A/HRC/42/24 respect to the realities on the ground. There are practical distinctions that may need to be maintained. With limited resources, there is often a tension between the need to address acute needs in a conflict – such as surgery on bullet wounds – and the need to devote attention to long-term health gains and systems, including realization of sexual and reproductive health and rights. 30. At the same time, stakeholders in emergencies may become mired in discussions around whether something is considered humanitarian (acute) or development (longerterm), when affected populations, particularly in protracted emergencies, simply want and need to use the broader health system. In practice, national health systems are often replaced by unsustainable international systems and therefore undermined, including in their provision of services to reduce preventable maternal mortality and morbidity. 31. The distinctions between humanitarian and development settings are not mutually exclusive, as often claimed, and they can reinforce one another. Experts noted that a middle ground can be found where provision addresses systemic issues without sacrificing immediate and urgent medical needs. A human rights-based approach can help identify such solutions. For instance, engaging meaningfully and listening to affected women and girls can, in fact, help guide assistance to where it is most needed, which can help identify and address acute needs while at the same time reinforce, rebuild and strengthen the existing health-care system. 32. Experts also observed that the division between humanitarian and development settings can be perpetuated by the “siloization” of funding, including what can be funded, who can fund what, to whom and for how long. Experiences were shared of protracted emergencies, which include an armed conflict, blockade, sanctions and disease outbreaks, where the lines drawn between humanitarian and development are difficult to navigate. This impacts what is funded, as “humanitarian” issues are often prioritized while sexual and reproductive health and rights are often perceived as a “development” issue. Dedicated attention to and interrogation of how and which kinds of interventions are actually costed is needed. As a good practice, some donors have mainstreamed sexual and reproductive health throughout their assistance without making any distinctions between humanitarian or development work. B. Preparedness 33. Experts highlighted the importance of the need to discuss, clarify and fund what we should do before a crisis hits in terms of establishing a strong baseline of the health system. Realization of human rights ensures a robust baseline in any context. Examples were shared of contexts where well-established elements of the health system prior to the crisis, such as effective referral pathways for victims of gender-based violence, were in fact successfully built on rapidly at the onset of the emergency. Identifying and supporting organizations on the ground, including health and human rights organizations, already doing this work is a good practice example. 34. A focus on preparedness can also involve ensuring that the Minimum Initial Service Package for Reproductive Health is integrated in medical curricula and practice at all levels, as well as building the capacities of local organizations and communities that are often first responders in an emergency. Good practice examples shared included advocating with Governments for the inclusion of comprehensive sexual and reproductive health services into disaster response plans and establishment of multi-stakeholder “disaster response committees” which would help elaborate the roles and responsibilities of different actors when crisis hits. A human rights-based approach calls for multi-stakeholder engagement and helps uncover pre-existing discrimination, women and girls in vulnerable situations, preparedness needs, and different stakeholder roles and responsibilities. Despite the importance of preparedness, however, identifying funding for this work has proven to be difficult. 35. Experts also underlined that preparedness is not only relevant before a crisis hits but also during crises, when new emergencies can arise. Outbreaks of disease in existing crises are not uncommon and can lead to their own emergency, impacting efforts to address 7