conditioned each other. In this regard, the Court recalls that intersectional discrimination is the result of the confluence of different factors of vulnerability or sources of discrimination associated with certain conditions of an individual. Thus, as the Court has indicated, discrimination against women based on sex and gender is indivisibly combined with other factors that affect women, and this type of discrimination may affect women from some groups to a different degree or in a different way than it affects men. Consequently, in their legal instruments, States should recognize and prohibit these intersecting forms of discrimination and their combined negative impact on the women concerned, as well as adopt and implement policies and programs to eliminate such situations. 166 139. Consequently, the Court concludes that the State is responsible for the violation of the prohibition of discrimination in relation to the obligation to ensure the right to health, recognized in Article 26 of the Convention, in relation to Article 1(1), to the detriment of Sandra Lisbeth Zepeda Herrera and Pascuala de Jesús Mérida Rodríguez. B.4.4. The violation of the principle of progressivity in relation to the right to health 140. The Court recalls that one of the disputes in this case refers to whether the State violated the principle of progressivity contained in Article 26 of the Convention, owing to the alleged retrogressive measures it adopted that prejudiced the full realization of the right to health of people living with HIV in Guatemala. In this regard, the representatives asserted that, despite being aware of the existence of an HIV epidemic in its territory, the State adopted retrogressive measures and did not use the maximum of its available resources to prevent the propagation of the virus and to ensure the right to health. Specifically, the representatives referred to the legal barriers concerning patents that had prevented a permanent supply of low-cost drugs under the public health system. They also referred to obstacles in relation to administrative contracting and to acts of corruption. B.4.1.1. Standards for the right to health applicable to the principle of progressivity 141. The Court finds it pertinent to reiterate that, by virtue of Article 26 of the Convention, it has full competence to examine violations of the rights derived from the economic, social, educational, scientific and cultural standards of the OAS Charter (supra para. 97). The Court also reiterates that two types of obligations arise from these provisions: those that can be claimed immediately, and those of a progressive nature. Regarding the latter, the Court considers that, in general, it will not be possible to achieve the progressive development of economic, social, cultural and environmental rights in the short-term and, therefore, “a necessary flexibility device is required reflecting the realities of the real world and the difficulties involved for any country in ensuring their full realization.”167 Cf. Case of Ramírez Escobar et al. v. Guatemala. Merits, reparations and costs. Judgment of March 9, 2018. Series C No. 351, para. 276, and Committee for the Elimination of Discrimination against Women, General Recommendation No. 28 on the Core Obligations of States Parties under Article 2 of the Convention on the Elimination of All Forms of Discrimination against Women, December 16, 2010, U.N. Doc. CEDAW/C/GC/28, para. 18. 166 Cf. Case of Acevedo Buendía et al. (“Discharged and Retired Employees of the Comptroller’s Office”) v. Peru. Preliminary objection, merits, reparations and costs. Judgment of July 1, 2009. Series C No. 198, para. 102, and Committee on Economic, Social and Cultural Rights, General Comment No. 3: The Nature of States Parties’ Obligations (Art. 2, Para. 1, of the Covenant), December 14, 1990, U.N. Doc. E/1991/23, para. 9. 167 49