Indigenous peoples are not included in the current draft of WHO’s Pandemic Treaty, raising concern about their health and well-being in the case of new pandemics
The Pandemic Treaty proposed by the World Health Organization (WHO) in mid-March does not include reference to Indigenous peoples and communities, showing a significant omission of their voices and ancestral knowledge in the negotiation process. The document lacks an inclusive and intercultural approach, and does not reflect the need for differential approaches that consider the diversity of social, ethnic, educational, labor and territorial situations, among others.
This is largely due to the fact that Indigenous peoples have not had sufficient opportunities for participation in the negotiations as advised in ILO Convention 169.
The COVID-19 pandemic exposed the different impacts that pandemics have on vulnerable groups, and showed that it is essential to ensure equality and non-discrimination protocols in order to safeguard the health of Indigenous people in such situations. However, the WHO document does not reflect such an intersectional approach, and doesn’t take into account the different forms of oppression suffered by these communities.
The structural situation prior to the pandemic placed Indigenous peoples in a particularly precarious situation. In light of the new negotiating document, it seems that nothing has been learned from the pandemic.
Read more: World Health Assembly resolution on the health of Indigenous peoples is a landmark moment
58 million people, belonging to 800 Indigenous nations and groups, live in Latin America and the Caribbean. This amounts to 9.8% of the regional population, according to the United Nations Economic Commission for Latin America and the Caribbean (ECLAC). According to a 2015 World Bank report, the percentage of the Indigenous population living in extreme poverty in these countries is triple that of non-Indigenous populations. Thus, in 2022, ECLA pointed out that Indigenous peoples in the region are overrepresented in the poorest segments of the population in these countries.
The Inter-American Commission on Human Rights warned about the situation of special exposure of Indigenous peoples during the COVID-19 pandemic and encouraged states to take measures that are consistent with respect for their cultures and territories. Despite this, the draft treaty discussed in March does not refer to previous recommendations or warnings.
Indigenous peoples face an extremely precarious health reality, which includes poor access to health, a lack of access to adequate food, as well as access to safe water, without access to sanitation, without access to preventive hygiene measures, without access to diagnostic tests, treatments, vaccines, and precarious living conditions. Indigenous peoples are also exposed to different types of institutional violence, with episodes of increased persecution, harassment, and criminalization for demands for their rights.
In accordance with ILO Convention 169, known as the Indigenous and Tribal Peoples Convention, Indigenous communities have the right to access treatments, benefits, medications and health technologies such as vaccines. But, these cannot be compulsorily imposed, overriding Indigenous peoples’ autonomy in health, illness, care and attention processes.
The new WHO instrument should include such safeguards, yet it does not take into account the worldview of Indigenous peoples with regard to their health. Nor does it contemplate the participation of representatives of Indigenous communities, leaders and traditional authorities, in its design and implementation.
Read more: WHO negotiations for Pandemic Treaty extended due to disagreements
The current instrument refers generically to “people in vulnerable situations” and, on two occasions, to “community,” without reference to Indigenous peoples. The two references occur when the document refers to “community-based early detection and control measures” and when it regulates that “the parties will promote effective and meaningful participation of communities in the development and application of policies, strategies and measures for the prevention, detection and responses to zoonotic outbreaks.”
It is striking that this last measure is recognized as a priority for states parties to the instrument, yet the treaty negotiation process itself fails to respect and encourage the same sort of participation.
During the COVID-19 pandemic, intergovernmental organizations formulated recommendations to increase the visibility of, and strengthen, containment and recovery mechanisms for Indigenous peoples in the face of the COVID-19 pandemic. However, these recommendations have not been incorporated into the text of the treaty.
Failure to involve Indigenous voices in the negotiations leads to omissions of key measures
Among other things, the current draft fails to recognize Indigenous institutions, community care and self-care models, despite the fact that it is necessary to ensure the availability and access to culturally appropriate medical services, and to consider intercultural or complementary perspectives of medicine use, in order to protect the right to health in the same communities. This includes non-discriminatory access to medical tests, emergency care, including mental health and reproductive and sexual health.
The design of communication and information strategies needs to take into account Indigenous languages, guaranteeing the inclusion of different formats and traditional means of communication. This would allow for eliminating gaps in access to information and communication technology.
It is also necessary to improve statistical health records, disaggregated by place of residence, allowing ethnic self-identification, gender, age and deaths of Indigenous people associated with the particular disease.
During pandemics, measures need to be implemented to protect basic life needs in Indigenous communities. Measures to allow independent decision-making on traditional food systems are an integral part of this recommendation, to guarantee food and nutritional security. The same is true for ensuring the supply of safe water, preventive hygiene measures and sanitation for communities that do not yet have these services.
Forced evictions against Indigenous communities must be suspended at all times, avoiding displacement and respecting the territories. Similarly, during pandemic situations, governments have to refrain from authorizing extractive projects in relation to Indigenous territories.
To ensure the implementation of such safeguards, it is necessary to strengthen coordination with the United Nations Expert Mechanism on the Rights of Indigenous Peoples and the special rapporteurs. Expeditious mechanisms for access to justice, mediators and judicial and health facilitators must be ensured so that Indigenous communities can resort to administrative, alternative or judicial instances if necessary.
The Pandemic Treaty must take into account the recognition and exercise of Indigenous communities’ rights: the right to self-determination, as well as the respect for free, timely and informed consultation and consent on projects that impact ways of life and health of the same communities.
Finally, we consider it essential that a future Pandemic Treaty reflects the notion of buen vivir of Indigenous peoples, incorporating the perspective of interculturality and intersectionality in health. The right to health must be integrated with other forms of community care and self-care.
The treaty must take into account a differential approach in access to genetic resources based on what is established in the Convention on Biological Diversity, which allows enjoying the shared benefits of technology transfer and the adequate protection of human genetic resources for Indigenous villages.
In this sense, it is vitally important that biodiversity be regulated and protected in the future pandemic instrument. The document should explicitly prohibit intellectual property over, and patenting of the traditional knowledge of Indigenous peoples and their medicines.
We need the future Pandemic Treaty to reflect the voices, struggles and demands of Indigenous peoples. Only then can we think about forms of prevention, preparation and responses to new health crises.
Romina Duarte is a member of ALAMES Argentina, the working group on interculturality and health, and the Health and Climate Justice Observatory.
María Natalia Echegoyemberry is Vice-President of the human rights association XUMEK and a member of the People’s Health Movement Argentina. She is academic director of the Health and Climate Justice Observatory, and the coordinator of the working group on preparedness, prevention and vaccine pandemic responses for the people of Latin America.
People’s Health Dispatch is a fortnightly bulletin published by the People’s Health Movement and Peoples Dispatch. For more articles and to subscribe to People’s Health Dispatch, click here.