Message of the Chairperson of the United Nations
Permanent Forum on Indigenous Issues
It is a great joy again to celebrate this special day with the indigenous peoples around the world, who number more than 370 million in all the earth's regions. In 1994, this International Day of the World's Indigenous People was celebrated for the first time at the beginning of the International Decade of the World's Indigenous People declared by the United Nations General Assembly. It is an occasion for indigenous peoples and the world to assess where they are in their bid to have their human rights recognized and respected and to plan where they are going in the years to come.
This year the special theme is HIV/AIDS. I would like to begin by stating that overall, access to antiretrovirals, as well as to HIV prevention, care and support, remains a major global health and human rights emergency for millions of peoples in need. Nonetheless, the numbers of those having such access is rising. In 2006 governments and the international community have made commitments to pursue all necessary efforts towards achieving the goal of universal access to comprehensive HIV prevention programmes, treatment, care and support by 2010.
Other time-bound commitments have been made during the decade in the Millennium Declaration, and in the Declaration of Commitment adopted by the UN General Assembly Special Session on HIV/AIDS in 2001 and confirmed and expanded by the Political Declaration of the 2006 High Level Meeting on AIDS at the General Assembly. Global funding for HIV programmes has risen almost 30-fold in the course of the decade.
Nevertheless, the situation remains grave, with a doubling of people living with HIV worldwide to over 40 million, with women now comprising half of those living with HIV, with young people, particularly young women, having the fastest rates of infection, and with some 14 million children having been orphaned by AIDS. Sadly, interventions to educate people about HIV; to provide them with HIV prevention commodities, services and treatment; to protect them from discrimination and sexual violence; and to empower them to participate in the response and live successfully in a world with HIV is unacceptably low in many places in the world.
HIV/AIDS is of major concern for indigenous peoples’ and their communities. HIV infection is a continuing health crisis for indigenous peoples. The global experience with the epidemic has made it clear that there are key factors that render indigenous peoples acutely vulnerable to HIV. They include poverty, marginalization, lack of political or social power, fragmentation of family and community relationships, geographical isolation, low literacy rates, poor general health, limited access to health care and drug use. Maternal HIV infection has particular importance to infants and young children because of increased risk of perinatal mortality, transplacental transmission of the virus, and the consequences of probable premature maternal death.
Protecting indigenous people living with, or affected by, HIV, and preventing its further spread is a major development and human rights challenge. Stigma, silence, discrimination, privacy issues and denial of psychosocial and medical services, including antiretroviral treatment, undermines prevention and care efforts. The fact that the epidemic is increasingly affecting young people and women, who may have limited power to refuse sex or negotiate safer sex, brings additional human rights dimensions to this tragic disease.
Article 24 of the United Nations Declaration on the Rights of Indigenous Peoples specifically refers to indigenous peoples’ right to access, all social and health services and that indigenous peoples have an equal right to the enjoyment of the highest attainable standard of physical and mental health.
The United Nations Permanent Forum on Indigenous Issues has been placing priority on data collection and disaggregation. With respect to HIV/AIDS and indigenous peoples, the Permanent Forum has pointed out that:
- Epidemiological data on incidence and prevalence among indigenous peoples’ communities is rare;
- Surveillance sites are often not established in rural/remote areas where a large number of indigenous peoples live; and
- Internal migration, displacement, trafficking of indigenous women and girls, and lack of access to adequate and culturally appropriate healthcare all add to the increased vulnerability of indigenous peoples to the transmission of HIV.
Furthermore, the issue of awareness-raising is a very low point in indigenous peoples’ communities and is sorely needed as well as culturally sensitive strategies for indigenous peoples and their communities.
Unfortunately, it has become obvious that very few countries have any reliable national surveillance data to indicate the true level of HIV infection among indigenous peoples. Only some surveillance programmes record the cultural background of those tested and, even where infection levels in specific groups are identified, there is limited information about the specific patterns of HIV risk and the way in which HIV affects those communities. As with all data about HIV incidence and prevalence, caution must be exercised when drawing conclusions about the level of HIV risk based only on the results of HIV tests carried out on selected segments of the population.
This is particularly true when trying to determine levels of HIV infection among indigenous peoples. In many instances, where indigenous peoples are geographically isolated, or less able to access the healthcare system, they may be missed by many HIV testing programmes. Moreover, where stigma and discrimination are associated with indigenous status, there is a disincentive for indigenous peoples to disclose their status if asked. Social and cultural taboos may also discourage indigenous peoples from disclosing forms of behaviour that place them at risk of HIV infection, if those behaviours are considered unacceptable in their communities.
There are sensitivities around targeting indigenous peoples, for specific HIV data collection. Indigenous peoples are already disadvantaged and subject to stigmatization and often the publication of data suggesting high levels of HIV infection can increase the stigma indigenous peoples experience, even though there might be high infection rates in other parts of the population. However, just as the collection of data on HIV in indigenous communities may lead to stigma and discrimination, the absence of data can lead to neglect or invisibility.
The absence of reliable data about HIV infection among indigenous peoples has sometimes made it more difficult for concerns about the impact of the HIV epidemic on indigenous peoples to be given priority on national and international policy agendas. There is a risk that resources will instead go to HIV progr
At its fifth session in 2006, the United Nations Permanent Forum on Indigenous Issues, focused on the theme “The Millennium Development Goals and indigenous peoples: redefining the Goals’. At this session, the permanent Forum expressed it s support for the Toronto Charter: The Toronto Charter – Indigenous Peoples Action Plan on HIV/AIDS 2006, where indigenous peoples defined the challenges and action required. This plan, launched at the 16th World AIDS Conference held in Toronto, demands that indigenous peoples must be at the centre of HIV health responses that affect indigenous peoples and their communities. The Toronto Charter considers indigenous peoples’ holistic view of health which includes the physical, social, mental, emotional and spiritual dimensions, all of which need to be considered and emphasized as part of indigenous peoples’ right to determine their own health priorities.
As previously stated, in a number of countries indigenous peoples bear a disproportionate share of the HIV/AIDS epidemic. This is not only due to their lack of access to mainstream HIV education and health services, but also due to the fact that these services are often not relevant to nor address the needs of indigenous peoples. HIV/AIDS is another challenge concerning the rights of indigenous peoples to maintain their cultural identity and heritage.
In the context of HIV/AIDS, the enjoyment of the right to health and life depend in part of being empowered to develop HIV prevention and support programmes which are effective and based on all four elements of life: the physical, emotional, mental, and spiritual, all of which are intricately woven together and interact to support a strong and healthy person. Balance extends beyond the individual realm, because good health and healing also require that an indigenous person lives in harmony with others, their community, and the spirit worlds.