A/HRC/41/34/Add.2 and territory has its own approach: some have specific programmes with different degrees of pharmaceutical coverage for groups in vulnerable situations, such as those who receive social assistance, older and young persons, or by specific disease, such as cancer, palliative care or infectious diseases. 18 For example, British Columbia and Manitoba do not have plans specifically for older persons. Others have established income-based plans that provide pharmaceutical coverage for the entire population only against catastrophic costs and only when a household’s pharmaceutical spending rises to a substantial share of its annual income. 40. Overall prices of medicines are high throughout the country. Recent efforts through the pan-Canadian Pharmaceutical Alliance to lower prices for some medicines are positive but remain insufficient to benefit either uninsured persons, who continue to purchase medicines out-of-pocket, or those who are privately insured. Furthermore, the segmented provincial/territorial approach to pharmacare has a negative impact on prices, which are negotiated separately in each province and territory. The high costs of medicines are further compounded by overprescribing practices by medical professionals. 41. The right-to-health framework compels States to provide access to essential medicines and to ensure non-discriminatory access to health facilities, goods and services, including medicines. The Special Rapporteur commends the Federal Government’s establishment in 2018 of the Advisory Council on the Implementation of National Pharmacare and its interim report of March 2019. He hopes that the process triggered by the Council will allow for the establishment of a national pharmacare plan or guidelines that are compliant with the country’s right-to-health obligations, including nondiscrimination, accountability, availability, accessibility, acceptability and quality. 42. The second gap is illustrated by access to abortion, which is elaborated in paragraphs 93 and 94 below. The rest of the challenges are developed in specific sections. 2. Civil society partnerships 43. Civil society organizations contribute to closing the remaining gaps; they are sometimes funded by the Federal and/or provincial/territorial governments and, in most cases, have developed innovative approaches, often including a human rights approach, even if not explicitly. 44. The Special Rapporteur recommends that the Federal Government continue to support these good projects, while investing and building human rights capacity within the publicly financed and administered health-care system. This, together with new rightsbased criteria for federal transfers under the Canada Health Transfer, will allow federal and provincial/territorial governments not only to strengthen the health-related expertise developed by the civil society, but also to use and mainstream it. In that process, the level of governance and cooperation between federal and provincial/territorial authorities should be enhanced to prevent miscommunications between various levels of governments. 45. The funding from federal and provincial/territorial governments to civil society projects should be further revisited, so as to: (a) allow for multi-year funding of, for example, 7 years; (b) support projects in different regions within provinces and territories; and (c) include mechanisms of accountability and transparency. Notably, long multi-year funding would provide stabilization to civil society projects, allowing them to build programmes, build trust with constituencies and stakeholders and to evaluate activities properly. 18 See www.ncbi.nlm.nih.gov/pmc/articles/PMC5915235/. 9