A/67/302 health. The right to access good quality health facilities, goods and services on a non-discriminatory basis, particularly for vulnerable or marginalized groups, including, among others, ethnic, racial, religious and sexual minority groups, women, children and the poor, constitutes an additional core obligation for States. In order to meet these core obligations under the right to health, States must ensure the equitable allocation of health funds and resources towards achieving universal access to good quality health facilities, goods and services, in accordance with the principle of non-discrimination and with special attention to the needs of vulnerable or marginalized populations. Inequitable allocation of health funds and resources may lead to indirect discrimination within health systems, particularly with respect to vulnerable or marginalized groups who often lack the social and political means to challenge the inequitable allocation of public resources (General Comment No. 14, para. 19). 11. Equitable allocation of funds and resources for health may be achieved through the pooling of health funds collected through prepayment schemes. Pooling allows for the cross-subsidization of financial risks associated with health care among different groups across large populations and the transfer of health funds from the rich to the poor and the healthy to the sick. Cross-subsidization of financial risks thus protects vulnerable or marginalized groups, such as the poor, from catastrophic health expenditures and ensures access to good quality health facilities, goods and services that may otherwise be financially inaccessible. Pooling of funds for health in order to facilitate the cross-subsidization of health and financial risks is thus an essential method by which States may ensure the equitable allocation of health funds and resources as required under the right to health. 12. General Comment No. 14 of the Committee on Economic, Social and Cultural Rights recognizes that investments in health should not disproportionately favour expensive curative care services, which are often accessible only to a small fraction of the population, over primary and preventive health care, which benefit a far larger part of the population. Primary health-care services are generally less costly than secondary and tertiary care, which by definition require health-care workers with specialized training, sophisticated diagnostic equipment and significant physical health infrastructure. Investment in primary health care is thus more costefficient in the long run because it prevents illness and promotes general health, which reduces the need for more costly secondary and tertiary care. 1 The resulting savings may be reinvested in the health system, possibly in the form of additional health-care subsidies for the poor. The right to health thus requires an efficient allocation of health funds and resources between primary, secondary and tertiary care sectors, with an emphasis on primary health care. 13. States should allocate health funds and resources towards ensuring good quality health facilities, goods and services are available and easily accessible for rural and remote populations. The significant disparity in health outcomes among rural and remote populations and their urban counterparts in many States is well documented. 2 This is due to a number of factors, including inadequate investment in __________________ 1 2 6 Rifat Atun, What are the advantages and disadvantages of restructuring a health care system to be more focused on primary care services? (Copenhagen, WHO, 2004), pp. 6-8. Juan Antonio Casas et al., “Health Disparities in Latin America and the Caribbean: The Role of Social and Economic Determinants”, Equity and Health, Occasional Paper No. 8 (Pan American Health Organization, 2008), pp. 37 and 42. 12-46101