A/HRC/11/10 page 11 cancellation could hardly afford. The World Bank reports that at least 11 Heavily Indebted Poor Countries have been targeted by lawsuits by a total of 44 commercial creditors.16 32. It is notable that high debt burdens are an obstacle not only in the low-income countries that have been the focus of debt relief programmes, but also in several middle-income countries that are not considered eligible for any of these measures on the grounds that their debts are “sustainable”.17 For example, in 2004, the total external debt of Ecuador was US$ 16.9 billion. The same year, the country spent a total of US$ 3.7 billion on debt repayments, and public spending on debt service was more than six times the amount spent on health care. Despite that, the World Bank considers Ecuador’s debt to be “sustainable” because its debt to GDP ratio in 2006 was relatively low. This reality is inconsistent with the Millennium Declaration commitment to “deal comprehensively and effectively with the debt problems of low-and middle-income developing countries, through various national and international measures designed to make their debt sustainable in the long term”. 33. The various human rights treaty bodies have also noted, in their concluding observations on the State party reports submitted to them, that excessive debt burdens pose a significant challenge to the realization of human rights by undermining the human rights obligations of States, thereby confirming the link between foreign debt and human rights. For example, in its concluding observations on the report submitted by Honduras in 2001, the Committee on Economic, Social and Cultural Rights took “note that the efforts of the State party to comply with its obligations under the Covenant [were] impeded by the fact that it [was] classified as a highly indebted poor country and that up to 40 per cent of its annual national budget (was) allocated to foreign debt servicing.”18 34. The Committee on the Rights of the Child and the Committee on the Elimination of Discrimination against Women have made similar observations with respect to the implementation of the rights under the respective treaties they supervise. For example, in its concluding observations on the report of the United Republic of Tanzania in 2001, the Committee on the Rights of the Child noted the “impact of the structural adjustment programme, high external debt payments, and increasing levels of unemployment and poverty within the 16 World Bank, “Heavily Indebted Poor Countries (HIPC) Initiative and Multilateral Debt Relief Initiative (MDRI) - Status of Implementation” (February 2008). 17 See Jubilee-Zambia, “The Benefits and Challenges of Debt Cancellation in Zambia, Testimony submitted to the Foreign Relations Committee of the United States Senate for Hearing, ‘Building on International Debt Relief Initiatives’” (24 April 2008). 18 E/C.1/12/Add.57; see also E/C.12/Add.71 (Algeria); E/C.12/1/Add.55 (Morocco); E/C.12/1/Add.63 (Syrian Arab Republic); E/C.12/1/Add.48 (Sudan); E/C.12/1/Add.78 (Benin); E/C.12/1/Add.62 (Senegal); E/C.12/1/Add.106 (Zambia); E/C.12/1/Add.60 (Bolivia); E/C.12/1/Add.100 (Ecuador); E/C.12/1/Add.66 (Nepal); and E/C.12/1/Add.49 (Kyrgyzstan).