HEALTH RIGHTS obligations to protect public health and the environment, as well as provisions for indigenous peoples to control their lands and environment. Obligations of states and other actors Under international law, state parties to a variety of different treaties assume three dimensions of obligations. First, the obligation to respect requires governments to refrain from directly contravening the provisions set out under the respective treaty. The obligation to respect would include, for example, the obligation to eliminate institutional discrimination against minorities within the health care system. The prohibition of discrimination does not mean that difference should not be acknowledged, or that special measures may not be taken to redress past inequities faced by minorities or indigenous peoples, but rather that differential treatment must be based on objective criteria reasonably intended to remedy injustice within a society.9 Second, the obligation to protect requires the government to protect the enjoyment of the right from interference by third parties, for example, appropriate regulation of mining companies that are operating on indigenous lands. Third, the obligation to fulfil requires that governments satisfy at least a minimum core of the right to health and that they progressively realize the other programmatic aspects of the right over time. Violations of the obligation to fulfil occur when a state fails to satisfy a ‘minimum core obligation to ensure the satisfaction of, at the very least, minimum essential levels of each of the rights’.10 When a failure to meet any of the minimum obligations set out in paragraphs 43 or 44 of General Comment No.14 is identified, the burden of proof shifts to the state party to demonstrate that it has done everything possible to meet its basic obligations.11 National courts and regional bodies have also addressed the question of what minimum standards governments can be required to meet. States have an obligation not to adopt retrogressive measures. For example, if a state has a programme to provide anti-retroviral drugs, backsliding due to budget crunches or political expediency is impermissible.12 Also, the obligation to implement the right to health must be done on a non-discriminatory basis13 and there should be some evidence of efforts to control or regulate the conduct of third parties that are interfering with the right to health.14 Finally, all states can develop a national public health plan, with measurable targets and deadlines, which is open for public debate and evaluation.15 Such a plan should be directed at remedying past inequities and should pay particular attention to vulnerable and marginalized groups.16 With respect to health-care facilities, goods and services, the CESCR has established that there are four interrelated aspects of state obligations. 43