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During the 76th World Health Assembly, members of the World Health Organization (WHO) adopted an unprecedented resolution on the health of Indigenous peoples. The drafting process of the resolution was primarily driven by Brazil, with support from other countries in Latin America. The adoption of the resolution could pave the way for combating the health inequities that Indigenous communities have been exposed to for centuries, and open the doors to greater participation from Indigenous movements.
Mariana Lopes Simões, who took part in the World Health Assembly as part of the People’s Health Movement’s WHO Watch team, spoke to Ricardo Weibe Nascimento Costa, Vice-minister for the Health of Indigenous Peoples in Brazil, on the significance of this step.
WHO Watch (WW): Why did you feel the need to bring a specific resolution for the health of Indigenous people?
Ricardo Weibe Nascimento Costa (RW): We believe that in the Indigenous territories, the people are still exposed to many human rights violations, including in access to health.
In recent years, the human rights of Indigenous people have been neglected and even violated. For example, more than 600 Yanomami Indigenous people — most of them children — have died due to the violation of their human rights through acts of negligence by the State. At this moment, we are re-assuming a leading role in addressing the gaps in assistance to guarantee health coverage and universal healthcare for Indigenous peoples, while also recognizing the knowledge held by Indigenous communities themselves.
We understand that these populations require approaches and actions rooted in policy programs that can adapt to their realities while respecting their customs, traditions, cultural heritage, and policies.
WW: What kind of consultations did you have with the different Indigenous communities in order to formulate this resolution?
RW: First of all, let me say that the issue of Indigenous people’s health was already the subject of some international treaties, like Convention 169 of the International Labor Organization (ILO). The United Nations Declaration on the Rights of Indigenous Peoples also deals with Indigenous health. For us, the 76th World Health Assembly, which coincided with the 75th anniversary of the founding of the World Health Organization (WHO), was remarkable because it marked the first time the organization adopted a special resolution on the health of Indigenous Peoples.
The resolution was the product of many contributions. For instance, Fiocruz, a renowned higher education institution in our country which is also a partner of the Indigenous peoples, was among the contributors. Indigenous peoples from sister countries helped us in the elaboration of the draft, acting as key allies and partners in the process. So, the resolution was a result of participative work — not only of the Indigenous movement, institutions, and the Brazilian Department of Indigenous Health (SESAI – Secretária de Saúde Indígena), but also of other countries that were committed to the idea of having an international instrument that could deal with Indigenous peoples’ health.
WW: When working on a resolution like that, having so many people involved can be a barrier. Were there any significant barriers to the resolution, either before or during the WHA 76?
RW: I think that this initiative was very well received by other countries. There was no resistance. Some of the questions that came up were conceptual. We work a lot with the concept of native people or Indigenous peoples, yet some countries wanted to use the term ‘local community’ instead. However, for most countries, the meaning of the term ‘local community’ is not clear. There are several types of communities that don’t include Indigenous peoples but are considered local. We agreed that this resolution should focus on the Indigenous communities in a very defined way, as a strategy that the countries need to adopt in order to ensure universality and integrality of health in the Indigenous territories with efficiency and quality. But this needs to be done with respect to the social organization, the cultural particularities of the ways of life, and local knowledge—in short, the whole cultural heritage, and also the customs existing in the territories.
WW: What would be your recommendations to countries in the adoption and implementation of the resolution in their territories?
RW: The resolution is an important international instrument to guide member states of the WHO. Of course, it includes a set of recommendations, but above all, it is an international agreement. It’s an agreement saying that the world is committing to overcome social inequalities in Indigenous territories. All the countries, all the nations, are committing to what is in the resolution to ensure assistance, health coverage for all the Indigenous peoples of the world and, above all, to ensure respect of the traditional knowledge held by the communities themselves.
It says that there will be no top-down approaches, programs that disrespect the ways of life of Indigenous communities, their cultures, their social organizations. All actions must be built with the participation of Indigenous people. The right to consultation is a premise of other international treaties that we have also incorporated in the resolution.
WW: You mentioned that while Brazilian Indigenous populations were central to the process of drafting the resolution, you also worked with the Indigenous populations of other countries. How was the process of communication between different countries and communities? Did you have any help?
RW: The Pan American Health Organization (PAHO) has been a strategic institution in this process because it has managed to coordinate with the countries in the Americas and build the understanding that we should have an international mechanism that also considers our regional reality. Obviously, this is a resolution with international implications, so it was only natural that PAHO, and countries in Latin America, Central America, and North America, to take such an active role. We even held an event during the 76th World Health Assembly that had strategic participation and expressed solidarity among countries, which I found very interesting. I would also like to recognize the role of the PAHO in this process of political coordination and effort that was made so that this resolution could have the acceptance that it had.
The WHO Watch team was made of: Marta Caminiti, Dian Blandina, Mariana Lopes Simoes, Juliette Claudine Mattijsen, Facundo Fernandez, Chiamo Seraphine, Ben Verboom, Axelle Ebode, Lauren Paremoer, Candelaria Araoz Falcon, Jyotsna Singh
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