The second risk is that even when the poor have access to the services concerned, the services provided may be of sub-standard quality. This may be true particularly in areas such as healthcare or education where quality matters as much as volume and may be more difficult to assess by the average user, so that private service providers may be tempted to sacrifice quality for profitability.82 The risk is particularly high since the possibilities for the users to hold private service providers accountable are generally rather weak. Indeed, whereas in democratic States poor performance of public services may be challenged by voters, such accountability mechanisms are generally absent where private actors provide services: although the government could still be held accountable for its failure to control adequately such provision of services by the private sector, such a form of accountability is more indirect and generally less effective.83 Privatization therefore may result in the richest segments of society receiving a better service, worsening the impacts of income inequality on the enjoyment of basic rights : even where the poorest groups do have access to goods or services provided by the private sector, such services may be of sub-standard quality, without any effective means for the poor to challenge this situation or even without them being aware of how much this is penalizing them. Therefore, whereas privatization is not per se prohibited by the Covenant even in areas such as the provision of water or electricity, education or healthcare where the role of the public sector has traditionally been strong, private providers at the very least should be subject to strict regulations, imposing on them so-called "public service obligations": in the provision of water or electricity, this may include requirements concerning universality of coverage and the continuity of the service, pricing policies, quality requirements, and user participation84; it may concern the qualifications of teachers and the pupil / teacher ratio, or the quality of educational materials, in the provision of education.85 Whether appropriate regulation of that sort is always a substitute to the provision of such services by the State remains an open question. For non-governmental watchdogs and human rights bodies seeking to assess whether public budgets are effectively designed in accordance with the requirements of human rights, however, this uncertainty is vexing: should they focus, as a measure of whether the 82 On the problem of asymmetry of information making it difficult for the average consumer to sanction sellers of goods or service providers, see George A. Akerlof, "The Market for 'Lemons': Quality Uncertainty and the Market Mechanism", The Quaterly Journal of Economics, vol. 84, No. 3 (1970): 488-500. This inability for the user to assess the quality of the service provided is one of the reasons why the normal route through which the user may express dissatisfaction, which is to "exit" to another service provider, may provide a very weak check against poor service quality, a limitation Albert O. Hirschman may have been insufficiently attentive to in the important book he published the same year the article by Akerlof appeared: Albert O. Hirschman, Exit, Voice and Loyalty: Responses to Decline in Firms, Organizations and States (Cambridge, Harvard Univ. Press, 1970). The other limitation of course is that many services that are essential to the enjoyment of economic and social rights -- such as water, electricity, or certain means of transportation such as railroads, services that are related to the right to water and to the right to housing -- are "natural monopolies": due to the costs of the initial infrastructural investment, it would be highly irrational from the economic point of view to have more than one service provider setting up the infrastructure. The implication is that, in many cases, the user will be facing only one service provider, in a monopoly position in the area concerned. 83 Specific difficulties arise where foreign actors are tasked with the provision of services that contribute to the realization of economic, social and cultural rights: in addition to the often strong bargaining power they have in their relationship with the host government, their rights as investors are generally protected under customary international law or through investment treaties, weakening the possibilities for host States in which they operate to sanction any violation of economic, social and cultural rights that they may commit. See, e.g., Ryan Suda, ‘The Effect of Bilateral Investment Treaties on Human Rights Enforcement and Realization’, in O. De Schutter (ed.), Transnational Corporations and Human Rights (Oxford and Portland, Oregon: Hart Publ., 2006), 73-160. 84 See, e.g., Human Rights Council Resolution 15/9: Human Rights and Access to Safe Drinking Water and Sanitation, A/HRC/RES/15/9, of 6 October 2010 (noting that "the delegation of the delivery of safe drinking water and/or sanitation services to a third party does not exempt the State from its human rights obligations"). 85 See, e.g., Human Rights Council Resolution 32/L.33: The right to education, A/HRC/RES/32/L.33, of 26 June 2016, para. 2, e) (urging States to comply with their obligations "to respect, protect and fulfil the right to education by all appropriate means, including by [...] [p]utting in place a regulatory framework for education providers, including those operating independently or in partnership with States, guided by international human rights obligations, that establishes, inter alia, minimum norms and standards for the creation and operation of educational services, addresses any negative impacts of the commercialization of education, and strengthens access to appropriate remedies and reparation for victims of violations of the right to education"). 17