regard to procedural norms, such as those referring to compliance with the decisions of the Court. These obligations shall be interpreted and applied so that the protected guarantee is truly practical and effective, bearing in mind the special nature of human rights treaties. 3 A) Regarding the obligation to provide free medical and psychological care to Wilson García Asto through the State’s health services, including the provision of medicines free of charge (eleventh operative paragraph of the judgment) 6. The State indicated that the Head of the Comprehensive Health Insurance System (SIS) had outlined “the procedures to follow in order to implement the Government’s commitment to the Inter-American Court.” In addition, it indicated that “the Supranational Special Public Attorney’s Office had asked the representative of the Ministry of Health to the National Human Rights Council for his collaboration in order to comply with the aspects of the judgment that corresponded to his sector.” It added that “the Ministry of Health has reported that it has been providing health care, through the [SIS],” because Mr. García Asto “is a member of [the said system] as part of a beneficiary focal group of the IACHR/Court in the Flor de Carabayllo Health Center […], and can therefore receive the medical care he requires covered by the SIS.” 7. The representatives indicated that “[t]he Ombudsman has raised the issue of the shortcomings of the SIS,” and that this system “has [a series of] constraints [that could] jeopardize the services that the State offers through it to the poorest sectors.” In addition, they expressed their disagreement with the inclusion of Mr. García Asto in the E-2 Plan of the SIS, instead of the E-1 Plan. In addition, they repeated that “beyond the communications sent by the Ministry of Justice – National Human Rights Council to the Ministry of Health and the response received from the latter, the State has not adopted any measure that results in Mr. García Asto being able to receive the medical and psychological care that he requires.” The representatives specified that doctors attached to the Ministry of Health had contacted Mr. García Asto towards the end of 2008 and the beginning of 2009, in order to obtain updated information on the state of his physical and mental health. Mr. García Asto provided this information, but this did not lead to specific measures. In addition, they advised that Mr. García Asto had registered “with the Comprehensive Health Insurance System – La Flor Health Center.” However, “[t]his Center […] does not possess the medical specialties that the state of [his] health requires.” Also, the representatives indicated that “the mere registration” of Mr. García Asto “in the [SIS] and his referral to a health care center that does not offer medical care in all areas, including psychology, that his state of health requires does not comply with the ruling” of the Court. They added that “the State has never provided Mr. García Asto with medicines.” 8. Regarding the foregoing, the Commission observed that the information presented by the State “does not show that it has overcome the obstacles to free access to medicines that it had reported in the past.” In addition, it considered that “the information provided by the State is very general and does not answer the concerns raised by the representatives.” It added that it hoped that the State would refer “to the new difficulties mentioned by Mr. García Asto as regards the constraints of the health center with which he was affiliated.” 9. The Court appreciates the information that Mr. García Asto is affiliated with the health system and that he receives attention in a health care center. Nevertheless, the 3 Cf. Case of Ivcher Bronstein v. Peru. Competence. Judgment of of the Inter-American Court of Human Rights of September 24, 1999. Series C No. 54, para. 37; Case of the Dos Erres Massacre, supra note 1, fifth considering paragraph, and Case of Montero Aranguren et al. (Retén de Catia), supra note 1, fifth considering paragraph. 3