A/HRC/4/10 page 17 avoidable mortality. Minimum core obligations cannot be relegated to progressive realization: all States regardless of their level of development are required to take immediate action to implement them. This entails, inter alia, enacting enabling legislations; regulations, designs and enforcement of policies; and mobilization of the necessary resources. In the same context, States must meet certain standards of availability, accessibility, acceptability and quality of health-care facilities. 64. While increased public expenditure in the health sector is often part of economic reform packages, the scope of services provided is, in general, only partially coherent with minimum core obligations under international human rights law. PRSP health expenditure usually targets an expanded access to primary (essential preventive) health care while free curative health care is restricted to a few specific diseases. In general, user fees are advocated for curative health care, sometimes complemented by social or private insurance schemes.27 65. Regarding the right to education, comprehensive provisions relating thereto are stipulated in article 13 of ICESCR and in general comment No. 13 (1999) of the Committee on Economic, Social and Cultural Rights on the right to education. State parties have immediate obligations in relation to the right to education, such as the guarantee that the right will be exercised without discrimination of any kind and the obligation, at least, to take steps towards the full realization of the right. States also have obligations to respect, protect and fulfil each of the “essential features” (availability, accessibility, acceptability, adaptability) of the right to education. The question of economic accessibility to education is subject to differentiation: whereas primary education shall be available “free to all”, States parties are only required to progressively introduce free secondary and higher education. According to article 14 of the Covenant, countries which, at the time of becoming a party, are not able to ensure compulsory and free primary education have to adopt, within two years, a detailed plan on how this objective can be attained. 66. In this regard, it should be noted that free education can have an important impact on the general perception, within the population, of economic, social and cultural rights. Government programmes such as the Universal Primary Education Programme in Uganda can trigger a systemic change in the mindset of the poor families, who saw the education of their children not simply as a privilege but as something to which their children are entitled. As the independent expert has previously noted, this new perception has a positive impact on enrolment (E/CN.4/2004/47, para. 18). 67. Economic reform polices adopted under PRSPs are often only partially compatible with human rights requirements. A common objective of PRSPs is to provide universal primary education. In many countries education reform includes abolishing or reducing school fees and providing exemption to targeted groups, as well as free school books for all or targeted groups. As far as secondary and tertiary education is concerned most strategies consider that they have to be covered at least partially by user fees.28 68. In order to ensure coherence with human rights obligations, free primary education has to be part of all PRSPs. Corresponding sector policy should be based on a comprehensive plan of action, as foreseen under article 14 of ICESCR. Strategies for higher education should be guided

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