from a lifestyle that allows the individual to achieve total balance. 301 Thus, the right to health refers to the right of everyone to enjoy the highest level of physical, mental and social wellbeing.302 185. The general obligation to protect health translates into the state obligation to ensure access to essential health services, ensuring effective and quality medical services, and to promote the improvement of the population’s health.303 This right encompasses timely and appropriate health care in keeping with the principles of availability, accessibility, acceptability and quality, the application of which will depend on the prevailing circumstances in each State. Compliance with the State obligation to respect and to ensure this right must pay special attention to vulnerable and marginalized groups, and must be realized progressively in line with available resources and the applicable domestic laws.304 186. As it has reiterated in its recent case law, the Court considers that the nature and scope of the obligations derived from the protection of the right to health include aspects that may be required immediately and those that are of a progressive nature. 305 In this regard, the Court recalls that, regarding the former (obligations that may be required immediately), States must adopt effective measures to ensure access without discrimination to the services recognized by the right to health, ensure equality of rights between men and women and, in general, advance towards the full effectiveness of the economic, social, cultural and environmental rights (ESCER). Regarding the latter (obligations of a progressive nature), progressive realization means that States Parties have the concrete and constant obligation to advance as expeditiously and efficiently as possible towards the full effectiveness of the said right, to the extent of their available resources, by legislation or other appropriate means. In addition, there is an obligation of non-retrogressivity in relation to the rights realized. In light of the above, the treaty-based obligations to respect and to ensure rights, as well as to adopt domestic legal provisions (Articles 1(1) and 2), are essential to achieve their effectiveness.306 187. In the instant case the Court must examine the State’s conduct regarding compliance with its obligation to ensure respect for Manuela’s rights to life, personal integrity and health. All the obligations that will be examined correspond to obligations that may be required immediately. Cf. Case of Poblete Vilches et al. v. Chile, supra, para. 118, and Case of Guachalá Chimbo et al. v. Ecuador. Merits, reparations and costs, supra, para. 100. 301 Cf. Case of Poblete Vilches et al. v. Chile, supra, para. 118, and Case of Guachalá Chimbo et al. v. Ecuador. Merits, reparations and costs, supra, para. 100. See, inter alia, Preamble to the Constitution of the World Health Organization (WHO), adopted by the International Health Conference held in New York from 19 June to 22 July 1946, signed on 22 July 1946, by the representatives of 61 States (Off. Rec. WHO, 2, 100), and entered into force on 7 April 1948. Amendments adopted by the Twenty-sixth, Twenty-ninth, Thirty-ninth and Fifty-first World Health Assemblies (resolutions WHA26.37, WHA29.38, WHA39.6 and WHA51.23) came into force on 3 February 1977, 20 January 1984, 11 July 1994 and 15 September 2005 respectively and are incorporated into the present text. Committee on Economic, Social and Cultural Rights, General Comment No. 14: The right to the highest attainable standard of health, August 11, 2000, UN Doc. E/C.12/2000/4, para. 12. 302 Cf. Case of Poblete Vilches et al. v. Chile, supra, para. 118, and Case of Guachalá Chimbo et al. v. Ecuador. Merits, reparations and costs, supra, para. 101. 303 Cf. Case of Cuscul Pivaral et al. v. Guatemala. Preliminary objection, merits, reparations and costs. Judgment of August 23, 2018. Series C No. 359, para. 39, and Case of Guachalá Chimbo et al. v. Ecuador. Merits, reparations and costs, supra, para. 100. 304 Cf. Case of Poblete Vilches et al. v. Chile, supra, para. 104, and Case of Guachalá Chimbo et al. v. Ecuador. Merits, reparations and costs, supra, para. 106. 305 Cf. Case of Muelle Flores v. Peru. Preliminary objections, merits, reparations and costs. Judgment of March 6, 2019. Series C No. 375, para. 190, and Case of Guachalá Chimbo et al. v. Ecuador. Merits, reparations and costs, supra, para. 106. 306 54