This Planetary Health Alliance (PHA) Policy Note aims to elevate the views expressed by Indigenous leaders in the 2023 UN Permanent Forum on Indigenous Issues (1) (UNPFII) and call attention to how Planetary Health work can align with UNPFII.
UNPFII has convened annually since 2000 to raise discussion from Indigenous leaders on priority issues. These Forums provide essential input to UN agencies, governments, and across regions and Indigenous Peoples and their organizations, and as well, serve an advisory function to the Economic and Social Council (ECOSOC), a central organ of the United Nations system.
Five of these past sessions have focused specifically on the environment: (2006, 2007) Territories, lands and natural resources; (2008) Climate change, bio-cultural diversity and livelihoods: the stewardship role of Indigenous Peoples and new challenges; (2018) Indigenous Peoples’ collective rights to lands, territories and resources; (2023) Indigenous Peoples, human health, planetary and territorial health and climate change: a rights-based approach. To note, 80% of the world's remaining biodiversity (2) is currently stewarded by Indigenous Peoples.
The 2023 session arrives during the UN International Decade on Indigenous Languages (2022-2032)3, and at a time when recognition of the role of Indigenous Peoples’ perspectives in policymaking, though underrepresented, has gained traction across intergovernmental dialogues and stakeholder groups. For instance, in 2022, the Intergovernmental Panel on Climate Change (IPCC) 6th Assessment report mentioned the role of colonialism in climate vulnerability4, the Kunming-Montréal Global Biodiversity Framework highlighted the contribution and rights of Indigenous Peoples and diverse value systems as central to its operationalization5, and in a pivotal move, the UN General Assembly adopted the human right to a clean, healthy, sustainable environment(6) reinforcing rights-based approaches to decision-making and the efforts of environmental defenders, many of whom are Indigenous, worldwide.
Planetary Health aligns with the Indigenous Peoples’ relational approach to nature and to health. In a collaborative global study by Indigenous leaders7 commissioned by UNPFII in 2022 to educate policymakers and to guide UN agencies and UN member states on Indigenous Peoples’ issues and strengthen work to achieve the Sustainable Development Goals (SDGs) and the 2030 Agenda, UNPFII expressed the centrality of nature like this: “An interdependent relationship exists between Indigenous Peoples and their local ecosystems. The health of the land and Peoples are synonymous, nurtured through relationships with the physical and social environments, providing a strong basis for health and overall well-being” (para 24). The approach to health is further described as “Indigenous Peoples tend to approach health as an equilibrium of spirituality, traditional medicine, biodiversity and the interconnectedness of all that exists” (para 1). In line with this, an objective of Planetary Health science is building a body of evidence documenting the interconnection between human health and the state of natural systems.
Planetary Health recognizes the centrality of nature to the health of humans and all of life on Earth. PHA also values the diverse knowledges, environmental stewardship, intergenerational learning, and health equity linked to biocultural diversity. Nature and the interconnection of the health of all species and the state of their environments are central to a Planetary Health governance framework. A recent global consensus perspective on the Indigenous Determinants of Planetary Health8 outlines an integrated way of thinking that charts a valuable path forward for the foundation of this framework.
Interrelated, concurrent, and compounding global environmental changes, and the “triple planetary crisis”9 of biodiversity loss, climate change, and pollution, cannot be solved without an integrated Planetary Health governance framework. Anthropogenic environmental change, human health and wellbeing, the right to a clean, healthy, sustainable environment, and Indigenous Peoples’ rights have been approached as discrete and separate issues, but they are, in fact, intertwined and require a more holistic set of approaches, policies, and metrics.
To further respect the rights of Indigenous Peoples, Planetary Health governance must underscore two additional issues, highlighted by UNPFII 2023: the importance of truth, transitional justice, and reconciliation processes (10), and the development and implementation of Free, Prior, and Informed Consent (11) practices as part of routine due diligence.
PHA welcomes the leadership of UNPFII in shaping a new narrative with its 2023 theme on “human health, planetary and territorial health and climate change”. PHA also welcomes the development of a guidance document on Indigenous Determinants of Health in the 2030 Agenda for Sustainable Development (7) as a critical complement to the body of work on public and global health and as a concrete application of the UN Declaration on the Rights of Indigenous Peoples (UNDRIP) (12).
The holistic framework for health articulated in the 2023 report on Indigenous Determinants of Health accurately reflects Planetary Health science that shows human health cannot continue to flourish while the natural life support systems we depend upon continue to decline. We align with this report and framework, and advocate for its broad integration into practices of the World Health Organization and other health-related agencies, and into a post-SDG framework.
PHA, as proposed by the UNPFII 2023 study, supports the incorporation of the Indigenous Peoples’ relational approach to nature and health into existing frameworks on social and ecological determinants of health and recognizes the importance of culturally-informed determinants of health. This is one way health systems can shift to address coloniality.
PHA endorses rights-based approaches. The human right to a clean, healthy, sustainable environment, the right to health, and the rights of Indigenous Peoples must be seen as interconnected and made explicit in intergovernmental negotiations as an essential element of an integrated Planetary Health governance framework.
Indigenous Peoples’ relational views of nature and of health and Planetary Health must be central to the post-2030 Agenda.
PHA is actively working to integrate the Planetary Health Education Framework (13) into curricula, incorporate Planetary Health into national health institution planning, develop Planetary Health impact assessments and a Planetary Health policy strategy, and welcomes input and support from UNPFII Members, and all Indigenous Peoples in this work.
We call on the Planetary Health community to draw on the work of the UNPFII and UNDRIP and expand recognition of Indigenous Peoples and diverse knowledges and their role in policies on both health and the environment. Recent Planetary Health policy guidance tools such as the São Paulo Declaration on Planetary Health (14) and the Academic Health Institutions' Declaration on Planetary Health (15), mobilized by the Association of Faculties of Medicine of Canada, have begun this work, but much more needs to be done.
The author of this document is Elizabeth Willetts. We appreciate the voluntary review of this document provided by Hindou Oumarou Ibrahim, member of Mbororo pastoralists, Nicole Redvers, member of Deninu K’ue First Nation, and Sione Tuitahi, member of six Indigenous nations of the Moana (Pacific Ocean).
©2023 Planetary Health Alliance
1. UN Permanent Forum on Indigenous Issues, see https://social.desa.un.org/issues/indigenous-peoples/unpfii
2. UN General Assembly, 71st Session. (29 July 2016) Rights of Indigenous People’s: Note by the Secretary General on the report of the Special Rapporteur of the Human Rights Council on the rights of Indigenous Peoples, corresponding to Council resolution 30/4. [A/71/229] https://www.un.org/development/desa/indigenouspeoples/wp-content/uploads/sites/19/2019/01/N1624109.pdf
3. Un Department of Economic and Social Affairs, see https://www.un.org/development/desa/indigenouspeoples/indigenous-languages.html
4. IPCC. (2022) Climate Change 2022: Impacts, Adaptation and Vulnerability. Contribution of Working Group II to the Sixth Assessment Report. Summary for Policymakers, see Section B.2.4, doi:10.1017/9781009325844.001.
5. CBD. (19 December 2022) 15th Conference of the Parties, Decision 15/4 Kunming-Montréal Global Biodiversity Framework [CBD/COP/DEC/15/4]. https://www.cbd.int/doc/decisions/cop-15/cop-15-dec-04-en.pdf
6. UN General Assembly, 76th Session. (26 July 2022) The human right to a clean, healthy, sustainable environment. [A/76/L.75]. https://digitallibrary.un.org/record/3982508?ln=en
7. UNPFII. (23 January 2023) 22nd Session, Indigenous Determinants of Health in the 2030 Agenda for Sustainable Development. [Report, E/C.19/2023/5]. https://undocs.org/Home/Mobile?FinalSymbol=E%2FC.19%2F2023%2F5&Language=E&DeviceType=Desktop&LangRequested=False
8. Redvers & others. (2022) Indigenous Determinants of Planetary Health: an Indigenous consensus perspective. The Lancet – Planetary Health. 6(2) e156-163. doi: https://doi.org/10.1016/S2542-5196(21)00354-5
9. UN Environment Programme Medium Term Strategy 2022-2025. For People and Planet: The United Nations Environment Programme strategy for tackling climate change, biodiversity and nature loss, and pollution and waste from 2022—2025. https://wedocs.unep.org/bitstream/handle/20.500.11822/35875/K2100501-e.pdf
10. UNPFII. (26 January 2023) 22nd Session, Note by the Secretariat: International expert group meeting on the theme “Truth, transitional justice and reconciliation processes.” [E/C.19/2023/3]. https://undocs.org/Home/Mobile?FinalSymbol=E%2FC.19%2F2023%2F3&Language=E&DeviceType=Desktop&LangRequested=False
11. UNPFII. (26 January 2023) 22nd Session, Note by the Secretariat: Implementing free, prior and informed consent in the context of Indigenous Peoples [E/C.19/2023/6]. https://undocs.org/Home/Mobile?FinalSymbol=E%2FC.19%2F2023%2F6&Language=E&DeviceType=Desktop&LangRequested=False
12. UN General Assembly. (13 September 2007) 61st Session, United Nations Declaration on the Rights of Indigenous Peoples. [Resolution 61/295]. https://social.desa.un.org/sites/default/files/migrated/19/2018/11/UNDRIP_E_web.pdf
13. PHA. (2021) Planetary Health Education Framework. doi:10.13140/RG.2.2.27505.20320. https://www.planetaryhealthalliance.org/education-framework
14. PHA and Universidad de São Paulo. (6 October 2021) São Paulo Declaration on Planetary Health. https://www.planetaryhealthalliance.org/sao-paulo-declaration
15. Association of Faculties of Medicine Canada. (April 2023) The Academic Health Institutions Declaration on Planetary Health. http://www.afmc.ca/initiatives/planetaryhealthdeclaration/