A/HRC/39/17/Add.2 E. Economic, social and cultural rights 71. Indigenous peoples face major obstacles to the realization of their economic, social and cultural rights. Long-standing structural discrimination has resulted in marginalization and multidimensional poverty, as well as a lack of adequate and culturally appropriate basic services. This is reflected in the specific challenges faced by certain sectors of the indigenous population, such as women, children and young people, migrants, victims and forcibly displaced persons. This discrimination is also illustrated by the lack of access to water and sanitation; the exploitation and contamination of water sources by megaprojects to the detriment of people’s health; and the restrictions on community management of water. 72. Official statistics confirm that indigenous peoples are at a clear socioeconomic disadvantage, as reflected by poverty rates, levels of education and employment, and other indicators. It is estimated that 71.9 per cent of the indigenous population live in poverty or extreme poverty, compared with 40.6 per cent of the national population. Overall, 55.5 per cent of the indigenous population live in municipalities that are considered highly or very highly marginalized and 87.5 per cent of indigenous municipalities, which are defined as those where at least 70 per cent of the population is of indigenous origin, are considered highly or very highly marginalized. 15 Indigenous persons have access to fewer formal employment opportunities and may therefore be excluded from employment benefits and other benefits.16 73. According to government information, the life expectancy of indigenous persons is seven years lower than that of the general population and infant, preschool-age child, school-age child and maternal mortality rates among the indigenous population are above the national average, mainly because of preventable diseases, such as infectious and parasitic diseases. Over the last 13 years, the people’s health insurance scheme was reportedly expanded to include over 5 million indigenous persons, who can make use of the scheme anywhere in national territory. Measures have also been taken to increase cultural awareness within the health system. However, there are still complaints about the lack of appropriate facilities and medical staff in indigenous communities and about cases of discrimination against indigenous persons in health centres. Traditional health systems ought to receive greater recognition and support. 74. According to indigenous representatives, most government programmes on indigenous affairs are prepared without the meaningful participation of indigenous persons; moreover, they are not culturally appropriate and their impact is limited by the fact that they are welfare-based. The Special Programme for Indigenous Peoples was set up to coordinate action in fields such as access to justice, food, health, education and housing. However, in 2017, the budget of the National Commission for the Development of Indigenous Peoples, the main entity responsible for implementing policies relating to indigenous peoples, was cut by 51.1 per cent. The Special Rapporteur is concerned about the effects that such drastic budget cuts are likely to have. Women 75. Indigenous women face serious discrimination on the basis of gender and ethnicity, within and outside their communities, which hinders their access to property, justice and health services and their enjoyment of other rights. 76. Discrimination with respect to land tenure is often due to internal cultural factors and the agrarian system. The current agrarian bodies are predominantly made up of men and indigenous women do not have full access to land, since it is inherited by men. There has also been a failure to take into account certain social changes in communities, such as 15 16 GE.18-10617 See National Commission for the Development of Indigenous Peoples, Indicadores socioeconómicos de los pueblos indígenas de México (Socioeconomic indicators relating to indigenous peoples in Mexico), 2015, p. 18. See National Council for the Evaluation of Social Development Policies, Informe de evaluación de la política del desarrollo social 2016 (2016 social development policy evaluation report), p. 63. 13