The Committee’s General Comments have also set out principles to guide the steps that a state
must take on specific rights. For example, policies and programs should be designed to improve
the availability, accessibility, acceptability, adaptability and quality of services necessary for the
realization of ESC rights (known as the ‘AAAAQ’ or ‘4A’ criteria). ‘Availability’ requires that goods or
services be available in sufficient quantities. ‘Accessibility’ requires that necessary goods (such as
food or medicine) or services (such as healthcare or education) are both physically and economically
accessible to all, without discrimination. ‘Acceptability’ and ‘adaptability’ mean that the necessary
goods and services must be culturally and socially acceptable and adapted to the local context and
‘quality’ means that they must be appropriate and adequate in standard and safety.
Another requirement is that steps taken must not be deliberately ‘retrogressive,’ meaning that
states must fully justify the adoption of policies that decrease people’s enjoyment of a right. Such
retrogressive measures are presumed to be a prima facie violation of the Covenant unless the state
can prove they have been introduced ‘after the most careful consideration of all alternatives and
that they are duly justified by reference to the totality of the rights provided for in the Covenant
in the context of the full use of the state party’s maximum available resources’.25 Domestic courts
in a number of jurisdictions have upheld challenges to legislation and administrative regulations
considered retrogressive.26 In the context of the global economic crisis, the Committee has further
emphasized that any austerity measures which threaten the progressive realization of economic and
social rights must protect the minimum core content of the rights, be temporary, non-discriminatory,
and necessary and proportionate in the sense that alternatives would be more detrimental to social
and economic rights.27
Finally, states must take these steps to achieve the full realization of ESC rights employing the maximum
of their available resources, a requirement that has been given greater clarity by the Committee, a
number of Special Rapporteurs and other legal experts.28 While what constitutes ‘maximum available
resources’ is yet to be conclusively defined, analysis by economists and human rights practitioners
has sought to examine the range of policy areas that need to be evaluated to assess whether a state
is employing its maximum available resources to fulfill ESC rights. This requires looking beyond
government expenditure and revenue (including taxation and development assistance) to economic
policy issues such as debt and deficit financing, monetary policy, and financial regulation.29
In interpreting these concepts, courts in different jurisdictions have developed various tests to judge
legislative or administrative action which they have commonly framed as either ‘reasonableness’,
‘adequacy’ or ‘proportionality’. For example, the reasonableness test was most famously articulated in
the South African Constitutional Court’s 2001 decision in Grootboom. In this case, the Court determined
that the state’s housing policy was unreasonable as it did not take into account the basic needs of
homeless people for temporary shelter. By contrast, the Court’s 1998 decision in Soobramoney held
that criteria in the state’s regulations governing the provision of dialysis services were reasonable.30
In addition, the Committee has also emphasized that policies must be designed and implemented
in accordance with the procedural rights articulated in international human rights law, including the
rights to information, participation, accountability and transparency. These principles are frequently
referred to using the mnemonic device PANTHER. First devised by the United Nations Food and
Agriculture Organization (FAO), PANTHER stands for Participation, Accountability, Non-Discrimination,
Transparency, Human dignity, Empowerment and Rule of Law.31 These principles—which relate
closely to the provisions of civil and political rights standards—have been further elaborated in the
Assessing compliance with the obligation to fulfill economic, social and cultural rights
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