Pandemic treaty talks: Is there room for indigenous knowledge?

An Indigenous man wearing a protective mask during a protest against President Jair Bolsonaro's mining politics regarding Indigenous lands, demanding Brazilian environment minister Ricardo Salles' resignation, outside the ministry of the environment in Brasilia on 20 April 2021, during the COVID-19 pandemic. (Keystone/AFP/Sergio Lima)

As the WHO attempts to keep the attention of the international community firmly on the pandemic ball in an bid to prevent future health crises, communities most affected by Covid-19 are feeling left out of health discussions. Indigenous groups are calling for inclusion in the dialogue.

Even as global temperatures rose at increasingly alarming rates, it took years before anyone began to listen to their message. Yet year after year, representatives of Indigenous communities attended global climate and biodiversity summits, striving to share their experience with climate change and their traditional knowledge as guardians of vast natural areas.

Three years after the start of the Covid-19 pandemic, it could seem like a case of déjà-vu. In spite of being the most affected by the health crisis and often having to fend for themselves, Indigenous people have still not found a place at the table of global health discussions. In the Amazon region, communities struggled during the pandemic as health services collapsed and oxygen supplies ran low. Many turned to natural cures as the virus spread and vaccine distribution trailed.

“With the pandemic, we went back to appreciating our traditional knowledge regarding plants and health protocols,” Gregorio Díaz Mirabal, chief coordinator of the Indigenous Organisations of the Amazon Basin, or COICA, an association of South American Indigenous groups, said. “With all of the pressure there is on nature, with pressure on resources, cattle raising, illegal mining and logging, plants and insects are disappearing. It’s the type of natural life that provides life to humans, and with that pressure, there will be more diseases.”

Fires and deforestation are causing further pressure on freshwater resources, while Indigenous land defenders are assassinated, and community members are moving to cities as their lands are encroached upon, he told Geneva Solutions in a phone interview from Ecuador.

This month, a select number of countries will huddle at the World Health Organization (WHO) to continue discussing a future pandemic treaty, which aims to improve the response to future global health emergencies, while the UN agency promotes the concept of one health, which emphasises the effects that a healthy environment has on human health.

During the pandemic, One Health gained ground, as experts pointed to the spillover risk of diseases from animal species to humans amid growing pressure on their natural habitats. While the origins of Covid-19 in China may never be known, early studies suggested the deadly virus may have come from animals.

A first draft of the pandemic treaty, scheduled to be adopted in 2024, circulated among delegates on Monday and seen by Geneva Solutions, mentions one option to include a section on one health and another one to scrap it altogether. In the first option, countries would commit “to promote and implement a one health approach at national, and, as appropriate, at regional and global levels”. It calls for a strengthening of synergies “with other existing instruments that address the drivers of pandemic, such as climate change, biodiversity loss, ecosystem degradation and increased risks at the human-animal-environment interface due to human activities”. The draft doesn’t mention Indigenous or traditional knowledge. 

Inviting the “non-usual suspects”

To make One Health a reality would, according to experts, require the participation of communities on the frontlines of nature conservation and which were the most vulnerable to the recent pandemic.

But negotiations over the pandemic treaty are strictly limited to members of the Intergovernmental Negotiating Body (INB) – WHO countries and regional organisations –, therefore excluding civil society groups, including Indigenous community representatives.

Foraus, the Swiss Forum on Foreign Policy, a think tank, recently published a brief to be presented to the government with proposals on how to protect the world from future pandemics. One of the four main pillars of the paper, which provides a timeline of measures to be adopted by 2040, was the recognition of the inherent links between human, animal and environmental health to achieve a sustainable future.

Starting next year, it recommended more engagement with Indigenous communities, who are responsible for preserving 80 per cent of the world’s biodiversity. It urged global leaders to “recognise their knowledge and efforts, while collaborating with Traditional Knowledge keepers to share their practices with the larger community to address global challenges”. Starting in 2026, they said the knowledge gathered from this exchange should be implemented to ensure food security, biodiversity and suppress the effects of climate change. The Swiss government, it said, should also support sustainable land management abroad and at home.

Diah Satyani Saminarsih, CEO at the Center for Indonesia’s Strategic Development Initiatives (CISDI), a NGO focused on strengthening primary health care, said it was regrettable that the WHO did not allow for engagement with civil society groups in the pandemic treaty discussions.

“Sadly, it is very much the norm that civil society has to always fight and advocate for a seat at the table or microphone in any global health proceedings,” she told Geneva Solutions. Saminarsih is a global south board member in the Pandemic Fund, established by the World Bank with the aim of providing long-term financing for pandemic preparedness and prevention.

She said this is an issue because the knowledge of Indigenous communities and patient groups on issues like pandemics could be of much value to discussions, as well as in the implementation of global policies in local communities. “They could bring more reality (to those talks). (Instead) these groups are the ones that are excluded.”

“The system needs to change to ensure that the WHO and member states can receive the reality of what is happening on the ground,” Saminarsih added. “How do we invite the non-usual suspects, not the big organisations, but the smaller groups, so that what happens at the global level can speak of the reality on the ground?”

In recent years, the WHO has responded to criticism regarding inclusion in policy processes by establishing a civil society commission, but members are often international NGOs that have already historically engaged with WHO, while many others that are active at national level “fall through the cracks”, the Indonesian expert said.

Maria Neira, director of public health, environment and social determinants at the WHO nonetheless told Geneva Solutions that the WHO would “always welcome knowledge”, when asked about opening dialogues with affected Indigenous communities.

The urgency of inclusion

On Monday, Neira was moderating a side event during the annual World Health Assembly (WHA) on health and climate, at which health ministers expressed their support for an intergovernmental WHO initiative, the Alliance for Action on Climate Change and Health (ATACH), which promotes climate mitigation strategies and the development of more climate-sustainable health systems.

Brazil, which just joined the initiative, is expected on Wednesday to present at the WHA a draft resolution on Indigenous peoples’ health, together with a number of other countries, including Amazon basin nations.

The document, which recognises the communities’ vulnerabilities, urges governments to work with Indigenous peoples, with their free, prior and informed consent, on health strategies and policies and to provide health services during future pandemics. It also encourages countries to explore ways to integrate traditional medical knowledge in their health systems and to “adopt an inclusive and participatory approach in the development and implementation of research and development to promote Indigenous health, taking into account their traditional knowledge and practices”.

Carlos Augusto Grabios Gadelham, vice minister for science, technology, innovation and health at Brazil’s health ministry, said that their initiative – the first WHA resolution to advocate for the health of Indigenous people – provided “a right way to use the resources of the Amazon and health as a driver of development”.

Jaime Urrego, Colombia’s vice minister of health, who was also present at the WHA side event, meanwhile told Geneva Solutions that it was important that Indigenous communities, as well as Afro-Colombians, be included in the critical discussions on health and climate. “They are strategic actors not only to guarantee their rights but also for the transformation of the economic model, environmental protection and the development of One Health.”

Gustavo Petro and Luiz Inácio Lula da Silva, the recently-elected presidents of Colombia and Brazil respectively, also said that an Amazon summit to energise efforts to save the rainforest from destruction would be held later this year among regional countries with the participation of Indigenous peoples.

Díaz Mirabal said the summit may be a source of hope for humanity in face of the “perfect storm of climate change that affects the whole planet and the human being”. He said Indigenous groups will present their own proposals at the conference.

In May 2020, as Covid-19 began to strike hard on ill-equipped Indigenous communities in the Amazon, COICA called on WHO to set up an emergency fund to protect them from the pandemic. At the time, the Pan American Health Organization (PAHO), WHO’s regional organisation, responded by saying it was working with member states on pandemic response.

“I think we could save the Amazon, to have a more dignified life while guaranteeing health, education and the economy, without destroying nature”, Díaz Mirabal said. “We have to provide a new vision of what life should be, because the Paris Accords and the sustainable development goals will not be achieved. We have to change plans and policies and strategies, in union with Indigenous and rural communities.”