United Nations Economic and Social Council Permanent Forum on Indigenous Issues

First Session, 13-24 May 2002,
New York Item 6 of the provisional agenda

INDIGENOUS PEOPLES AND HEALTH
A Briefing Paper For The Permanent Forum On Indigenous IssuesPrepared by the Committee on Indigenous Health[1]

1. The Committee on Indigenous Health has prepared this briefing paper for the United Nations Permanent Forum on Indigenous Issues, on the occasion of its inaugural session from 13-24 May 2002 at the Headquarters of the United Nations Organisation (UNO) in New York City, USA. The intent of this paper is to inform the members of the Permanent Forum of the current situation, review progress, recommendation and provide an entry point for this august body into the health and survival issues of indigenous peoples and nations from their own perspective and experiences. It is a voice of the indigenous peoples and nations. The paper is not an exhaustive or comprehensive treatment of the health issues among the indigenous peoples and nations of the world nor is it to be viewed as a definitive submission by the Committee on Indigenous Health to the members of the Permanent Forum.

1. The Committee wishes to take this opportunity to express its satisfaction at the establishment of the Permanent Forum on Indigenous Issues within the International Decade on the World’s Indigenous People; and believes that, with its establishment, the on-going process within the United Nations to address indigenous peoples’ issues concerning their human rights will be further strengthened.

1. The Permanent Forum on Indigenous Issues is mandated by ECOSOC (resolution 2000/22) to discuss indigenous issues within the mandate of the Council relating to economic and social development, culture, the environment, education, health and human rights. The mandate specifically empowers the Permanent Forum to provide expert advice and recommendations on indigenous issues to the Council as well as to programmes, funds and agencies of the United Nations, through the Council.

1. It is recognised that health, as perceived by indigenous peoples and nations, is a very broad and holistic concept that is not confined to the narrower conventional health concept or definition. Within the ambit of Permanent Forum’s wide mandate, this paper hopes to review the current status and contribute to the discussions on the health of indigenous peoples so that it may be of assistance to the members of the Permanent Forum’s discussions, expert advice and recommendations in this area.

1. The Committee has worked closely with the Working Group on Indigenous populations since 1997 and continues to do so. In this regard, the Committee on Indigenous Health wishes to reiterate its steadfast commitment and full support to the endeavours of the Permanent Forum in fulfilling its important mandate.

1. We recognise, however, that some progress has been achieved in the standard-setting activities within the United Nations and some regional inter-governmental organizations. The work of the Sub-Commission’s Working Group on Indigenous Populations since 1982 has been an inspiring rallying point for indigenous peoples and nations as well as many international organisations and specialized agencies and bodies of the United Nations. The International Labour Office (ILO) had paved the way in its progressive revision of Convention 107.

1. Among the areas in which increasing progress on the rights of indigenous peoples and nations in international and regional agendas have been made, mention may be made of inter alia the UN Declaration on the Rights of the Indigenous Peoples, the UN Convention on the Rights of the Child and the work of its monitoring body – the Committee on the Rights of the Child, the Convention on Biological Diversity, OAS Declaration on the Rights of Indigenous Peoples, the Berlin Agenda (5 November 1999), UN Framework on the Convention on Climate Change, the Convention to Combat Desertification and UN Development Programme’s draft policy.

1. However, there are other areas of work among international organisations where indigenous peoples and nations, from all regions, have expressed deep concern. These include the World Bank’s present conversion process of OD 4.20 and revision of the draft Operational Policy/Bank Procedures 4.10 and Indigenous Peoples policy of the Asian Development Bank. Special mention must be made on the current work being undertaken by the World Intellectual Property Organisation (WIPO) and the Intergovernmental Committee on Intellectual Property and Genetic Resources, Traditional Knowledge and Folklore. The issues being dealt with are of special significance to the health of Indigenous Peoples and Nations, and the COIH looks forward to the outcomes of the Committee.

1. Important thematic world conferences during the last century have also focused on the particular problematic of the indigenous peoples, calling on the international community to take urgent and appropriate action. Mention may be made inter alia of the Rio Declaration (1992; principle 22; agenda 21: 26.1), Vienna Declaration and Programme of Action of the World Conference on Human Rights (June 1993, Para 20 section I), the International Conference on Population and Development (Cairo 1994; Para 6.25 and 6.27); the Beijing Platform for Action of the Fourth World Conference on Women (1995, Para 116, 230, 233 and 242), and the Copenhagen Declaration on Social Development of the World Summit for Social Development (Copenhagen 1996, principle and goal 26m; commitment 6g, access to health care; 4f, support indigenous peoples’ aspirations for social justice and to provide an environment that facilitates indigenous peoples’ participation in socio-economic and political life of their country). Much more need to be done on the ground to make effective and lasting changes to the situation of indigenous peoples and nations, however.

1. Recently, at the World Conference on Racism, Racial Discrimination, Xenophobia and Related Intolerance (Durban, 2001), the adopted Declaration and Programme of Action have definitively expressed the world’s deep concern for the situation of indigenous peoples. These concerns that include the crucial issues of discrimination, self-determination and exclusion of indigenous peoples have very deep and ramifying implications for indigenous peoples’ survival and health.

1. In July 2001, during the session of the Working Group on Indigenous Populations, the Committee on Indigenous Health established formal contact with the newly established Special Rapporteur on the situation of human rights and fundamental freedoms of Indigenous People, Mr. Rodolfo Stavenhagen. In his first report to the Commission on Human Rights the Special Rapporteur has referred to the progress made in the area of health through a developing partnership between the World Health Organisation and indigenous peoples (E/CN.4/2002/97 dated 4 February 2002; Para 24). He has outlined the future activities of the Special Rapporteur, which includes particular areas of great significance to the health situation of indigenous peoples (Para 113 [a] to [g]).

1. The Special Rapporteur on adequate housing as a component of the right to an adequate standard of living, Mr. Miloon Kothari, stated in his first report to the Commission on Human Rights, in (E/CN.4/2001/51) that it was necessary to broaden the interpretation of the right to adequate housing since international legal standards already existed to address these, from a human rights based approach. Of particular interest the Special Rapporteur included within the framework of his mandate and related to health and well being is that of access to potable water. In the meanwhile several Indigenous NGO’s reminded the Special Rapporteur, and others, that they have an obligation to include indigenous peoples in their reports according to CHR resolution 1993/30 which call on them “to pay special attention, within the framework of their mandates, to the situation of Indigenous Peoples.” The Committee on Indigenous Health

1. The Committee on Indigenous Health (COIH) an indigenous peoples’ representative independent focal point was established by the Indigenous Peoples’ Caucus prior to the 15th session Working Group on Indigenous Populations in 1997 to:
a. ensure indigenous representation and participation in development and planning related to health issues, policy and initiatives.
b. assess the globalisation impact on indigenous health by environment degradation, rights violation and forced relocation.
c. provide a consistent interface with international and intergovernmental agencies and to ensure the dissemination of information to the widest possible extend among indigenous peoples, national government and other stakeholders.

1. A Forum on Indigenous Peoples and Health, in conjunction with the WGIP sessions, has been held annually at the Palais des Nations, Geneva by the COIH and WHO since 1998.

1. During the “International Consultation on the Health of Indigenous Peoples”, (Geneva, 21-22 November 1999) jointly organised by COIH And WHO, COIH organised a Indigenous Peoples’ Health Caucus and drafted, after extended discussions, “The Geneva Declaration on the Health and Survival of Indigenous Peoples” (see Annex 1). This Declaration was adopted during the International Consultation. The International Consultation was organised to progress a global plan of action for addressing and promoting the health of indigenous peoples. A framework for Indigenous Peoples’ Health Policy was also adopted at the Consultation. The framework identified three pre-requisites to address the health of the indigenous peoples; “respect for fundamental human rights; recognition of indigenous peoples; and political will of the states” and the approach to their development is characterized by three inter-related themes of; “interconnectedness, self-determination and Equity”. Each approach has three principles, “interconnectedness is associated with cultural responsiveness, intersectoralism, and vertical integration; self-determination is associated with control, capacity-building and intellectual property and Equity is associated with quality information, accountability and resourcing”.

1. The Consultation made a number of recommendations to WHO’s regional offices, State governments