The Ombudsman’s Office has just presented one of the most discouraging reports on the state of health in Colombia. For several years, the tutela (a legal action to protect a person’s fundamental rights) has become the most important tool to protect this fundamental right, something that has been proven because in the country these actions went from more than 265,000 in 2024 to around 312,500 in 2025, which translates into an increase of close to 47,500 cases (17.9%) and confirms the persistence of structural barriers in effective access to that right.
According to the entity in charge of protecting and promoting human rights, which presented its report at the Book Fair taking place in Bogota, health-related tutelas account for 34 percent of the total of these legal actions, consolidating themselves as one of the main causes of judicialization in Colombia.
The figures, based on information from the Constitutional Court, show that, for thousands of people in Colombia, the tutela action continues to be the main — and in many cases the only — mechanism to access health services and medications on time.
The diseases for which tutelas are most frequently filed
In this wave of tutelas, those filed for diseases of the circulatory system lead the list (12.2 percent), followed by those corresponding to osteomuscular, neurological, and endocrine conditions. Hypertension is the most frequent diagnosis, and there is also a significant presence of mental disorders such as anxiety, autism, and depression. The most complex diseases — such as cancer, severe neurological pathologies, and severe epilepsy — are overrepresented in tutelas.
On the other hand, the cost of these cases is, on average, 20% higher than that of general care, which reflects greater barriers to access for high-complexity conditions. Added to this is the fact that the report shows an inverse relationship between poverty and judicialization: Departments with high levels of poverty, such as Vichada, La Guajira, and Choco, record the lowest rates of tutelas. In contrast, regions with lower poverty show significantly higher rates.
Faced with this situation, the Ombudsman’s Office offers another bleak reading: The most vulnerable populations face a double exclusion: Difficulties in accessing both health services and justice. The low level of judicialization in these territories does not reflect better conditions, but rather greater structural barriers. In addition, 39.57% of health tutelas correspond to subjects of special constitutional protection. Among them are people with disabilities (15.37%), older adults (24.65%), and people with serious illnesses (35.30%).
A structural reform of the health system is necessary
On the other hand, persons deprived of liberty have the highest rates of judicialization, revealing serious failures in care within the penitentiary system. The Ombudsman’s Office warns that the high recurrence of tutelas in these groups reflects structural gaps and the lack of effective application of a differential approach in guaranteeing the right to health.
“Health cannot continue to depend on judicialization,” warned Ombudswoman Iris Marin Ortiz. “A system that forces citizens to resort massively to tutela shows failures in its capacity to respond, in guaranteeing timeliness, and in the continuity of care. The high rate of granting of these actions, close to 74.3%, shows that in most cases there is a real violation of rights.”
The Ombudsman’s Office concluded that what is happening reveals structural failures of the system, associated with problems of financing, management, access, and deep territorial inequalities. These findings demand a structural reform of the health system so that effective access is guaranteed, judicialization is reduced, and the needs of the population are addressed promptly. The entity also called for a rigorous look at the deep territorial and social inequalities revealed by this phenomenon.