42 HEALTH RIGHTS and urban women in conditions affecting health. ICERD calls on state parties to guarantee the right of everyone, inter alia, to public health and medical care.2 Article 25 of the ILO’s Indigenous and Tribal Peoples Convention (No. 169) specifically addresses the rights of indigenous peoples to health. At the regional level, a number of treaties also set out the right to health.3 A review of these treaties, together with interpretive documents, makes it clear that the right to health includes: (1) health care and healthy conditions – including environmental and living conditions and (2) effective participation in decisions affecting people’s well-being.4 In relation to indigenous peoples, ILO Convention No. 169 stresses that health services should be community-based, and planned and administered in cooperation with the peoples concerned, taking into account their traditional preventive care healing practices and medicines. Paul Hunt, the Special Rapporteur on the Right to Health has specifically called for governments and other actors to ensure participation in the formulation, implementation and monitoring of health policies and programmes.5 While not yet adopted, the Draft Declaration on Indigenous Peoples Article 31 explicitly connects health to selfdetermination. Participation of indigenous peoples in decisions affecting their own health entails greater respect for the use of traditional medicines and healing practices on the part of formal health systems, training of indigenous health workers, the use of indigenous languages in transmitting health information, and creating accountability to indigenous communities for policy and programmes that affect their health, including displacement of communities from their land.6 There is also a separate right to a healthy environment, which was first recognized in the 1972 Stockholm Declaration. The UN Working Group on Indigenous Populations has highlighted the importance of a healthy environment to indigenous peoples. In the Inter-American System, the Protocol of San Salvador distinguishes between the right to health and the separate right to a healthy environment. Article 24 of the African Charter on Human and Peoples’ Rights also provides for a separate right to a healthy environment. In the Ogoni case, the African Commission found a violation of Article 24 of the ACHPR, among other provisions.7 The CESCR’s General Comment No.15 on The Right to Water, protects a critically important element of the right to a healthy environment for indigenous peoples and minorities.8 At the domestic level, the right to health is recognized in over 70 national constitutions and in federal legislation in many countries around the world. Even in those countries that have not incorporated the full dimensions of ICESCR Article 12 into their domestic legislation, the right of minorities and indigenous peoples to be free from discrimination in access to health care is widely protected. Many constitutions provide directive principles to the effect that the state has

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