A/61/338 Rapporteur has considered the responsibility of those States that are in a position to assist, to engage in international assistance and cooperation, in a number of his other reports (see A/60/348). 64. In the context of medicines, this responsibility means that no rich State should encourage a developing country to accept intellectual property standards that do not take into account the safeguards and flexibilities included under the TRIPS Agreement.44 In other words, developed States should not encourage a developing country to accept “TRIPS-plus” standards in any bilateral or multilateral trade agreement. They should help developing countries establish effective, integrated, inclusive health systems that include reliable medicine supply systems delivering quality affordable medicines for all, and support research and development into the priority health needs of developing countries (see also para. 48). Monitoring and accountability 65. The right to health brings with it the crucial requirement of establishing accessible, transparent and effective mechanisms of monitoring and accountability. Those with right-to-health responsibilities must be held to account in relation to the discharge of their duties, with a view to identifying successes and difficulties; so far as necessary, policy and other adjustments can then be made. There are many different forms of monitoring and accountability mechanisms. While a State will decide which are most appropriate in its particular case, all mechanisms must be effective, accessible and transparent. 66. A national medicines policy must be subject to appropriate monitoring and accountability. This requires that the policy set out: the Government’s right-tohealth obligations in relation to medicines; an implementation plan that identifies objectives, timelines, duty holders and their responsibilities, indicators, benchmarks, and reporting procedures. From time to time, a suitable national body (e.g. a health ombudsman) will have to consider the degree to which those responsible for the implementation of the national medicines policy have fulfilled their duties — not with a view to sanction and punishment, but with a view to establishing which policies and institutions are working and which are not, with the aim of improving the realization of the right to medicines for all. A selection of specific, practical issues regarding access to medicines 67. Ensuring access to medicines for all gives rise to a wide range of specific, practical and important issues. By way of illustration, this section briefly introduces four of these issues, keeping in mind the analytical framework signalled in the preceding paragraphs. A reliable system for the supply of good-quality affordable medicines 68. Whether it chooses a supply system that is public, private or mixed, a State has a legal obligation to ensure that there is a reliable, efficient, transparent system for the supply of quality affordable medicines throughout its jurisdiction. The supply system must be attuned to current needs, obtain good value for money, minimize waste and avoid corruption (for more on corruption, see paras. 78-80). Crucially, it must be designed to serve those living in poverty and isolated communities, as well as wealthy urban elites. 16 06-51997