20 97 of bringing criminal proceedings and pursuing them to their conclusion. In turn, the Inter-American Court has said that the obligation of conducting an investigation “must have an objective and be assumed by the State as its own legal duty, not as a step taken by private interests that depends upon the initiative of the victim or his family or upon their offer of proof, without an effective search for the truth by the 98 government.” 82. Now, a breach of the State’s obligation of investigating does not occur simply because no one has been convicted or because, in spite of the efforts made, it was impossible to establish the facts. However, the judicial investigation must be undertaken in good faith in a diligent, exhaustive, and impartial fashion, and it must be aimed at exploring all the possible lines of inquiry to identify the 99 perpetrators of the crime with a view to their subsequent prosecution and punishment. To this end, Ecuadorian domestic law establishes guarantees, including the obligation of the Public Prosecution Service to pursue ex officio proceedings and the obligation of the judges who hear cases to act diligently 100 and promptly. In the addition, Ecuadorian laws stipulate the right to health as a fundamental human right and establish the obligation of the State to regulate health services provided to people subjected to 101 its jurisdiction, directly or through third parties. 83. It is not the function of the IACHR to serve as a fourth instance with respect to matters settled by the domestic courts. However, when the actions of the State’s authorities lead to a failure in the guarantees protected at the domestic and inter-American levels – hindering the right of access to justice 102 associated with a claim related to the right to health, a public service protected by the Statesand violating the right to a fair trial and judicial protection, a detailed analysis of the diligence with which the two phases of the criminal trial were pursued during the permitted five-year period is called for. On this point, for example, it can be seen that: a) Article 216 of the CCP (supra IV B) stated that judges must ensure that investigations are not overly long and are concluded within a maximum of sixty days (supra IV B); however, the 103 judge ruled the investigation closed seven months after it had been opened. b) On October 11, 2001, the judge ordered the second reopening of the investigation (supra IV B), on this occasion for a period of 10 days. On November 27, more than a month after the 104 expiration of that ten-day period, the judge ruled the reopened investigation concluded. 97 IACHR, Report No.52/97, Case 11.218, Arges Cerqueira Mangas v. Nicaragua, para. 96. 98 I/A Court H. R., Case of Velásquez Rodríguez v. Honduras, Judgment of July 29, 1988, Series C No. 1, para. 177. 99 IACHR, Annual Report 1997, Report No. 55/97, Case 11.137 (Juan Carlos Abella et al.), Argentina, para. 412. In connection with this point, see also: IACHR, Annual Report 1997, Report No. 52/97, Case 11.218 (Arges Sequeira Mangas), Nicaragua, paras. 96 and 97. 100 See Articles 14, 23, 216, 217, 228, 231, 232, 237, 238, 239, and 240 of the Code of Criminal Procedure, supra paras. 60-65. 101 Article 42 of the Constitution of 1998 establishes that the State will “guarantee the right to health, its promotion and protection […] and the possibility of permanent and uninterrupted access to health services, in conformity to the principles of equity, universality, solidarity, quality and efficiency”. Additionally, Article 44 refers that the State will “formulate a national health policy and will oversee its application; control the functioning of the entities of this sector […]” and Article 45 establishes that the State will “organize a national system of health, that will be integrates with public, autonomous, private and community entities of the sector […]”. 102 I.A. Court, Ximenes Lopes Case. Judgment of July 4, 2006. Series C No. 149, para. 89. 103 See: Annex 6. Trial commencement deed of August 16, 2000; and Annex 17. Declaration of conclusion of investigation, March 22, 2001. See also the request for the expansion of the investigation to cover Dr. Wilson Minchala Pinchú, which was resolved by the judge two months later. Annex 20. Request for expansion of investigation, dated June 7, 2001; and Annex 21. Order expanding the investigation. 104 See: Annex 27. Declaration of conclusion of investigation, September 19, 2001; Annex 29. Reopening of investigation, October 11, 2001; and Annex 42. Declaration of conclusion of investigation, November 27, 2001.