12 clamidia and gonorrhea) and unsafe abortions. 31 Estimates are that between 8 and 12% of couples experience some form of infertility during their reproductive years. 32 54. Infertility runs even higher in the developing countries. In some countries, as many as 25% of couples are unable to have children without medical assistance. 33 In the Latin American countries, estimates suggest that the incidence of infertility is 15% or higher. 34 55. There is no real consensus that infertility per se constitutes an illness. However, many of its causes can be traced to concrete physical conditions that require medical treatment. Also, in many cases, the inability to get pregnant can cause psychological disorders or mental suffering. 35 According to the World Medical Association: 36 Assisted conception differs from the treatment of illness in that the inability to become a parent without medical intervention is not always regarded as an illness. While it may have profound psychosocial, and thus medical, consequences, it is not in itself life limiting. It is, however, a significant cause of major psychological illness and its treatment is clearly medical. 56. According to the Inter-American Court, health is a public interest the protection of which is a duty of the States. 37 The World Health Organization has written that health is not only the absence of infirmity and disease but also a state of physical, mental and social well-being. Following the model of the World Health Organization, the Protocol of San Salvador states that everyone shall have the right to health, understood to mean the enjoyment of the highest level of physical, mental and social well-being. 38 And so, infertile couples, who endure real physical and psychological suffering because of their inability to reproduce, are not fully enjoying their right to health. 57. The United Nations Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health observed that States have an obligation to ensure access to such vital health services as […] infertility treatment. 39 Paragraph 7.6 of the Cairo Programme of Action urges the countries to strive to provide “prevention and appropriate treatment of infertility” among the health care services they offer. In vitro fertilization is 31 Inter-American Institute of Human Rights, Reproducción Asistida, género y derechos humanos en América Latina, Florencia Luna, 2007, p. 57. World Health Organization, Current Practices and Controversies in Assisted Reproduction, Report of a meeting on “Medical, Ethical and Social Aspects of Assisted Reproduction” held at WHO Headquarters in Geneva, Switzerland 17–21 September 2001, Infertility and social suffering: the case of ART in developing countries, Abdallah S. Daar, Zara Merali, p. 15. 32 33 Amicus curiae brief presented by Yale Law School’s Allard K. Lowenstein International Human Rights Law Clinic, September 26, 2005, pp. 2-3. 34 Amicus curiae brief presented by Yale Law School’s Allard K. Lowenstein International Human Rights Law Clinic, September 26, 2005, pp. 2-3. Inter-American Institute of Human Rights, Reproducción asistida, género y derechos humanos en América Latina, Florencia Luna, 2007, p. 75. 35 36 World Medical Association, Statement on Assisted Reproductive Technologies, South Africa, October 2006. Available online at: http://www.wma.net/en/30publications/10policies/r3/index.html 37 I/A Court H.R. Case of Ximenes Lopes v. Brazil. Merits, Reparations and Costs. Judgment of July 4, 2006. Series C No. 149, par. 89. 38 Article 10 of the Protocol of San Salvador. United Nations, Report of the Special Rapporteur, Paul Hunt, Economic, Social and Cultural Rights. The right of everyone to the enjoyment of the highest attainable standard of physical and mental health. February 16, 2004, par. 29. 39