A/HRC/7/11 page 17 They should especially assist low-income countries with the fulfilment of their core obligations arising from the right to the highest attainable standard of health. Equally, low-income States have a responsibility to seek appropriate international assistance and cooperation to help them strengthen their health systems. 62. The relationship between health “global public goods” and the human rights responsibility of international assistance and cooperation in health demands further study. 15. Striking balances 63. Few human rights are absolute. Frequently, balances have to be struck between competing human rights. Freedom of information, for example, has to be balanced with the right to privacy. Moreover, there are often legitimate but competing claims arising from the same human right, especially in relation to those numerous rights that are subject to resource availability. In the context of health systems, finite budgets give rise to tough policy choices. Should the Government build a new teaching hospital, establish more primary health-care clinics, strengthen community care for people with disabilities, improve sanitation in the capital’s slum, improve access to antiretrovirals, or subsidize an effective but expensive cancer drug? A preliminary report of the Special Rapporteur submitted to the United Nations General Assembly addressed these challenging issues (A/62/214). Human rights do not provide neat answers to such questions, any more than do ethics or economics. But human rights require that the questions be decided by way of a fair, transparent, participatory process, taking into account explicit criteria, such as the well-being of those living in poverty, and not just the claims of powerful interest groups. 64. Because of the complexity, sensitivity and importance of many health policy issues, it is vitally important that effective, accessible and independent mechanisms of accountability are in place to ensure that reasonable balances are struck by way of fair processes that take into account all relevant considerations, including the interests of disadvantaged individuals, communities and populations. 16. Monitoring and accountability 65. Rights imply duties, and duties demand accountability. Accountability is one of the most important features of human rights - and also one of the least understood. Although human rights demand accountability this does not mean that every health worker or specialized agency becomes a human rights enforcer. Accountability includes the monitoring of conduct, performance and outcomes. In the context of a health system, there must be accessible, transparent and effective mechanisms of accountability to understand how those with responsibilities towards the health system have discharged their duties. The crucial role of accountability is explored further in section E below. 17. Legal obligation 66. The right to the highest attainable standard of health gives rise to legally binding obligations. A State is legally obliged to ensure that its health system includes a number of the features and measures signalled in the preceding paragraphs. The health system must have, for example, a comprehensive, national plan; outreach programmes for the disadvantaged;