117. Based on the above, the Court observes that the laws cited have established, at least since 1985, the right to health as a right protected by the Constitution, and since 1997, the Health Code has established the State’s obligation to provide HIV education, detection, prevention and control services. The Court also notes that, in 2000, a specific law was enacted on the care and monitoring of HIV/AIDS. Consequently, the Court considers that the State adequately regulated the protection of the right to health for people living with HIV in Guatemala. The Court must now verify whether the State complied with its obligation to ensure the right to health of the presumed victims in this case. To this end, it will divide its analysis into two periods: (i) before 2004, and (ii) after 2004. B.4. The violation of the right to health B.4.1. Analysis of the medical treatment received by the presumed victims prior to 2004 118. In this chapter, the dispute focuses on whether the State is internationally responsible for the violation of the right to health as a result of the medical care – or lack of it – provided to the presumed victims as people living with HIV. It also refers to whether the State should have adopted differentiated measures for the treatment of individuals in a situation of vulnerability or risk. Lastly, it refers to whether the State is responsible for the violation of the principle of progressivity with regard to the right to health. The Court will examine the facts of the case in light of the State’s obligation to ensure the right to health of the presumed victims. To this end, the Court finds it necessary to differentiate two periods in the medical care provided to the presumed victims and the legal consequences of this care: (i) before 2004, and (ii) after 2004. 119. In this regard, in its brief answering the allegations, the State ratified the position it had assumed during the proceeding before the Commission.132 It indicated that, prior to 2004, most of the medical treatment in Guatemala was carried out by the Swiss organization Doctors Without Borders, and that the State only financed the treatment of 373 individuals.133 It also offered to take steps to assume the care in state hospitals of the presumed victims in this case who were being treated by Doctors Without Borders.134 In this regard, the Court notes that 48 of the presumed victims in this case had not received medical treatment by the State prior to 2004.135 Therefore, the Court finds it proved that, before 2004, these presumed victims had not received any kind of state medical treatment or that such treatment was ineffective to treat their condition as people living with HIV. Mr. Cabrera Morales was diagnosed in October 2001 and began receiving antiretroviral treatment provided by the IGSS in December 2001. However, the Court notes that his access to antiretroviral drugs, CD4 counts and viral load testing was irregular, that he did not receive genotype and phenotype testing, and that he had not received either social or psychological support, or family, community and home care in accordance with the standards established in this judgment (supra paras. 103 to 114). Thus, the medical treatment he received prior to 2004 lacked the elements of health care availability, accessibility and quality. Consequently, the Court concludes that the State is responsible for 132 Cf. The State’s answering brief (merits file, folio 853). Cf. Report on actions taken by the State to follow up on and comply with the precautionary measures ordered (evidence file, folio 231). 133 Cf. Observations of the State of Guatemala on the observations on Admissibility Report No. 32/05 (evidence file, folios 347 and 348). 134 The persons indicated as victims in annex 2 to this judgment fall into this category, with the exception of Felix de Jesús Cabrera Morales. 135 42