis stemming from the government's alleged failure to make timely payments to private dialysis centers, jeopardizing the lives of thousands of patients across the country.

Crisis Escalates Over Unpaid Debts and Supply Shortages

The crisis affecting kidney patients in Bolivia was primarily triggered by the government's substantial and prolonged debts to private dialysis centers, with some reports indicating outstanding payments for up to seven months. This financial shortfall led to interruptions in vital dialysis services and a critical shortage of essential medicines and supplies, placing approximately 2,000 patients in Santa Cruz alone at risk of death. Patients, supported by civic groups and legislators, had been conducting vigils and protests for nearly two weeks, demanding urgent solutions to ensure their continued treatment.

'Acción de Libertad' Filed Against Top Government Officials

The 'acción de libertad,' a legal mechanism in Bolivia designed to protect fundamental rights, was initiated by kidney patients, civic organizations such as the Comité Pro Santa Cruz, and legislators. The legal action was specifically directed against high-ranking government officials, including President Luis Arce Catacora, Minister of Health María Renée Castro, and Minister of Economy Marcelo Montenegro, holding them accountable for the crisis. Prominent figures involved in the petition included civic leader Stello Cochamanidis, vice president of the Comité Cívico cruceño Agustín Zambrana, and lawyer Andrés Ritter.

Court's Mandate and Government's Response

The court's decision is considered 'historic' as it establishes a crucial precedent for the protection of the right to health in Bolivia, emphasizing that this right is inalienable and must be effectively safeguarded, even amidst crises. The ruling explicitly mandates the State to ensure the provision of dialysis and other chronic treatments without delay. In response to the judicial order and the ongoing public outcry, officials from the Ministry of Health, including Advisor Javier Moreno and Legal Director Max Salazar, stated that all outstanding payments to dialysis centers in Santa Cruz had been completed on September 30, 2025, and that payments for the rest of the country would be finalized by October 1, 2025. They also questioned the timing of the legal action, suggesting it was politically motivated.

Ensuring the Right to Health

The ruling underscores the judiciary's role in upholding fundamental rights and places a clear obligation on the Bolivian government to prioritize the health and well-being of its citizens. While the government claims to have addressed the immediate financial issues, the court's decision serves as a powerful reminder of the State's responsibility to maintain continuous and adequate healthcare services, particularly for vulnerable patient populations.