69. 健康是行使其他人权所不可或缺的一项基本人权。
Health is a fundamental human right indispensable for the exercise of other human rights.
人人有权享有可获得的最高标准的健康，从而得以有尊严地生活。
Every human being is entitled to the enjoyment of the highest attainable standard of health conducive to living a life in dignity.
《阿拉木图宣言》指出：在人民健康状况上存在的严重不平等情况，特别是发达国家与发展中国家之间以及在各国内部存在的此种不平等情况，在政治、社会和经济上都是不能令人接受的，因此是各国的共同关注。
The Alma-Ata Declaration proclaims that the existing gross inequality in the health status of the people, particularly between developed and developing countries, as well as within countries, is politically, socially and economically unacceptable and is, therefore, of common concern to all countries.
(1) 尊重的义务：推行患者付费和医疗保险机制
The obligation to respect: the promotion of user fees and health insurance schemes
70. 比利时发展合作部目前使用“财政可持续性” 作为卫生部门项目集资决策的关键标准。
Belgian Development Cooperation (BDC) currently uses `financial sustainability' as a key criterion for making decisions concerning the financing of health sector projects.
不幸的是，这导致比利时发展公司支持无效用或歧视性的项目，使第三世界国家最贫穷和最弱势的社会成员无法享有医疗保健。
Unfortunately, this has led to BDC supporting ineffective or discriminatory projects that exclude the poorest and most vulnerable society members in developing countries from access to health care.
财务可持续性要求只以国家资源为依据，导致没有足够资金来实现基本医疗保健。
Financial sustainability requirements based on national resources only lead to insufficient funding to realise essential health care.
特别是，卫生部门资金的不足导致此患者通过患者付费和医疗保险会员费来支付基本的医疗保健。
In particular, this insufficient funding for health leads to patients paying for essential health care through user fees and membership fees for health insurance schemes.
71. 一份2004年无国界医生协会(比利时)的报告 记载了患者付费和费用回收机制(确保财政可持续性的方法)对布隆迪弱势群体享有医疗保健的负面影响。
A 2004 MSF Belgium report documented the negative impact of user fees and cost recovery mechanisms (methods of ensuring financial sustainability) on access to health care by vulnerable groups in Burundi.
2006年5月1日实施了一项布隆迪总统令，规定免费提供儿童(5岁以下儿童)和孕产妇医疗服务，改善了大多数布隆迪人的医疗保健服务。
On 1 May 2006, a Burundian Presidential Directive providing for free paediatric (children under the age of five) and maternal health services was implemented improving access to health care services for a majority of Burundians.
委员会第14号一般性意见强调，孕产妇医疗保健和5岁以下儿童医疗保健是《公约》缔约国的核心义务。
General Comment 14 of the Committee stressed that maternal health care and health care for children under five are core obligation of States' parties to ICESCR.
自从执行总统令以来，布隆迪享有医疗保健设施的人口有了令人鼓舞的增加。
Since implementing the Presidential Directive Burundi has experienced an encouraging increase in utilisation of healthcare facilities by the population, but due to resource deficiencies this has led to overcrowding of healthcare facilities and other implementation issues.
但是由于资源不足，导致了医疗保健设施过于拥挤和其他的执行问题。
Since implementing the Presidential Directive Burundi has experienced an encouraging increase in utilisation of healthcare facilities by the population, but due to resource deficiencies this has led to overcrowding of healthcare facilities and other implementation issues.
72. 如委员会在第14号一般性意见中指出的，“缔约国和其他能够给予帮助的角色尤其有责任提供`国际援助和合作，特别是经济和技术援助和合作'，使发展中国家能够履行其核心义务和其它义务”。
As the Committee clarified in General Comment 14 “it is particularly incumbent on States parties and other actors in a position to assist, to provide "international assistance and cooperation, especially economic and technical" which enable developing countries to fulfil their core and other obligations.
73. 布隆迪是比利时主要发展伙伴之一。
Burundi is one of Belgium's key development partners.
2006年10月于布琼布拉，比利时发展合作部长De Decker与布隆迪政府签署了一项为期三年的合作协定。
In Bujumbura, in October 2006 BDC Minister De Decker signed a three year cooperation agreement with the Burundian Government.
仍然不清楚发展合作部是否对布隆迪政府提供新的财政支持，使其可以改进母婴医疗保健免费服务。
It is still unclear whether BDC will provide additional financing support to the Burundian Government so it can improve access to free maternal and paediatric health care services.
同样，比利时合作援助所支持的卫生机构正致力于处理增加的病人数量，但没有新的比利时资金。
Also, health structures supported by Belgian cooperation aid struggle to handle an increased number of patients without additional Belgian funding.
与此成鲜明对比的是，某些其他捐助者根据增长的需求而迅速向政府提供额外资金以支持药品供应。
This is in sharp contrast with some other donors that have come forward rapidly to provide the government with extra funding to support the drug supply in light of increased demand.
(2) 保护的义务：没能影响国际货币基金组织和世界银行的政策
The obligation to protect: the failure to influence IMF and World Bank policy
74. 世界卫生组织 和联合国艾滋病规划署 最近的出版物确认了国际货币基金组织和世界银行政策(比如工资开支限制和宏观经济限制)对公共开支的负面影响。
Recent publications by WHO and UNAIDS confirm the negative effect IMF and Bank policies, e.g. wage bill restrictions and macro-economic ceilings, have on public expenditure.
另外，这些政策防碍了发展中国家提供基本医疗保健服务的能力，特别是对其保留和招募必要的卫生人力资源能力造成了负面效果。
Further, these affect the ability of developing countries to offer access to essential health care, in particular due to the negative consequences on their ability to retain and recruit the necessary human resources for health.
75. 某些捐助者已经向世界银行和国际货币基金组织施加压力，要求它们调整机制，允许增加国际开支，以解决卫生人力资源危机现象。
Some donors have pressured the Bank and IMF to adapt mechanisms to allow increased international spending on measures to combat the human resources for health crisis.
在马拉维达成的协议允许由国际集资来资助紧急人力资源行动规划，这表明有可能采取切实措施：在承诺投入国际资金后，开展自动调整，解除对于医疗工作者工资和公共开支的限制。
The agreement reached in Malawi allowing the financing of an emergency human resources action plan by international funding shows that concrete measures are possible: with the commitment of international funds, an automatic adjustment is made to lift the restrictions on the wage bill for health staff and public spending.