With regard to the protection of the fundamental rights of the person whose surrender is sought — and, in particular, the right to health — the Court cannot confine itself to verifying whether, in the requesting State, healthcare facilities are adequate to meet the person’s therapeutic needs, but must also take into account the concrete impact and, therefore, the potential adverse effects of the surrender procedure on the individual’s health condition, including, for example, the difficulties and possible complications arising from the transfer abroad or the need to ensure continuity of ongoing medical treatment.

For the purposes of assessing the risk of inhuman or degrading treatment, sources of knowledge may properly include documents and reports produced by non-governmental organisations whose reliability is generally recognised at the international level, such as Amnesty International and Human Rights Watch. According to reports from various non-governmental sources, including Amnesty International and Human Rights Watch, the situation in Brazilian prisons has long been endemically characterised—particularly in certain state districts, including Espírito Santo, which is specifically relevant to the present proceedings—by practices of violence and abuse against detainees, carried out both by internal criminal gangs, known to and tolerated by prison authorities, and by prison officers themselves. This occurs within a broader structural context of dilapidation and inadequacy of prison facilities, resulting in severe overcrowding and deficient sanitary and hygienic conditions, which in turn facilitate the spread of serious infectious diseases.