Spain: Strengthening joint action to protect the right to health of undocumented migrants

The joint statement issued by Amnesty International, CESR, Medicos del Mundo
and Red Acoge can de downloaded in pdf format here

Two years ago, on 1 September 2012, Royal Decree Law 16/2012 (RDL 16) – “concerning urgent measures to guarantee the sustainability of the National Health System and improve the quality and security of its services” - came into effect. Using the context of “fiscal austerity” as a justification, the Spanish government initiated implementation of this law, which was severely criticized by UN human rights treaty bodies and Special Procedures of the Office of the High Commissioner for Human Rights, and the European Committee on Social Rights of the Council of Europe.

The Royal Decree not only eroded the system of universal national health coverage that existed up until that point, but also left undocumented immigrants over 18 years of age without access to health care, except for emergency situations, pregnancy (pre and post natal care), and victims of human trafficking within the period of recovery and reflection. What’s more, many undocumented migrants with chronic illnesses such as cancer or diabetes now do not have access to free health care or medications.

It is estimated that, thus far, the Spanish Ministry of Health has withdrawn the health entitlements of some 873,000 people. Furthermore, it has opposed in court the continued application of norms at the level of Autonomous Communities that allow health care to be provided to undocumented migrants, and it has ignored the allegations of civil society organizations with regard to the negative impact and possible irregularities in application of RDL 16.

Since 2012, the Spanish organizations Médicos del Mundo (MDM), Red ACOGE and the Spanish section of Amnesty International, together with the Center for Economic and Social Rights (CESR), have been taking action to strengthen the accountability of the Spanish state for the human rights impacts of RDL 16. These organizations have carried out, both individually and collectively, policy monitoring, evidence gathering and advocacy, at both the national and international levels, in order to bring attention to these issues. Said organizations are also working to strengthen the capacity of the juridical sector to carry out strategic litigation on violations resulting from the application of RDL, in collaboration with the Strategic Litigation Working Group of the International Network on Economic, Social and Cultural Rights. This initiative has occurred against the backdrop of the entry into force of the Optional Protocol to the International Covenant on Economic, Social and Cultural Rights, which Spain has ratified,

Today, Amnesty International, CESR, MDM and Red Acoge have issued a joint statement denouncing Spain’s non-compliance with its international human rights obligations, and the deepening exclusion of undocumented migrants from access to health services. For its part, Red Acoge, a federation of 17 organizations that provides social and legal services to immigrants, has made a call to “not renounce legitimate demands” for compliance with the human right to health and the derogation of RDL 16.

To learn more about the negative human rights impact of RDL 16, please consult the following research and advocacy materials:

Center for Economic and Social Rights: 


Amnesty International:

Medicos del Mundo:


Red Acoge: