46 HEALTH RIGHTS Enforcement mechanisms Some committees, such as CERD, allow for urgent action petitions in emergency situations involving environmental or other health issues. Shadow reports to treaty bodies can also be an important form of advocacy but should not simply repeat general health data or denounce the government. Key questions to address include: what are the most urgent health-related issues facing their (minority or indigenous) population? Is there systematic discrimination against their population within the health system? What are the actual results of government’s policies and other laws aimed at promoting the right to health for minorities or indigenous peoples? What are some of the concrete obstacles faced in achieving the right to health for minorities or indigenous peoples (e.g. in terms of availability, accessibility, acceptability, quality)? 21 Focusing on a very few issues and providing evidence (ideally budgetary and statistical, in addition to testimonial), as well as making reference to past reports by the government, will be important in conveying the message to the committee. Indigenous peoples and minorities can work with the Special Rapporteur on the Right to Health, the Special Rapporteur on Indigenous Peoples (currently Rudolfo Stavenhagen) and the Special Rapporteur on Contemporary Forms of Racism, Racial Discrimination, Xenophobia and Related Intolerance (currently Doudou Diene), as well as potentially with other Special Rapporteurs, in various ways to promote enforcement of their health rights. For example, they can request that a Special Rapporteur makes a country visit to examine issues of particular concern to their population. (Note however that Special Rapporteurs are very limited in the site visits they can make per year). Groups can also notify the Special Rapporteurs of cases involving situations of serious violations of their health rights or systemic discrimination resulting in such violations. Unlike the criterion for submitting a communication, there is no condition of exhaustion of domestic remedies before contacting a Special Rapporteur. Note that the two themes which the Special Rapportuer on the Right to Health has chosen to focus his mandate on are: (1) poverty and the right to health. (2) stigma and discrimination and the right to health, both of which can disproportionately affect minorities and indigenous peoples.22 With regard to the World Bank Inspection Panel, most of the cases brought to the Panel involve environmental claims that relate to the right to health and a healthy environment. In some cases, claims brought and the reports issued by the Inspection Panel have caused the Bank to withdraw support for the project.23 In other cases, indigenous peoples and minorities have successfully challenged their exclusion from compensation plans provided by the Bank.24 When domestic remedies are exhausted or inapplicable, advocates may consider bringing petitions to regional human rights institutions. Although there are a

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