A/HRC/42/24 16. Highlighted were the centrality of affected people and localization, correlation between the principles of non-discrimination and impartiality, and linkages between the rights to life and health and the humanitarian principle of humanity. Moreover, humanitarian actors working on sexual and reproductive health also often discuss ensuring the availability, accessibility, quantity and quality of services as good medical practice. This is central in the normative content of the human right to health. 17. Strengthened linkages between human rights and humanitarian action concerning maternal and newborn health is also evident through developments in the Inter-Agency Working Group on Reproductive Health in Crises and the organization Sphere, where concerted efforts have been undertaken to strengthen bridges between the different constituencies. In 2018, the revised Sphere Handbook re-emphasized and strengthened its rights-based foundations. 2 In the same year, the Inter-Agency Field Manual on Reproductive Health in Crisis was also revised with human rights as its core principle.3 Experts also noted processes such as the Global Roadmap for Improving Data, Monitoring and Accountability for Family Planning and Sexual and Reproductive Health in Crises and subsequent technical consultations. 18. Human rights and humanitarian actors were encouraged to collectively build on these efforts and seek to harmonize them with several other technically oriented processes and developments at the global level to flesh out and integrate human rights norms and standards in different humanitarian spaces, including in the context of Women Deliver, the Inter-Agency Standing Committee, and the anniversaries of the International Conference on Population and Development, the Fourth World Conference on Women and the adoption of the women, peace and security agenda. 19. At the same time, experts also acknowledged challenges. Some of these relate to misconceptions about human rights, including particularly the normative content and applicability of economic, social and cultural rights in humanitarian settings. In practice, this may exclude ensuring an effective remedy in the context of service roll-out and delivery and inhibit closer collaboration between humanitarian and human rights actors. Other challenges relate to navigating the politics of maintaining access to affected populations in complex environments, the reality of operating in insecure settings and the difficulty of providing immediate, urgent medical care which displaces attention to systematic health-care needs and the inequalities that may restrict its provision. D. Rights holders and duty bearers 20. A human rights-based approach identifies who has rights (rights holders) and what freedoms and entitlements they have under international human rights law, as well as the obligations of those responsible for making sure rights holders enjoy their rights (duty bearers). 21. Experts identified as rights holders affected populations, host populations, internally displaced persons and refugees, among others. With respect to duty bearers, experts stressed that there is a need to insist on the legal accountability of the State as the primary duty bearer to affected individuals. This includes obligations to ensure and maintain access of humanitarian and human rights actors when assistance is required and preventing premature shutdown of humanitarian operations. 22. Experts also explained that the primary responsibility of the State must be viewed across different potential and changing scenarios which also have a direct impact on the roles of the different actors involved. For example, there are circumstances where the State is willing and able to provide assistance, is willing but unable to provide assistance and is neither willing nor able to provide assistance; where there is no State or Government in place; or where there is a state of occupation. 2 3 See www.spherestandards.org/handbook-2018/. See http://iawg.net/iafm/. 5