30 In the case of essential competences related to the supervision and control of the provisions of services of public interest, such as health care, by either public or private entities (as in the case of a private hospital), responsibility stems from the failure to comply with the obligation to supervise the provision of the services in order to protect the respective right 176. 145. In the Case of Suárez Peralta v. Ecuador, the Inter-American Court linked these obligations of supervision and control over health services with the principles of availability, accessibility, acceptability and quality in medical services, indicating that the former obligations must be “aimed at” satisfying these principles,177 which were formulated by the Committee on Economic, Social and Cultural Rights in General Comment No.14 as “essential and interrelated”, in the following terms: a) Availability. Functioning public health and health-care facilities, goods and services, as well as programs, have to be available in sufficient quantity within the State party. [T]hese services will include the underlying determinants of health, such as safe and potable drinking water and adequate sanitation facilities, hospitals, clinics and other health-related buildings, trained medical and professional personnel [...]; b) Accessibility. Health facilities, goods and services have to be accessible to everyone without discrimination, within the jurisdiction of the State party; c) Acceptability. All health facilities, goods and services must be respectful of medical ethics and culturally appropriate, [...] as well as being designed to respect confidentiality and improve the health status of those concerned; d) Quality. As well as being culturally acceptable, health facilities, goods and services must also be scientifically and medically appropriate and of good quality. This requires, inter alia, skilled medical personnel, scientifically approved and unexpired drugs and hospital equipment, safe and potable water, and adequate sanitation.178 146. Regarding the quality of the service, the Court indicated that the State has the duty to regulate, supervise and inspect health services, ensuring amonth other aspects that the sanirary conditions and the personnel are adequate, that are duly qualified and that continue to be capable to exercise the profession179. 147. In brief, the Court has indicated that “the eventual provision of medical care in institutions without the proper authorization, the infrastructure and hygiene of which are inadequate for the provision of medical services, or by professionals who do not have the appropriate qualifications for such activities, could have a significant impact on the rights to life and to integrity of the patient 180. 148. In this sense, the Commission will examine whether the State is responsible for the failure to fulfill its obligation to ensure the right to physical integrity vis-à-vis the right to health to the prejudice of TGGL, while she was in hospital at the Humanitarian Clinic and when she received a blood transfusion originating from the Azuay Red Cross Blood Bank. 2. 176 Special Obligations for the Fulfillment of the Duty to Ensure the Right to Humane Treatment vis-à-vis the Right to Health in the case of Children IA Court HR Case of Suarez Peralta v. Ecuador, Judgment of May 21 2013, para. 150. IA Court HR Case of Suarez Peralta v. Ecuador, Judgment of May 21 2013, para. 144, citing Cfr. I/A Court H.R., Case of Ximenes Lopes v. Brazil. Preliminary Objection. Judgment of November 30, 2005. Series C No. 139, paras. 89 and 99, para. 152. 177 178 (2000). United Nations, Economic and Social Council, Committee on Economic, Social and Cultural Rights, General Comment No.14 179 Corte IDH. Caso Suárez Peralta Vs. Ecuador. Excepciones Preliminares, Fondo, Reparaciones y Costas. Sentencia de 21 de mayo de 2013. Serie C No. 261. Párr. 152. 180 United Nations, Economic and Social Council, Committee on Economic, Social and Cultural Rights, General Comment No.14 (2000, paras. 12 and 35.

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