Although the object of Article 8 is essentially that of protecting the individual against arbitrary interference by the public authorities, it does not merely compel the State to abstain from such interference since it may also give rise to positive obligations inherent in effective ‘respect’ for private and family life. While the boundaries between the State’s positive and negative obligations under this provision do not always lend themselves to precise definition, the applicable principles are similar. In both contexts regard must be had to the fair balance that has to be struck between the competing interests of the individual and the community as a whole, and in both contexts the State enjoys a certain margin of appreciation (Zehnalová and Zehnal v Czech Republic, App no 38621/97).

The court has previously held that private life includes a person’s physical and psychological integrity (Niemietz v Germany (1993) 16 EHRR 97 at [29]). While the Convention does not guarantee as such a right to free medical care, in a number of cases the Court has held that Article 8 is relevant to complaints about public funding to facilitate the mobility and quality of life of disabled applicants (see, Zehnalová and Zehnal, cited above, and Sentges v Netherlands, App no 27677/02). The court is therefore prepared to assume for the purposes of this application, that Article 8 is applicable to the applicants’ complaints about lack of sufficient funding of their treatment.

The margin of appreciation referred to above is even wider when, as in the present case, the issues involve an assessment of the priorities in the context of the allocation of limited State resources (see, mutatis mutandis, Osman v United Kingdom (2000) 29 EHRR 245 at [116], App no 54725/00, O’Reilly v Ireland, App no 54725/00 (2002)). In view of their familiarity with the demands made on the health care system as well as with the funds available to meet those demands, the national authorities are in a better position to carry out this assessment than an international court. In addition, the court should also be mindful of the fact that, while it will apply the Convention to the concrete facts of this particular case in accordance with Article 34, a decision issued in an individual case will nevertheless at least to some extent establish a precedent, valid for all Contracting States (Sentges v Netherlands, cited above).

The court considers that the core problem in the present case reflected in the numerous complaints is the alleged insufficient public funding for the treatment of their disease. In support of their claims the applicants compare the amount of public expenditure on renal failure treatment in Moldova to that in some industrialised countries like the United States of America, the United Kingdom, Australia and Israel. The court sees no reason to question the applicants’ assertion that they have no means to pay for the cost of the medication not provided free by the State and that the medication and in some cases a third haemodialysis session per week is of great importance for their fight with the disease. However, it notes that the applicants’ claim amounts to a call on public funds which, in view of the scarce resources, would have to be directed from other worthy needs funded by the taxpayer.

While it is clearly desirable that everyone has access to a full range of medical treatment, including life-saving medical procedures and drugs, the lack of resources means that there are, unfortunately, in the Contracting States many individuals who do not enjoy them, especially in cases of permanent and expensive treatment.

In the present case the court notes that the applicants had access to the standard of health care offered to the general public both before the implementation of the medical care system reform, and after the implementation thereof. It thus appears that they were provided with basic medical care and basic medication before January 1, 2004, and have been provided with almost full medical care after that date. The Court by no means wishes to underestimate the difficulties apparently encountered by the applicants and appreciates the very real improvement which a total haemodialysis coverage would entail for their private and family lives. Nevertheless, the Court is of the opinion that in the circumstances of the present case it cannot be said that the respondent State failed to strike a fair balance between the competing interests of the applicants and the community as a whole.

Bearing in mind the medical treatment and the facilities provided to the applicants and the fact that the applicants’ situation has considerably improved after the implementation of the medical care system reform in January 2004, the Court considers that the respondent State cannot be said, in the special circumstances of the present case, to have failed to discharge its positive obligations under Article 8 of the Convention. As to the problem concerning the non-reimbursement of all the transportation expenses, the court, assuming that the applicants exhausted domestic remedies, notes that the Government produced copies of payment rolls recording the payment of those expenses to all the applicants and that the applicants failed to make any comment on them. Moreover, the applicants sent the court a copy of a judgment of the Briceni District Court, by which Eduard Pritula was awarded money for his travel expenses, to be paid by the local authorities.

It follows that the complaint under Article 8 of the Convention is manifestly ill-founded and must be rejected in accordance with Article 35(3) and (4) of the Convention.

The applicants complain that the failure of the State to cover the cost of all the medication necessary for their haemodialysis, and the poor financing of the haemodialysis section of the SCR, violated their right to life guaranteed by Article 2 of the Convention.

The court recalls that the first sentence of Article 2 enjoins the State not only to refrain from the intentional and unlawful taking of life, but also to take appropriate steps to safeguard the lives of those within its jurisdiction (see LCB v United Kingdom (1999) 27 EHRR 212 at [36]). It cannot be excluded that the acts and omissions of the authorities in the field of health care policy may in certain circumstances engage their responsibility under Article 2 (see Powell v United Kingdom (2000) 30 EHRR CD362).

Moreover, an issue may arise under Article 2 where it is shown that the authorities of a Contracting State put an individual’s life at risk through the denial of health care which they have undertaken to make available to the population generally (see Cyprus v Turkey [GC] (2002) 35 EHRR 30 at [219] and Nitecki v Poland, App no 65653/01 (2002)).

Turning to the facts of the instant case, the court notes that the applicants have failed to adduce any evidence that their lives have been put at risk. They claim that a few patients have died in recent years and rely on the example of Gheorghe Lungu, but they have not adduced any evidence that the cause of death was the lack of any specific drug or the lack of appropriate medical care. The court notes that chronic renal failure is a very serious progressive disease with a high rate of mortality, not only in Moldova but throughout the world. The fact that a person has died of this disease is not, therefore, proof in itself that the death was caused by shortcomings in the medical care system.

In any event, as regards the issue of the State’s positive obligations, the Court has examined the issue under Article 8 of the Convention and sees no reason to reach any different conclusion under Article 2 of the Convention.

Accordingly, the Court concludes that the complaint under Article 2 of the Convention is manifestly ill-founded within the meaning of Article 35(3) of the Convention.