A/HRC/33/57 Annex Expert Mechanism advice No. 9 on the right to health and indigenous peoples A. General advice 1. The right to health of indigenous peoples is enshrined in multiple international and national instruments, and forms an important part of human rights law. That right is interrelated with various key rights accrued by indigenous peoples, including the rights to self-determination; development; culture; land, territories and resources; language; and the natural environment. 2. Indigenous concepts of health are broad and holistic, incorporating spiritual, environmental, cultural and social dimensions in addition to physical health. Forced cultural assimilation; land dispossessions and the use of indigenous land for the extractive industry; political and economic marginalization; poverty; and other legacies of colonialism have led to a lack of control over individual and collective health and undermined the realization of indigenous peoples’ health rights. 3. Health statistics the world over illustrate indigenous peoples’ disadvantaged position in terms of access to quality health care and their vulnerability to numerous health problems, including communicable and non-communicable diseases. Indigenous women, youth, children and persons with disabilities face particular challenges, including higher maternal mortality and suicide rates, and face multifaceted forms of discrimination. B. Advice for States 4. States should recognize and enhance the protection of the right to health of indigenous peoples by ratifying and incorporating into their domestic law the Indigenous and Tribal Peoples Convention, 1989 (No. 169), of the International Labour Organization, the International Covenant on Economic, Social and Cultural Rights and other key human rights treaties, and by taking concrete measures to implement the United Nations Declaration on the Rights of Indigenous Peoples. 5. States should recognize the inherent right of indigenous peoples to determine their own futures, including in terms of exercising control over their own health. States should consider entering into treaties with indigenous peoples, explicitly safeguarding rights to self-determination and health, and implement relevant treaty commitments where they already exist. 6. Health is an indispensable component of indigenous peoples’ very existence, survival and entitlement to live in dignity and determine their own futures. States should therefore seek the free, prior and informed consent of indigenous peoples before implementing laws, policies or programmes affecting their health or health rights. 7. States should implement national plans for indigenous peoples’ health with the full participation of indigenous peoples and with their free, prior and informed consent, or create or amend existing national health plans to incorporate specific programmes and policies for indigenous peoples. States should also incorporate the right to health into national action plans for the implementation of the United Nations Declaration on the Rights of Indigenous Peoples. 21