A/HRC/7/11 page 21 84. Health workers must receive domestically competitive salaries, as well as other reasonable terms and conditions of employment. Their human rights must be respected, for example, freedoms of association, assembly and expression. They must be provided with the opportunity of active and informed participation in health policymaking. The safety of health workers, who are disproportionately exposed to health hazards, is a major human rights issue. 85. There should be incentives to encourage the appointment, and retention, of health workers in underserved areas. When considering the situation of health workers in Uganda, this was one of the issues considered by the Special Rapporteur.34 86. The skills drain raises numerous human rights issues, including in relation to the right to the highest attainable standard of health in countries of origin. Where relevant, both sending and receiving States must have policies in place to address the skills drain. In an earlier report, the Special Rapporteur examined the skills drain through the right-to-health lens.35 2. Leadership, governance, stewardship 87. This is “arguably the most complex but critical building block of any health system”.36 It encompasses many elements, including planning and accountability. (a) Planning 88. In the Special Rapporteur’s experience, this is one of the weakest features of the development and strengthening of health systems. With a few honourable exceptions, the record of health planning is poor, while the history of health planning is surprisingly short. Many States do not have comprehensive, up-to-date health plans. Where they exist, plans “often fail to be implemented and remain grand designs on paper. Elsewhere plans may be implemented but fail to respond to the real needs of the population.”37 89. However, from the perspective of the right to the highest attainable standard of health, effective planning is absolutely critical. Progressive realization and resource availability - two inescapable components of the international right to health - cannot be addressed without planning.38 34 E/CN.4/2006/48/Add.2. 35 A/60/348. 36 Everybody’s Business… (note 2 above), p. 23. 37 An Introduction to Health Planning… (note 8 above), p. 18. 38 See section C above on progressive realization and resource availability.