A/69/299 I. Introduction 1. Article 12 of the International Covenant on Economic, Social and Cultural Rights is a comprehensive statement of the right to health. It has been elaborated and interpreted in general comment No. 14 (2000) of the Committee on Economic, Social and Cultural Rights. The right to health framework set out in the general comment has empowered individuals to ensure that States respect, protect and fulfil the right to health. However, some issues need to be addressed not only within the international right to health framework, but also within the right to health in domestic law. 2. In contrast to the immediate obligations of States under the International Covenant on Civil and Political Rights, the International Covenant on Economic, Social and Cultural Rights has been seen as enumerating rights that need not be fulfilled immediately. This has resulted in the view that economic, social and cultural rights can be fulfilled separately from civil and political rights, and that the former may not be justiciable. This view overlooks the fact that economic, social and cultural rights, including the right to health, are required for the full enjoyment of civil and political rights. Furthermore, the realization of the right to health is assumed to be dependent on available resources. This view is also fallacious, as States need resources to ensure the enforceme nt and enjoyment of civil and political rights as well. For example, States require resources for properly equipped investigative agencies and functioning courts to ensure the right of the accused to a fair trial. 3. The fulfilment of certain obligations relating to the right to health — although not all — may depend on available resources and be progressively realized. It is important to scrutinize whether States’ resources are used efficiently in realizing the right to health. It is equally important to examine the totality of those resources and review the proportion employed in ensuring the right to health. States ’ policies to progressively realize the right to health should be reasonable, pay special attention to vulnerable groups, be formulated with the participation of affected communities and fulfil, at a minimum, States’ core obligations. 4. Globalization and market liberalization have afforded transnational corporations the opportunity to enter into domestic markets, resulting in their growing domination in world markets. While transnational corporations have the ability to influence international and domestic policies, States have been unable to regulate those corporations to prevent them from violating the right to health. The efforts that have to date been made to curb the activities of transnational corporations have been only voluntary and have not persuaded industries to prevent violations of the right to health. In addition, international investment agreements and investor-State dispute settlement systems benefit transnational corporations at the cost of States’ sovereign functions of legislation and adjudication. Existing international investment agreements have no checks on the activities of transnational corporations and many do not recognize States’ prerogative to legislate and enforce health-related laws. This power asymmetry is perpetuated by the fact that States often have no ability under international investment agreements to initiate disputes against transnational corporations for viol ating the right to health. Furthermore, investor-State dispute settlements suffer from bias, opacity and arbitrariness. They prevent affected third parties from gaining access to the system to demonstrate the violation of the third party’s right to health and receive a remedy. 14-59014 3/22