CRC/C/PER/CO/3 page 9 Health and health services 46. The Committee is concerned that: (a) Access to health and health services is inadequate especially in rural and remote areas of the country, resulting in significant disparities in health-care provisions; (b) The rates of maternal, infant and under-five mortality, despite some improvements, continue to be among the highest in Latin America; (c) There is high incidence of hepatitis B and anaemia especially among particular groups of indigenous people; (d) A significant proportion of people living in poverty and extreme poverty, including women and children under 18, are reportedly not affiliated to SIS (Seguro Integral de Salud); (e) Despite various programmes undertaken in this respect - including the National Programme of Food Assistance (PRONAA) - 25 per cent of children under 5 years of age and 32 per cent of children under 2 years of age still suffer from chronic malnutrition. 47. The Committee recommends that the State party: (a) Ensure basic health care and services to all children throughout the country and continue to address the problem of malnutrition, with special emphasis on rural and remote areas; (b) Strengthen its efforts to urgently tackle infant, child and maternal mortality throughout the country; (c) Expand the “Health Integral Service” (Servicio Integral de Salud) addressed to families living in poverty or extreme poverty; (d) Give special attention to the problem of indigenous communities affected by Hepatitis B epidemic, including by urgently ensuring vaccination for newborn babies. 48. The Committee notes the concerns of the Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health, who recently visited the State party, with respect to the potential impact that bilateral Trade Agreements may have on the access to affordable essential medicines for some individuals and groups, including antiretrovirals for people with HIV/AIDS (E/CN.4/2005/51/Add.3). 49. The Committee recommends that the State party always take its human rights obligations into account when negotiating Trade Agreements, in particular as to the possible impact of commercial agreements on the full enjoyment of the right to health.