Health Equity as a Justiciable Right in Nigeria: A Doctrinal Framework for Judicial Enforcement

Abstract

Despite the widespread recognition of the right to health across international, regional, and domestic human rights frameworks, courts have struggled to address persistent health inequities in a principled and consistent manner. This difficulty stems not from the non-justiciability of the right to health per se, but from a deeper doctrinal limitation: health equity is still predominantly treated as a policy aspiration rather than a legally enforceable standard. These disparities reflect in access, financing, geography, and health outcomes and reveal a persistent gap between normative legal commitments and their practical realization. This article argues that this conceptual mischaracterization has constrained judicial engagement with systemic disparities in access, financing, and health outcomes. Focusing on Nigeria, the article reconceptualizes health equity as a justiciable dimension of the right to health and develops a doctrinal framework for its judicial enforcement. Drawing on jurisdictions that adjudicate inequities within the right to health, it reinterprets and integrates the principles of non-discrimination, substantive equality, and reasonableness review into a structured, analytical model for adjudicating inequities in healthcare systems. On this basis, the article advances a set of enforceable standards as a judicial test that enables courts to identify and evaluate systemic health inequities as rights violations rather than mere policy deficiencies. By transforming health equity from a programmatic objective into an enforceable legal standard, the article offers a normative and doctrinal intervention that strengthens the capacity of courts to address structural injustice in healthcare.