We focus on access to EmOC because it a key evidence based intervention vital for reducing maternal mortality in all countries and it is identified as an obligation of comparable priority to a core obligation under the right to health.
The framing of maternal health as an obligation of comparable priority to a core obligation has important funding and priority setting implications for the national government and the international community; specifically that states in a position to assist must help those that cannot fulfil their core maternal health obligations, including access to EmOC.
[ http://www.gavialliance.org/resources/HSF_Platform_FAQ_15.01.2010.pdf] Specifically paragraph 47 affirms "a State party cannot, under any circumstances whatsoever, justify its non-compliance with the core obligations … which are non-derogable" For a rich analysis of potential perils associated with the minimum core approach please see ref. [ 52].
However, as discussed above, ensuring universal access to anti-retroviral treatment (ARVs) for people living with HIV is clearly a core obligation related to the right to health that many states can not fulfil due to resource constraints.
In General Comment 14, the Committee endorsed its earlier suggestion that states hold "minimum core obligations" to ensure satisfaction of minimum essential levels for all [ 5].
First, what is the scope of their obligation, i.e. what does this core obligation include, and when is it satisfied?
This lack of drafting and definitional clarity and the failure to specifically list primary care as one of the core obligations add confusion to whether in fact primary health care is considered to be a core obligation.
Alternatively, Singh proposes that a state's "minimum core obligation" be used as a guiding principle in HIV programmes.
Given the vast global economic disparities the international community must have a role in fulfilling core obligations on a global scale if they are to be a reality for low income, vulnerable and disadvantaged people.
However essential primary health care was not defined, and in General Comment 14 for the first time, the Committee clarified the content of "core obligations" under the right to health.
This is particularly relevant for people living in low and lower middle income countries, where governments may be unable to fulfil their minimum core obligations without international assistance.
