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1 May 2002
INDIGENOUS PEOPLES AND HEALTH A Briefing Paper For The Permanent Forum On Indigenous Issues
Prepared by the Committee on Indigenous HealthAnnex 4
COIH Letter to the Global Fund to Fights AIDS, Tuberculosis and Malaria
To
Anders Nordstrom
GLOBAL FUND TO FIGHT AIDS, TB
AND MALARIA FAX: +41 22 791 9461
24 February 2002
Dear Mr. Anders Nordstrom,
I am writing this letter on behalf of the Committee on Indigenous Health, constituted in 1997 in Geneva during the session of the UN Working Group on Indigenous Populations. We express optimism that a global fund of this nature has been constituted and wish you success in handling a very difficult and challenging task. We take this opportunity to communicate our commitment to the health issues of indigenous peoples worldwide and our support to this initiative.
We have worked for these past years to advocate and inform relevant institutions and mechanisms worldwide about the need to address the extremely precarious situation of indigenous peoples - in particular the situation regarding their survival and health. The Working Group has been debating this issue for years now and accumulated a large body of information. It has made some very key recommendations to the World Health Organisation including its Executive Board and General Assembly over the past years.
These include the areas of: 1. access to healthcare services for indigenous groups and communities 2. audit of national health programmes receiving international financial and technical support to ensure inclusion of indigenous peoples 3. prioritising, in areas of research, information gathering, dissemination of the information, response to new medical emergencies the needs of particularly vulnerable indigenous population 4. meaningful and close consultations with indigenous peoples and their representatives providing technical and financial assistance to indigenous organisations with health expertise so that they can collaborate with governments and better the services they provide 5. develop and implement appropriate ethical standards
The Committee, in its statement to the Working Group on Indigenous Populations last year, had referred to the fund. In this statement, we had drawn the special attention of the working group to our concerns regarding the nature of accountability, participation, equity and transparency in the administration and utilisation of the fund.
We note that the Board of the fund has taken steps to address this issue. But we feel that these steps may be in danger of being totally negated in the very process adopted.
Secondly, and in reference to the issue raised in the preceding paragraph, as a focal point member for indigenous peoples worldwide deeply concerned about their health issues, we have been immediately and widely circulating the recent announcement within our network. We had tendered our apologies (on behalf of the GFATM secretariat!) that the information is not widely accessible due to lack of timely versions in other major international languages, such as Spanish, Russian and French - languages widely spoken in some regions where large numbers of indigenous peoples exist today. This is particularly relevant when deadlines are so narrow and the preparatory work envisaged is so vast.
Thirdly, the decision making structure and the representation in the regional consultation process seem to be heavily biased towards AIDS with very little representation of groups, NGOs, experts representing Tuberculosis and Malaria. This could be a very serious mistake because Tuberculosis and Malaria by themselves constitute major health problems and killers among very vulnerable populations such as indigenous and tribal peoples, mountain peoples, forest peoples, refugees and internally displaced peoples, migrants, particularly women and children. Tuberculosis and Malaria have both recently had a comeback globally and existing programmes have been forced to be re-evaluated and drastically revised. The results of these revised strategies and programmes are still filtering in and a true picture from different regions has not emerged yet.
Moreover, the time frame of the proposal processing process and the haste with which the TRG is to be constituted has posed very major hurdles to the very intent and mandate of the GFATM. This is a confusing and regrettable paradox.
We draw your attention to the findings and concerns raised by a recent study of the GAVI (Global Alliance for Vaccines and Immunisation) conducted by The Lancet. This study has highlighted some very key areas that the Global Fund could learn from. Whereas, the world is optimistically seeing globalisation’s manifestations in many arenas of international activity, in the area of health, the pitfalls of such initiatives as the GFATM are many.
We, on behalf of the long-suffering indigenous peoples of the world, draw your attention to these pitfalls, which would seriously jeopardise the success of the Fund:
1. A danger of strong bias in implementation and benefits to favour only the countries that can comply with the timeframe and conditions set by the GFATM - countries with the wherewithal for research, infrastructure, technically competent human resources and capacity to handle complex health programmes such as TB, Malaria, AIDS;
2. Lack of wide consultations and collaborations among the players and stakeholders thereby leading to an undermining of legitimacy;
3. Conflict between political pressures and the Fund's technocratic approach to the problems of TB, Malaria and AIDS that may become very difficult to resolve;
4. Putting performance based indicators foremost for allotment or continuing access to the fund instead of needs of vulnerable peoples - many countries would then fuzz statistics and evaluation results to gain funds
5. The rapid pace of implementation adopted by the fund which has very little pledged still, would squander this chance to reach the really needy populations.
6. The reliance on country mechanisms could pose serious problems for indigenous peoples whose territories and living space transcends recognised State boundaries and borders. We strongly recommend that indigenous organisations and institutions approaching the Fund and representing such situations be given special attention while giving due recognition of the specific situations.
6. In many parts of this world, where indigenous and tribal peoples live, there is still considerably prevalent and effective use of traditional medicines and indigenous systems of medicine to address Tuberculosis and Malaria. This is especially true in prevention, among particular sections of the population such as the young and women. These same areas and regions have very little, if at all, formal health services based on Western models in place. No mention of encouraging and promoting such systems and approaches is made in the absence of alternatives.
We recommend that the GFATM:
1. Provide the opportunity for indigenous peoples' representation to be present in decision making and technical appraisal levels of the Fund 2. Adopt a well-measured and inclusive pace of planning to ensure that the global mandate of Fund can be given a chance to become reality. Official language versions of all key documents should be made available simultaneously in order not to handicap those who are not using English as a working language 3. Provide a limited well-tested set of initial steps to go into rather than just handing out funds to countries - to ensure the inclusion principles of gender, best interests of children, best practices, health access equity and sustainability of the programme within countries and not just among countries 4. To include the promotion of and support to traditional and indigenous systems of medicine where these are prevalent, widely accessible and effective.
We hope that you will consider these matter we have brought to your attention very seriously. We reiterate our support and willingness to work in close consultation with the Fund and its Secretariat to fight against the threat of AIDS, Tuberculosis and Malaria among the indigenous communities and peoples of the world.
Yours sincerely,
Dr. D Roy Laifungbam, MPH Co-Chairperson, Committee on Indigenous Health Centre for Organisation Research & Education (CORE) Manipur Lane 3 Basishtapur, Beltola, Guwahati 781028, Assam INDIA TeleFax: +91 361 228730 Email: core_ne@sify.com
PRESENT Members of the Committee on Indigenous Health
Charon Asetoyer Chairperson, Committee on Indigenous Health (Comanche Nation) Elisabeth Bell (Meti Nation) Rhonda Griffiths (Norfolk Island) Jose Carlos Morales (Costa Rica) Germaine Tremmel (Native American Women’s Health Education Resource Center) Member (Contact: Antonio Gonzales) (International Indian Treaty Council) Larissa Abroutina (RAIPON) Abdoulahi Monsarrat (TINHINAN) Emmanuel Lousot (Kenya) Tarcila Rivera Zea (Chirapaq) Naomi Mayers (Australia) Apenisa Ratu (Fiji Island) Silole Mpoki (Contact Lucy Mulenki) (African Indigenous Women’s Organisation) Member (Contact: Vicky Tauli-Corpuz) (TEBTEBBA Foundation Inc.)
Endorsements:
Nicodemus Andris Paskalino Yomaki (Denny) The Institute for Human Rights Study and Advocacy in Papua ELSHAM West Papua
Maire Kipa
Puna Matariki Ltd Aotearoa/NZ
Karen Mills
Puna Matariki Ltd Aotearoa/NZ
Alejandro Argumedo Indigenous Peoples' Biodiversity Network (IPBN) (International) Coordinating Office PERU
Sofia Villafuerte Asociacion Kechua-Aymara ANDES PERU
Pranayan Khisha Parbatya Chattagram Jana Samhati Samiti (PCJSS), Chittagong Hill Tracts Bangladesh
Jason Adawai Pan Pazeh People Plains Aborigine Pazeh People Association Taiwan
Kripa Kirati NIPDISC, Kathmandu Nepal
Dr. Binayak Sen Chhattisgarh Lok Swatantra Sangathan India |
