125. The Court considers that, in the case of the five presumed victims, the distance to the health clinic and their precarious financial situation constituted a barrier to their access to the health centers, and this had an impact on their possibility of receiving medical care and, therefore, on their possibility of beginning or continuing their treatment satisfactorily. The Court notes that the financial situation of the presumed victims was a determinant factor in their possibility of accessing the health care facilities, goods and services and that the State failed to take steps to mitigate this impact. Consequently, the Court considers that Corina Dianeth Robledo Alvarado, Dora Marina Martínez Sofoifa, Zoila Marina Pérez Ruíz, Francisco Sop Quiej and Miguel Lucas Vaíl did not have adequate access to medical care owing to their financial situation and the remoteness of their place of residence. Regarding the other presumed victims, the Court lacks sufficient information to determine whether their financial situation or the geographical location of their homes constituted obstacle to receiving medical care. 126. The Court considers that, since the irregular, inadequate or total lack of access to antiretroviral drugs (supra para. 121), the lack of access to periodic CD4 counts, and viral load, phenotype and genotype testing (supra para. 122), the inadequate or total lack of social support (supra para. 123), and the impossibility of access to the health centers for financial reasons or the location of the homes of some of the presumed victims (supra para. 125) has been proved, the State failed to comply with its obligation to guarantee the right to health because its omissions are incompatible with the elements of the availability, accessibility and quality of health care. The elements of availability and quality require the existence of a sufficient quantity of the goods, services and medicines needed for health care, which should also be of a good quality and appropriate from the medical perspective, which did not occur in this case. The element of accessibility requires that the health care facilities, goods and services are accessible, in law and in fact, for the most vulnerable and marginalized sectors, and that they are located at a reasonable geographical distance, a situation that did not occur in this case. 127. Consequently, the Court concludes that the State failed to ensure the right to health of Rita Mariana Dubón Orozco, Luis Edwin Cruz Gramajo, Petrona López Robledo, Maria Blanca Vaíl López, Guadalupe Herminia Cayaxon García, José Rubén Delgado López, Elsa Miriam Estrada Ruíz, Silvia Mirtala Álvarez Villatoro, Juana Aguilar, Melvin Yovani Ajtun Escobar, José Cupertino Ramírez, Sebastián Emilio Dueñas, Julia Aguilar, Felipe Tebalan Ordoñez, Martina Candelaria Alvarez Estrada, Luis Rubén Isabel Alvarez Flores, Saira Elisa Barrios, Felix de Jesús Cabrera Morales, César Noé Cancinos Gómez, Aracely Cinto, Luis Rolando Cuscul Pivaral, María Felipe Pérez, Ismerai Olibia García Castañon, Santos Isacar Vásquez Barrios, Mardo Luis Hernández and Hernández, Luis Armando Linares Ruano, Marta Alicia Maldonado Paz, Dora Marina Martínez Sofoifa, Pascuala de Jesús Mérida Rodríguez, Darinel López Montes de Oca, Israel Perez Charal, Corina Dianeth Robledo Alvarado, Audencio Rodas Rodríguez, Zoila Marina Pérez Ruíz, Santiago Francisco Valdéz Aguilar, Teresa Magdalena Ramírez Castro, Karen Judith Samayoa Vásquez, Francisco Sop Quiej, Jorge Armando Tavares Barreno, Miguel Lucas Vaíl, Santos Vásquez Oliveros, Iris Carolina Vicente Baullas and Sandra Lisbeth Zepeda Herrera. Therefore, the State is responsible for the violation of the obligation to ensure the right to health in accordance with Article 26 of the American Convention, in relation to Article 1(1) of this instrument. B.4.3. Analysis of the scope of the discrimination that occurred in this case 128. The representatives argued that the State had discriminated against the presumed victims in this case by failing to ensure them comprehensive, accessible, acceptable and good quality care, taking into account the diverse situations of vulnerability they faced. They 45