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and ensure that health financing is correspondingly prioritized in national and
subnational budgets. Budget prioritization requires States to set aside a significant
portion of general government expenditures towards spending on health and
prioritize health alongside other core funding commitments, such as spending on
education, social security and defence. States have a positive obligation in this
regard to facilitate the active and informed participation of affected individuals and
communities in the formulation, implementation, monitoring and evaluation of
health budgets. States should also ensure transparency in the formulation,
implementation, monitoring and evaluation of budgets for health. In order to ensure
accountability for the implementation of national and subnational health budgets
and related laws and policies, States should also develop and implement
mechanisms that allow or provide for independent auditing and oversight of those
instruments.
8.
The obligation to prioritize funding or health in State budgets is closely linked
to the principle of progressive realization, which establishes a specific and
continuing obligation for States to move as expeditiously and effectively as possible
towards the full realization of the right to health of all persons, without
discrimination and taking into account constraints due to the limits of available
resources (General Comment No. 14, paras. 30 and 31, and General Comment
No. 3, para. 9). In order to facilitate progressive realization of the right to health for
all persons, States should make use of the maximum available funds and resources
to realize the right to health, which requires successfully raising funds and ensuring
that they are allocated to health through budget prioritization. States unwilling to
utilize the maximum of their available resources towards realization of the right to
health are in violation of their obligations under the right (General Comment
No. 14, para. 47).
9.
The obligation to ensure that adequate funds are available for health and to
prioritize financing for health should be informed by the core obligations of the
right to health (General Comment No. 14, paras. 43-45). Core obligations are
non-derogable and represent the minimum essential levels which States are required
to meet in order to be in compliance with the right to health. Core obligations
include positive and negative entitlements and address distributional and equity
concerns. Positive entitlements, such as the obligation to ensure access to basic
shelter, housing and sanitation, and an adequate supply of safe and potable water,
often require States to utilize significant funds and resources towards their
realization. Core obligations that establish negative entitlements and address
distributional concerns, such as the obligation to ensure equitable allocation of, and
non-discriminatory access to, good quality health facilities, goods and services
assume the existence of such facilities, goods and services, and thus also require
significant financial outlays from States. States should therefore ensure that
adequate funds are available for health and prioritize financing for health in order to
meet at least these core obligations of the right to health. In this sense, core
obligations establish a funding baseline below which States would be considered in
violation of their obligations under the right to health.
B.
Pooling and allocation of health funds and resources
10. The obligation to ensure the equitable allocation of health facilities, goods and
services for all persons without discrimination is a core obligation under the right to
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