A/HRC/7/11 page 11 2. Not only outcomes, but also processes 39. The right to the highest attainable standard of health is concerned with both processes and outcomes. It is not only interested in what a health system does (e.g. providing access to essential medicines and safe drinking water), but also how it does it (e.g. transparently, in a participatory manner, and without discrimination). 3. Transparency 40. Access to health information is an essential feature of an effective health system, as well as the right to the highest attainable standard of health. Health information enables individuals and communities to promote their own health, participate effectively, claim quality services, monitor progressive realization, expose corruption, hold those responsible to account, and so on. The requirement of transparency applies to all those working in health-related sectors, including States, international organizations, public private partnerships, business enterprises and civil society organizations. 4. Participation 41. All individuals and communities are entitled to active and informed participation on issues relating to their health. In the context of health systems, this includes participation in identifying overall strategy, policymaking, implementation and accountability. The importance of community participation is one of the principal themes recurring throughout the Declaration of Alma-Ata. Crucially, States have a human rights responsibility to establish institutional arrangements for the active and informed participation of all relevant stakeholders, including disadvantaged communities.17 These issues have been explored in several of the Special Rapporteur’s reports, including on Uganda and mental disability.18 5. Equity, equality and non-discrimination 42. Equality and non-discrimination are among the most fundamental elements of international human rights, including the right to the highest attainable standard of health. A State has a legal obligation to ensure that a health system is accessible to all without discrimination, including those living in poverty, minorities, indigenous peoples, women, children, slum and rural dwellers, people with disabilities, and other disadvantaged individuals and communities. Also, the health system must be responsive to the particular health needs of women, children, adolescents, the elderly, and so on. The twin human rights principles of equality and non-discrimination mean that outreach (and other) programmes must be in place to ensure that disadvantaged individuals and communities enjoy, in practice, the same access as those who are more advantaged. 17 See H. Potts, Human Rights in Public Health: Rhetoric, Reality and Reconciliation, PhD thesis, Monash University, Melbourne, Australia, 2006. 18 E/CN.4/2006/48/Add.2 and E/CN.4/2005/51.