A/HRC/48/54 systems of indigenous peoples; their rights to self-determination and self-governance; meaningful participation in all decision-making processes that may affect them; and nondiscrimination and equality. 28. Indigenous peoples have the right to the enjoyment of the highest attainable standard of physical and mental health, free of discrimination. That requires States to implement culturally appropriate access to health facilities in or near indigenous communities and to combat systemic racism in national health-care systems. 29. Indigenous peoples have been severely and disproportionately affected by COVID-19 and face higher risks of infection and death from it,40 especially as new variants of the virus continue to emerge. Despite the increased vulnerability of indigenous peoples to the virus caused by lack of basic health services, sanitation and other infrastructure41 vaccine roll-out for indigenous peoples, in particular those living in remote areas, has mostly not been prioritized. Canada and Brazil have taken certain measures to prioritize indigenous peoples for vaccination.42 In the Amazon, vaccines are reaching some isolated communities who are experiencing high rates of contagion and death.43 30. Traditional doctors, ancestral experts and community promoters are central to the recovery plans, due to their cultural and medical knowledge and their role in coping with the pandemic. Indigenous organizations are calling for the implementation of “culturally appropriate vaccination actions, paying attention to local practices, collective memory of epidemics and vaccination campaigns, audiovisual and printed materials in the indigenous languages”.44 31. Education campaigns are necessary to combat the spread of misinformation about vaccines. Vaccine scepticism and mistrust of the health authorities has deep roots among indigenous peoples who have experienced centuries of mistreatment. Public health officials need to acknowledge the historical harm done to indigenous peoples and communicate evidence of vaccine safety in culturally appropriate ways to overcome distrust of the medical system. 32. Some State vaccination plans restrict the eligibility of indigenous peoples to those living in recognized and demarcated indigenous lands. 45 As a result, indigenous peoples living in cities and unrecognized indigenous lands are excluded from national vaccination plans.46 States should respect the rights of indigenous peoples to self-identify and not exclude from national vaccine plans indigenous individuals who reside in urban areas or remote locations. Vaccine delivery also needs to consider the specific situation of peoples living in voluntary isolation and initial contact, nomadic and semi-nomadic communities and indigenous peoples living in urban areas. 33. Swift international cooperation is required for the equitable and universal distribution of COVID-19 vaccines. “Vaccine nationalism” risks infringing the extraterritorial obligations of States and the human rights related to the right to health, as it results in a shortage of vaccines for those who are most in need in the least developed countries.47 States should ensure that vaccines are available to all persons free of discrimination, including indigenous peoples, and should support programmes such as COVAX, the global initiative for equitable access to COVID-19 vaccines. 40 41 42 43 44 45 46 47 See A/75/185; submission by Instituto de Pesquisa e Formação Indígena; and Asia Indigenous Peoples Pact, “Covid-19, a special volume on indigenous women and indigenous persons with disabilities” (November 2020). See submission by Ogiek Peoples’ Development Program. See submission by Tsilhqot’in Nation and Moira Warburton (Reuters), “Northern territories, home to many of Canada’s indigenous people, lead COVID-19 vaccine rollout”, 31 January 2021. See submissions by Centro de Investigación y Educación Popular/Programa por la Paz; la Fundación Gaia Amazonas y la Fundación Natura; Amazon Cooperation Network and Cultural Survival. See submission by Instituto de Pesquisa e Formação Indígena. See submission by Cultural Survival. See submission by Amazon Cooperation Network. See E/C.12/2021/1. 9