A/HRC/25/56 C. Health 62. According to Paul Hunt, former Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health (2002–2008): We live in a world of profound health inequalities, a world in which a person’s health and the quality of care they receive is determined by their ethnicity, the language they speak or their religious and cultural beliefs. In almost every country in the world, minorities and indigenous peoples are among the poorest and most vulnerable groups, suffer greater ill-health and receive poorer quality of care than other segments of the population. They die younger, suffer from higher rates of disease and struggle more to access health services compared to the rest of the population. More often than not, this ill-health and poor healthcare is a symptom of poverty and discrimination.28 63. Minorities frequently live in remote or inaccessible localities and often Government health-care facilities and provision do not reach there. In many countries, the health-care infrastructure, including hospitals or clinics, is simply not available in minority areas. In some cases, health-care provision comes at a cost relating to treatment and drugs that poor communities — often minority communities — cannot afford. The infrastructure to ensure safe drinking water and hygiene facilities may also not reach areas where minorities live. In some cases the provision of health care is also limited due to discrimination. New attention to minorities and strategies to address their health situations are urgently required. A greater understanding of their health needs is essential and requires research and data collection. 64. In Nepal, according to UNDP, life expectancy of a Hill Dalit was 61 in 2009 compared to 68 for a higher caste Hill Brahmin. A 2011 Open Society Foundation study reported that Roma are disproportionately unvaccinated, have poorer than average nutrition and experience higher rates of infant mortality and tuberculosis. There is evidence that life expectancy among Roma communities is 10 to 15 years lower than in non-Roma communities.29 In Cameroon, visited by the Independent Expert in 2013, the access to health and health situation of Pygmy communities is extremely poor relative to other population groups. In Pakistan, UNICEF reports that the maternal mortality ratio for Baluchistan — largely inhabited by the Baluchi minority — is 758 per 100,000 live births, almost three times the national average of 276 per 100,000 and far from the MDG target of 140 per 100,000.30 D. Growth and employment 65. Economic exclusion is a cause, a manifestation and a consequence of discrimination against minorities. As was strongly emphasized at the World Conference against Racism in Durban in 2001, poverty can contribute to the persistence of racist attitudes and practices, which in turn generate more poverty, a situation coined as the “vicious cycle of poverty”. 28 29 30 Minority Rights, State of the World’s Minorities, p. 7. See http://web.ua.es/en/actualidad-universitaria/2013/septiembre2013/septiembre2013-23-30/lifeexpectancy-in-roma-communities-is-10-15-years-less-than-that-of-those-in-non-romacommunities.htm Fatima Raja, Pakistan: Annual Report 2011 (UNICEF Pakistan, 2012). Available from www.unicef.org/pakistan/Annual_Report_2011.pdf. 17