STATE OF THE WORLD's INDIGENOUs PEOpLEs - CINU

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EMBARGOED UNTIL 14 January 2010STATE OF THE WORLD’S INDIGENOUS PEOPLESNot for distributionIn accordance with the international human rights instruments that provide forthe right to health, most initiatives that seek to improve the health of poor andmarginalized populations focus primarily on increasing access by individualsfrom those populations to state health systems. Indeed, full access to qualityhealth care is a human right of all individuals, and it is therefore critical toensure equal access to health care, including through efforts to eliminate thediscrimination and marginalization faced by indigenous peoples. However, toaddress the root causes of indigenous peoples’ health problems, there mustalso be full recognition and exercise of indigenous peoples’ collective rights tocommunal assets and self-determination.Gap in life expectancy between indigenous and non-indigenouspeople (in years)Guatemala Panama Mexico Nepal Australia Canada New Zealand13 10 6 20 20 7 11Source: Hanemann (2006), 5 & Health Canada (2007).Many of the most urgent health challenges faced by indigenous peoples, suchas illnesses from pesticides and extractive industries, malnutrition, diabetes andHIV/AIDS, stem from the contamination and depletion of their land and naturalresources, and from their forced displacement from their territories. The right tocollective land, territories and natural resources is thus an essential componentthat lays the foundations for improving the health of indigenous peoples. In addition,the rights to preserve, practise and transmit traditional knowledge and to maintaincultural, spiritual and social beliefs and institutions are integral to ensuring thehealth of indigenous communities. Many mental health issues such as depression,substance abuse and suicide have been identified as connected to the historicalcolonization and dispossession of indigenous peoples, which has resulted in thefragmentation of indigenous social, cultural, economic and political institutions.Similarly, the right to self-determination with respect to health implies creatingconditions for the full and effective participation of indigenous communities inthe design and management of health systems, in addition to adherence to theprinciple of free, prior and informed consent in the planning and implementationof health and development programmes and projects. 14 Furthermore, theremust be a commitment to building the human resources necessary for theparticipation of indigenous peoples in health policy and management, as well astraining non-indigenous health professionals in the cultures and languages ofindigenous peoples. Finally, it is essential to recognize that the health situationof indigenous peoples is linked to the sustainable human development ofto address the rootcauses of indigenouspeoples’ health problems,there must also be fullrecognition and exerciseof indigenous peoples’collective rights tocommunal assets andself-determination14For more on the concept of free, prior and informed consent, see UNPFII (2005).HEALTH | 159
EMBARGOED UNTIL 14 January 2010STATE OF THE WORLD’S INDIGENOUS PEOPLESNot for distributionindigenous communities in all aspects, which includes issues of education, political participation, environmentand economic development; efforts to improve the health of indigenous peoples must therefore involve a multisectoraland multidisciplinary approach. 15Over the course of the last decade, some international and regional health initiatives have begun to paygreater attention to the specific needs of indigenous peoples, many of which were precipitated by the firstInternational Decade of the World’s Indigenous Peoples (1995-2004) proclaimed by the United Nations GeneralAssembly. WHO, for example, has various initiatives administered by their Health and Human Rights Teamthat focus on improving the health of indigenous peoples, and the World Health Assembly (WHA) has passeda number of resolutions affirming its intention to tackle health disparities between indigenous and nonindigenouspopulations. 16 In addition, WHO has urged member States to “develop and implement, in closecooperation with indigenous people, national plans of action or programmes on indigenous people’s healthwhich focus on ensuring access of indigenous people to health care.” 17 The Pan-American Health Organization(PAHO) has been one of the institutions most attuned to the demands of indigenous peoples. In 1993, within theframework of the United Nations International Year of Indigenous Peoples, PAHO held a meeting on the healthof indigenous peoples. 18 The recommendations of that meeting were approved by the PAHO Directing Councilas Resolution V, “Health of Indigenous Peoples”, and secured a commitment from member Governments, atleast at the policy level, to grant priority to improving the health of indigenous peoples while respecting theirancestral culture and knowledge. 19Core elements of PAHO Resolution V Promoting the participation of leaders and representatives of indigenous peoples and theircommunities in the formulation of health policies and strategies and the development of healthand environmental activities directed at their people; Strengthening the technical, administrative and management capacity of national and localinstitutions responsible for the health of indigenous peoples, with particular attention to the needto overcome the lack of information;Ensuring greater access by indigenous peoples to quality health services;Facilitating inter-sectoral actions (government, non-governmental, universities, research centresand indigenous organizations);Promoting the transformation of health systems and supporting the development of alternativemodels of care, including research and certification of traditional medicine;Promoting programmes in disease prevention and health promotion to address the problemsmost relevant to each country; and15This has been recognized by the Pan-American Health Organization. See PAHO (2003), 7.16WHA (1994-2001). Resolutions 54.16, 53.10, 51.24, 50.31, 49.26, 48.24, and 47.27.17WHA Resolution 51.24, International Decade of the World’s Indigenous People, (1998), 1.18The meeting was held in Winnipeg in April 1993, with the participation of indigenous peoples from the Americas and functionariesof WHO, Ministries of Health, and non-governmental organizations.19PAHO Resolution V also includes the adoption of Document CD37/20, creating the PAHO Health of the Indigenous Peoples of theAmericas Initiative.160 | CHAPTER V
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STATE OF THE WORLD's INDIGENOUs PEOpLEs - CINU

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