A/HRC/7/11 page 9 29. As the health crisis deepened, efficiency became the watchword and health sector reform “focused above all on doing more for less”.10 It was only around the turn of the century that the international community started to confront the reality that running health systems on US$ 10 per capita, or less, is simply not a viable proposition. 30. In the last few years, there has been a significant increase in the amount of international funding available to health. Some States have also increased their domestic health funding. Much of the increase in investment by external partners, such as the Global Fund to Fight AIDS, Tuberculosis and Malaria, as well as the GAVI Alliance (GAVI), has focused on specific diseases and conditions. However, these initiatives exposed (some would say aggravated) the degraded state of many health systems. There has been a dawning realization that these specific initiatives cannot thrive without effective, strengthened health systems. Recent years have also seen a growing appreciation of the seriousness of the health workforce crisis, including the skills drain from low-income to high-income countries, a perverse subsidy from the poor to the rich.11 31. In 2005, recognizing that inadequate health systems were impeding progress towards improved immunization coverage, GAVI decided to support health system strengthening with an initial commitment of US$ 500 million for 2006-2010.12 Launched in 2007, the International Health Partnership - a global compact for achieving the health Millennium Development Goals aims to build health systems in some of the poorest countries in the world. It is hoped that the Partnership will go beyond making better use of existing aid and also generate additional resources. 32. As increased resources are invested in health systems, the timeliness of the Human Rights Council’s decision 2/108 becomes apparent. It is important to clarify the relationship between health systems and the right to the highest attainable standard of health. In this way, the right to the highest attainable standard of health, informed by health good practices, can help to make a practical, constructive contribution to health system strengthening. 33. Additionally, States have a legal duty to comply with their binding international and national human rights obligations. Identifying the features of a health system that arise from the right to the highest attainable standard of health can help States ensure that their policies and practices are in conformity with their legally binding human rights duties. B. Definitions 34. There are countless competing definitions of health systems. In an important publication brought out by WHO in 1991, Tarimo defines a health system as “the complex of interrelated elements that contribute to health in homes, educational institutions, workplaces, public places and communities, as well as in the physical and psychological environment and the health and 10 Ibid. 11 For the Special Rapporteur’s report on the skills drain, see A/60/348, paragraphs 18-89. 12 See http://www.gavialliance.org/resources/HSS_Background.pdf.