A/63/263 addition, some of his other publications have examined States’ duties in relation to access to medicines, such as “Neglected diseases: A human rights analysis”. 4 20. Moreover, the Special Rapporteur has frequently discussed access to medicines with States, including the adverse impact of import tariffs on access, the enormous problem of failing and collapsing health systems, counterfeiting, diversion, and so on. He has provided States with numerous recommendations regarding access to medicines and he has also commented when, in his view, States have failed to do all they reasonably can to enhance access to this vital component of the right to the highest attainable standard of health. 21. In short, States have been the central focus of his attention in relation to access to medicines. 22. On numerous occasions over the last six years, Ministers, senior public officials and others have informed the Special Rapporteur that, when endeavouring to implement the right to the highest attainable standard of health, States encounter many obstacles. Among the obstacles they have mentioned, two stand out. First, the policies and practices of donor countries; for this reason, the Special Rapporteur has looked, on numerous occasions in several reports, at the role of donors, most recently in his report on his mission to Sweden, the World Bank and the International Monetary Fund (A/HRC/7/11/Add.2). 23. Secondly, Ministers, senior public officials and others have argued that the policies and practices of some pharmaceutical companies constitute obstacles to States’ implementation of the right to the highest attainable standard of health and, in particular, their endeavours to enhance access to medicines. They have mentioned, for example, excessively high prices, inadequate attention to research and development concerning diseases that disproportionately impact people in developing countries, inappropriate drug promotion, and problematic clinical trials. Ministers and senior public officials have also acknowledged, however, that the pharmaceutical sector has an indispensable role to play in relation to the right to health and access to medicines. Moreover, they have recognized the constructive contribution of specific pharmaceutical companies. 24. The Special Rapporteur’s mandate expressly requires him to identify, inter alia, obstacles to the implementation of the right to the highest attainable standard of health. He is also expressly mandated to report on good practices, and to make recommendations that will help to promote and protect the right to the highest attainable standard of health. 25. Between 2003 and 2006, the Special Rapporteur engaged in many discussions on access to medicines with numerous parties, including pharmaceutical companies. These substantive discussions took place at symposiums and workshops, as well as informal visits to pharmaceutical companies. They were informed by the work of States, pharmaceutical companies (and their associations, such as the International Federation of Pharmaceutical Manufacturers and Associations), the United Nations Global Compact, the Office of the High Commissioner for Human Rights, the World Health Organization and other elements of the United Nations system, the Business Leaders Initiative on Human Rights, numerous civil society organizations, and __________________ 4 08-45647 Paul Hunt et al., Neglected diseases: A human rights analysis, World Health Organization Special Programme for Research and Training, Special Topics No.6, 2007. 7