A/HRC/15/41 S. Right to the highest attainable standard of physical and mental health 81. Health is a clear example of how the deprivations of persons living in poverty can significantly reduce their ability to escape poverty: poverty engenders ill health and ill health engenders poverty. Limited access to physical and mental health care including medicine, insufficient nutrition and unsafe living environments, deeply affects the health status of persons living in extreme poverty and impairs their ability to engage in incomegenerating activities. 82. T. A revised version of the draft guiding principles should: • Recall State obligations to ensure the enjoyment of a variety of facilities, goods, services and conditions necessary for the realization of the highest attainable standard of health. • Recommend taking special measures to target the main health conditions affecting persons living in extreme poverty, in particular neglected diseases that are particularly prevalent in impoverished communities and countries.50 This includes identifying diseases and medical conditions that particularly affect those living in poverty, implementing the necessary immunization, education and other programmes, and training health practitioners to identify and treat particular illnesses that especially affect those living in poverty. • Call on States to provide tailor-made services for groups whose access to health services may raise particular challenges, such as women, older persons, children, indigenous peoples, minorities, slum-dwellers, labour migrants and those living in remote rural communities. Right to work and rights at work 83. Persons living in extreme poverty often lack adequate and secure work. In rural and urban areas alike they experience unemployment, underemployment, unreliable casual labour, low wages and unsafe and degrading working conditions. Women are particularly at risk, as are other groups affected by discrimination, such as migrants and persons with disabilities. Persons living in extreme poverty tend to work outside the formal economy, without any entitlement to social security benefits, such as maternity leave, sick leave, pensions, and disability and widowhood benefits. They commonly work in inappropriate or dangerous conditions for very low wages. Minimum work standards are rarely applied and they face job insecurity, with increased vulnerability to exploitation including bonded or forced labour, arbitrary dismissal and abuse, particularly female workers. 84. A revised version of the draft guiding principles should: • 50 22 Recall State obligations to establish and enforce minimum legal standards and administrative measures to ensure that all workers, in both the formal and informal sectors, enjoy just and favourable conditions of work, including a minimum wage that enables them to secure the essential components of the right to an adequate standard of living; equal pay for work of equal value; safe and healthy working conditions; rest, leisure and reasonable limitation of working hours; and the right to organize and bargain collectively. E/CN.4/2006/48/Add.2.