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Extradition to a State bound by the ECHR cannot be refused on health grounds where: the requesting State provides adequate assurances regarding medical care; and there is no concrete evidence of a real risk of treatment contrary to Articles 2 or 3 ECHR. Mutual trust applies to “first circle” States (such as France), and no specific guarantees are required, even in the presence of serious health conditions, unless a concrete and individualised risk is demonstrated.