A/HRC/33/56 55. Mr. Tsykarev referred to the outcomes of an expert seminar on indigenous peoples and the right to health held on 26 and 27 of May 2016 in the Russian Federation to discuss regional challenges and best practices pertaining to health issues. Participants had, for example, outlined that States must create innovative models that would make it possible to increase access to public health services, including for those who live a nomadic life or live in remote and inaccessible areas. He also highlighted the need to consider the close interconnections between health, livelihoods and ecology. He called upon States to allocate adequate finances to health care, but underlined that many steps could be undertaken within existing resources, including developing paramedicine by involving indigenous health-care practitioners. 56. The ensuing interventions by participants demonstrated widespread support for the main issues raised in the draft study. A particular emphasis was placed on the following issues: the holistic nature of indigenous approaches to health; the need to address maternal and infant mortality; the participation of indigenous peoples in the design of health-care services so that those services incorporated intercultural approaches and were culturally sensitive; disaggregated data on the health of indigenous peoples; the need for Western medicine to recognize the value of indigenous approaches to medicine; and the strengthening and protection of traditional knowledge about health. A central theme among the statements of all participants was that self-determination could only be fully achieved if the right to health was protected. 57. Participants highlighted issues that they believed needed to be further emphasized in the study. They included the need for health professionals and indigenous health workers to be trained in the treatment of psychosocial diseases and mental illness. At present, many indigenous persons who suffered from those conditions due to exposure to violent crimes and conflict-related trauma (including intergenerational trauma) did not have access to treatment. Participants also emphasized the need to recognize the importance of collective well-being and the role of families in the realization of the right to health, particularly for indigenous children and adolescents. 58. Several participants noted that a greater emphasis needed to be placed on language as an important component of the right to health, both in relation to ensuring that healthcare services were provided in indigenous languages and the role that language played in the healing process. Comments were also made on the relationship between poor health outcomes and environmental degradation caused by extractive industries and large-scale development, as well as the intersection between food, nutrition and the right to health. Finally, a significant number of participants and States called on the Expert Mechanism to provide support and advice on county-specific health issues, in conjunction with WHO, and noted the need for WHO to appoint a focal point on issues relating to the health of indigenous peoples. 59. Chief Littlechild supported the call made by Ms. Yamada to attend to the rights of indigenous peoples in voluntary isolation. He also highlighted the issue of uranium mining and its negative impact on indigenous peoples’ health, and the inclusion of a reference to the “famine and pestilence clause” and the “medicine chest clause” of Treaty No. 6 in Canada. 60. In closing, Mr. Barume reiterated the link between self-determination and the right to health. He highlighted some of the key concerns that had come up during the discussion, including: the strong correlation between historical trauma and the current health conditions faced by indigenous peoples; the important role of indigenous languages in the right to health; the impact of environmental toxins and chemical contamination on not only air and water but entire food systems; the need to develop good practices in the funding models for indigenous health systems; the health challenges faced by indigenous peoples living in conflict and detention; the central role that consultation and free, prior and informed 14

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