A/HRC/12/43 page 12 from 7.6 per cent in 2005 to 5.6 per cent in 2007, and a steep rise in the vaccination rate of infants aged 0-12 months. On 29 January 2009, US$ 832 million of Burundi’s foreign debt owed to all its creditors was written off by the Bretton Woods institutions under the Enhanced Highly Indebted Poor Countries (HIPC) Initiative.11 42. No discernable progress has been made in the area of accountability and the rectification of the laws, structures, processes and practices in these sectors to conform to international standards. Reports continue to be received of public schoolteachers having raped a student or enticed her (most are girls) to engage in sex in exchange for favours - incidents that are rarely followed by investigations or punitive action. In general, the high demand for services declared free for all has led many working in those sectors to demand informal fees. In extreme cases, the inability to pay leads to deprivation of liberty. A common and widely denounced practice is that of private and public hospitals detaining patients, sometimes for months at a time, for inability to pay their medical bills. 43. Among the most urgent tasks for Burundi is ensuring the right to food. Only 19 per cent of the population is food-secure and as many as 46 per cent are chronically malnourished.12 Recurring climatic shocks, increasing demographic pressures and declining harvest yields, compounded by the destruction during the crisis of distribution channels for goods and services, have had a direct impact on the level of food security. The world hunger index reveals that the level of hunger in Burundi is “extremely alarming”.13 International cooperation, mainly through the World Food Programme, helps to compensate for the food deficit. However, claimable guarantees for ensuring that the right to food is realized for all, on the basis of non-discrimination, are yet to be institutionalized at the national level. 44. It is imperative that Burundi comply with its international human rights obligations to create an adequate and sustainable social safety net for all, to help prevent socio-economic inequalities from becoming destabilizing factors in the post-conflict period. A process is under way to devolve certain functions to local administrations, which risks creating further disparities among and within the provinces, but also creates opportunities for better management of basic social services that are more attuned to local circumstances and demands. VII. GROUPS AT RISK A. Attacks on persons with albinism 45. At the time of writing, 14 persons with albinism had been attacked in Burundi since September 2008: 9 were killed; 4 escaped; and one boy of 4 years of age disappeared. 11 In net present value (NPV) terms, see World Bank, press release No. 2009/211/AFR, 29 January 2009 available at http://go.worldbank.org/2FQEKTZIY0. 12 World Food Programme (http://www.wfp.org/countries/burundi). 13 Global Hunger Index of the International Food Policy Research Institute, 2008.