Abstract
This article critically examines the fragmentation of international law and its effects on the effective realization of the right to health, with particular emphasis on access to medicines and medical technologies. In the context of global chains of innovation, production, and distribution, the non-hierarchical coexistence of specialized legal regimes, especially in trade, investment, intellectual property, human rights, and public health, has generated normative tensions, institutional overlaps, and governance gaps that negatively affect the safety, quality, and equitable access to essential health inputs. Adopting a qualitative, documentary, and analytical–interpretive approach, the study reviews specialized academic literature, reports from international organizations, and relevant legal instruments in order to assess the structural impacts of fragmentation on standards for the realization of the right to health. Through the analysis of paradigmatic cases, such as the arbitration Eli Lilly v. Canada and the debate within the World Trade Organization on the temporary suspension of TRIPS obligations during the COVID-19 pandemic, the article shows how fragmentation incentivizes practices of regulatory arbitrage and forum shopping, which may weaken states’ regulatory autonomy and deepen inequalities in access to medicines and medical technologies. It concludes that, without disregarding the benefits of normative specialization, there is a pressing need to move toward global regulatory coordination mechanisms capable of managing legal pluralism and strengthening the effective protection of the right to health in the contemporary international order.
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