A/HRC/12/34/Add.2 page 18 60. The Government has developed an important redistributive programme, known as the Family Stipend (Bolsa Família), to address extreme poverty in Brazil. Cash is transferred to poor families according to the level of poverty per capita and is based on the number of children and adolescents in the household. The Government reports that nearly 56,000 indigenous families receive the Family Stipend benefit, but that the programme needs to be adapted to the sociocultural realities of indigenous peoples in order to better enable their development on the basis of their own values and ethnographic patterns. 61. A noteworthy development initiative that specifically targets indigenous peoples is the “Indigenous Portfolio” (Carteira Indigena), a programme implemented in partnership with the Ministry of Social Development, the Ministry of Environment and FUNAI to support food security, income generation and cultural enhancement projects proposed and carried out by indigenous communities themselves. This programme, along with several other Government and NGO development initiatives, have achieved positive results in many cases, such as in the Cunuri community in Alto Rio Negro, Amazonas, helping to better social and economic conditions. Still, members of this community, as well as other indigenous persons interviewed by the Special Rapporteur in various localities, many of them in positions of leadership, reported that their communities and organizations are not effectively in control of the design and delivery of the programmes. In order to be successful and break from cycles of dependency, development programmes for indigenous peoples need to be both culturally appropriate and serve to enhance indigenous autonomy, including in the management and delivery of the programme benefits. The Special Rapporteur acknowledges the substantial financial resources that the Government of Brazil has devoted to the Indigenous Portfolio and other development initiatives for the benefit of indigenous peoples, and the steps it has taken to enhance indigenous participation in their implementation. B. Health 62. By all indicators, indigenous peoples in Brazil suffer from poor health conditions; malnutrition, dengue, malaria, hepatitis, tuberculosis and parasites are among the frequent ailments and principal causes of death. Indigenous women suffer disproportionately from cervical cancer, most likely due to lack of early detection related to scant adequate pre- and post-natal care. Indigenous communities also on the whole suffer from alarming rates of alcoholism and suicide. 63. The poor health conditions are often tied to precarious land tenure situations. As already mentioned, the highest indigenous infant mortality rate is in the State of Mato Grosso do Sul, where indigenous communities face scarcity of land and consequent inadequate access to food (see paragraphs 46-47 above). The remoteness of some indigenous communities is clearly another barrier to access to health services. During the visit, representatives of FUNASA, the Government health agency, reported difficulties in providing health services in remote areas, especially the Vale do Javari region, where its small population of approximately 3,700 is spread throughout the entire region, and where indigenous peoples have expressed feeling “abandoned to death”. In response FUNASA has undertaken special measures to provide health services for the remote indigenous communities of this region, although dire conditions persist.