A/HRC/7/11 page 6 14. WHO also confirms that sustainable development depends on effective health systems: “It will be impossible to achieve national and international goals - including the Millennium Development Goals - without greater and more effective investment in health systems and services.”4 15. At the heart of the right to the highest attainable standard of health lies an effective and integrated health system, encompassing health care and the underlying determinants of health, which is responsive to national and local priorities, and accessible to all. Without such a health system, the right to the highest attainable standard of health can never be realized. 16. Thus, it is only through building and strengthening health systems that it will be possible to secure sustainable development, poverty reduction, economic prosperity, improved health for individuals and populations, as well as the right to the highest attainable standard of health. 17. In decision 2/108, the Human Rights Council requested the Special Rapporteur, when presenting his report, to consider the possibility of identifying and exploring “the key features of an effective, integrated and accessible health system”. He was asked to undertake this task “bearing in mind the level of development of countries and from the perspective of the right to the highest attainable standard of physical and mental health”. 18. This report looks at health systems from the perspective of the right to the highest attainable standard of health, drawing on numerous consultations, as well as consideration of extensive literature from the fields of both medicine and public health.5 Crucially, the chapter is informed by an understanding of health good practices, as well as the right to the highest attainable standard of health. All of the features and measures identified here are already found in some health systems, recognized in some international health instruments (such as the Declaration of Alma-Ata) or advocated in the health literature. But they are not usually recognized as human rights issues. 19. The report outlines how the right to the highest attainable standard of health underpins and reinforces an effective, integrated, accessible health system - and why this is important. A. Health systems: some historical landmarks6 20. Health systems of some sort have existed as long as people have tried to protect their health and treat diseases, but organized health systems are barely 100 years old, even in industrialized countries. They are political and social institutions, and usually include the State, 4 Ibid., p. v. 5 This report has been enriched by consultations in the United Kingdom of Great Britain and Northern Ireland, the United States of America, New Zealand, Australia, Switzerland, Italy and Zimbabwe. The consultations have included a wide range of stakeholders from developing and developed countries, including indigenous people. The Special Rapporteur is very grateful to all those who organized, and participated in, these meetings. 6 This section draws extensively on Everybody’s Business ... (note 2 above), p. 9.