The Indigenous World 2026: Indigenous Health

Written on 22 April 2026. Posted in Indigenous Health

The Indigenous Determinants of Health Alliance (IDHA) is an Indigenous Peoples’ Organization^[1] dedicated to advocating for and supporting the implementation of culturally safe, rights-based health systems for Indigenous communities globally. Since its inception in 2022, the IDHA has worked to advance Indigenous rights across the UN system. IDHA's central contribution is the UN Permanent Forum on Indigenous Issues (UNPFII)–sponsored Indigenous Determinants of Health (IDH) framework, which reframes health beyond clinical outcomes and positions it as a precondition for the realization of all Indigenous rights, including self-determination, peace, land governance, and cultural survival.^[2] Grounded in the realities of Indigenous Peoples across the globe, the IDH framework provides: a) guidance for agencies on how to approach Indigenous health in a rights-based and culturally safe manner, and b) tools for Indigenous leaders to advocate for accountability under the UN Declaration on the Rights of Indigenous Peoples (UNDRIP).^[3]

The IDH framework comprises three studies that identify, operationalize, and evaluate institutional performance in their compliance with Indigenous Rights and in the incorporation of an Indigenous perspective to achieve the UN Sustainable Development Goal (SDG) #3 on healthy lives and wellbeing. These studies introduce the construct of Indigeneity as an overarching determinant of health by identifying 33 risk and protective factors specific to Indigenous Peoples.^[4] The framework elaborates on Indigenous knowledge-based strengths, as well as the circumstances stemming from colonialism, cultural erasure, and land dispossession that have shaped Indigenous Peoples' health disparities today.

This article is part of the 40^th edition of The Indigenous World, a yearly overview produced by IWGIA that serves to document and report on the developments Indigenous Peoples have experienced. Find The Indigenous World 2026 in full here

Indigenous health in 2025: building momentum for systemic change

2025 marked a critical acceleration in the global recognition of Indigenous Peoples' right to health. While advocacy for culturally grounded, rights-based health systems is not new, 2025 saw a convergence of institutional attention across the UN system, reinforcing Indigenous health not merely as a technical need but as a prerequisite for peace, justice, and sustainable development. This growing recognition was reflected in the announcement of the United Nations Permanent Forum on Indigenous Issues (UNPFII) 25^th session theme for 2026, "Ensuring Indigenous Peoples' health, including in the context of conflict."^[5] This theme affirms what Indigenous Peoples have long asserted: health is foundational to cultural survival, self-determination, and planetary health. Indigenous Peoples’ health is so intrinsically connected to the health of Mother Earth that the degradation of ecological, nutritional, and social systems has resulted in increased illness or chronic conditions for Indigenous Peoples,^[6] which in turn equates to measurable harm across generations. The 2026 UNPFII theme also reflects the expanding institutional reach of the Indigenous Determinants of Health (IDH) framework,^[7] which elaborates on institutional risk and protective factors impacting Indigenous Peoples’ health across disciplines. 2025 continued to emphasize that ensuring Indigenous Peoples' health requires continued vigilance, unified advocacy, and system-wide reforms across global agencies.

In April 2025, the UNPFII made recommendations to create a policy infrastructure that would expand Indigenous Peoples’ rights to health and cultural safety, in alignment with the UNDRIP. Key 2025 UNPFII recommendations for agencies included: adopting the IDH evaluation instrument;^[8] increasing Indigenous Peoples' participation^[9] in decision-making in agencies such as the Convention on Biological Diversity (CBD)^[10] and the UN Ocean Conference;^[11] and eliminating structural barriers, violence, and discrimination. The UNPFII has likewise requested that the Pan-American Health Organization (PAHO) halt the conflation of Indigenous Peoples with stakeholders through intercultural initiatives, in compliance with UNDRIP provisions, and acknowledges midwifery as an ancestral practice.^[12] These recommendations acknowledge and reinforce the need to advance systemic change and mark a step towards upholding cultural safety and Indigenous Peoples' rights.

World Health Organization's (WHO) World Report on the Social Determinants of Health Equity
Following the 2023 WHO Executive Board recommendation,^[13] in May 2025, WHO released its World Report on the Social Determinants of Health Equity,^[14] which formally recognized both the Indigenous Determinants of Health and Indigeneity as overarching determinants of health. This was a landmark moment, acknowledging that health disparities among Indigenous Peoples are rooted not only in access to services but in colonial developments and that the Indigenous perspective of health goes well beyond a clinical setting and into all other aspects of life.

Conflict, health, and peacebuilding

In its 2025 meeting, the UNPFII endorsed a major study entitled "Impact of Colonization and Armed Conflicts on Indigenous Peoples' Rights: The Imperative of Peacebuilding".^[15] Whether military, environmental, political, or resource-driven, conflict constitutes a direct and structural determinant of Indigenous Peoples' health. Peer-reviewed evidence demonstrates that conflict-related land dispossession, displacement, and environmental degradation are consistently associated with adverse Indigenous health outcomes, including loss of food systems, erosion of cultural and governance systems, psychological distress, and intergenerational trauma.^[16]

UN Convention on Biological Diversity

The UN Convention on Biological Diversity (CBD) began implementing Decision 16/19^[17] in Panama in October 2025, officially referencing the IDH framework in its Global Plan of Action on Biodiversity and Health. The CBD invited contributions from Indigenous Peoples and the UNPFII to guide operational frameworks under Article 8(j),^[18] which aims to ensure traditional knowledge is respected and integrated into biodiversity policy and practice. One concern raised during and after this meeting was the use of the combined category “Indigenous Peoples and Local Communities” in the CBD, without distinguishing the legal and rights-based differences between them.^[19] During the negotiations, the UNPFII president, Aluki Kotierk, stated that:

The Forum calls on all Parties to… ensure that the distinct status and rights of Indigenous Peoples are fully recognized, respected, and protected in all aspects of the Convention's implementation.^[20]

Although local communities may be geographically proximate and experience significant vulnerabilities, they do not share the holistic, spiritual, cultural, and historical trajectories of Indigenous Peoples. While these communities face real challenges, they differ fundamentally from Indigenous Peoples in terms of legal and political status. Indigenous Peoples are recognized as rights-holders under UNDRIP, whereas local communities are engaged primarily as stakeholders. The persistent institutional conflation of Indigenous Peoples with stakeholders obscures this distinction, weakening recognition of Indigenous-specific rights and undermining accountability for obligations related to health, cultural continuity, and intergenerational wellbeing.^[21]

UN Convention on Climate Change

While the November 2025 UNFCCC meetings (COP30) in Brazil announced a record-setting level of Indigenous Peoples' participation, disruptions by large numbers of local Indigenous groups revealed a persistent gap between presence and power. Indigenous representatives reported feeling marginalized in negotiations, especially in critical areas heavily impacting Indigenous determinants of health, including Non-Economic Losses and Damage (NELD), adaptation financing, and climate-related displacement.^[22] NELD areas are intrinsically connected to health: loss of ancestral knowledge, languages, ceremonial spaces, and sacred ecosystems, all of which are explained in the IDH framework, have an impact on Indigenous health. The IDH framework has been proposed to evaluate these impacts in order to define and measure such losses.^[23] It is critical that NELD for Indigenous Peoples are appropriately addressed since climate change intersects with every aspect of Indigenous life. Recognition of IDH at COP30 is also a recognition that disrupting ecosystems means a loss of knowledge, culture, practice, and linguistic elements. Climate disruptions impact individual and collective wellbeing in profound ways,^[24] including pushing Indigenous youth to migrate due to the compounded losses.

UN Food Systems Summit +4

At the UN Food Systems Summit held in Ethiopia in July 2025, Indigenous leaders held a session in which they reaffirmed that ancestral food systems are not merely sustenance but also crucial elements in ceremony, medicine, language, and identity.^[25] Despite the increased participation, many Indigenous leaders expressed concern over the lack of meaningful influence over decision-making and the absence of UNDRIP-aligned safeguards,^[26] especially since the Food and Agriculture Organization (FAO) is one of the few agencies with a codified Free, Prior Informed Consent (FPIC) policy.

Second Global WHO Traditional Medicine Summit

In December 2025, the WHO convened the Second Traditional Medicine Global Summit in India, highlighting the growing institutional recognition of ancestral health systems. Framed as part of WHO's 2025-2034 Traditional Medicine Strategy, the Summit positioned traditional knowledge as a tool for integrative global health.^[27] Nonetheless, Indigenous leaders from across the globe challenged the event's lack of structural or meaningful inclusion. Through a strategic statement documenting the Summit's systemic shortcomings, Indigenous leaders called out the Summit for its tokenistic representation and failure to uphold Indigenous rights as per the UNDRIP.^[28]

A challenge ahead: fragmentation of the Indigenous health agenda across UN bodies

One of the most urgent challenges noted by Indigenous leaders in 2025 was the fragmentation of Indigenous health governance across the UN system. While agencies such as WHO, CBD, FAO, PAHO, and the World Intellectual Property Organization (WIPO) all engage with dimensions of Indigenous health, their efforts remain largely uncoordinated, siloed by mandates, funding streams, and institutional frameworks that do not entirely incorporate the Indigenous holistic perspective.^[29] Furthermore, trade regimes are increasingly recognized as directly impacting health outcomes, as recently described by the Commercial Determinants of Health.^[30] These challenges are compounded by growing liquidity constraints across the UN system, with Indigenous leaders warning that the recent gains in staffing and participation risk being reversed.

Conclusion

As global attention to Indigenous health increases, the path forward must remain grounded in the UNDRIP, cultural integrity, and self-determination. For Indigenous Peoples, the environment, food systems, peace, and biodiversity are core health indicators. When disrupted, they lead to measurable harm and health outcomes. Health connects to all dimensions of Indigenous life: land, governance, and culture. While 2025 saw progress in recognition of IDH, these gains only contribute to a foundation. Sustained, unified engagement by Indigenous leaders is essential to ensure that momentum is not lost but transformed into coordinated, systemic change. Frameworks such as the IDH can support this but Indigenous voices must lead the way forward.

Geoffrey Roth, Lakota/Standing Rock Tribe (US); Chair, Indigenous Determinants of Health Alliance; CEO, Cedar Rock Alliance; former UNPFII Expert Member and Vice Chair, 2020-2025.

Amina Amharech, Amazigh (Morocco); Leader, Acal El Hajeb/AZUL Network, 2026-2028 Expert Member, UNPFII; Member, Indigenous Determinants of Health Alliance

Alejandro Bermudez-del-Villar, Mestizo ally (Mexico/US); Coordinator, Indigenous Determinants of Health Alliance; VP, Global Strategy and Operations, Cedar Rock Alliance
This email address is being protected from spambots. You need JavaScript enabled to view it.

This article is part of the 40^th edition of The Indigenous World, a yearly overview produced by IWGIA that serves to document and report on the developments Indigenous Peoples have experienced. Find The Indigenous World 2026 in full here

Notes and references

^[1] Indigenous Determinants of Health Alliance. www.indigenousdha.org

^[2] United Nations Permanent Forum on Indigenous Issues, Indigenous Determinants of Health in the 2030 Agenda for Sustainable Development, UN Doc. E/C.19/2023/5 (New York: United Nations, 2023), https://docs.un.org/E/C.19/2023/5.

^[3] United Nations General Assembly. United Nations Declaration on the Rights of Indigenous Peoples. Resolution adopted by the General Assembly, A/RES/61/295, 13 September 2007. https://social.desa.un.org/issues/indigenous-peoples/united-nations-declaration-on-the-rights-of-indigenous-peoples

^[4] Freddy Condo, Hannah McGlade, and Geoffrey Roth, Indigenous Determinants of Health in the 2030 Agenda for Sustainable Development https://docs.un.org/en/E/C.19/2023/5; Geoffrey Roth, Improving the Health and Wellness of Indigenous Peoples Globally: Operationalization of Indigenous Determinants of Health (New York: United Nations Permanent Forum on Indigenous Issues, 2024) https://docs.un.org/en/E/C.19/2024/5; Geoffrey Roth, Evaluating Institutional Structures to Improve the Health and Wellness of Indigenous Peoples Globally: The Indigenous Determinants of Health Measurement Instrument (New York: United Nations Permanent Forum on Indigenous Issues, 2025 https://docs.un.org/en/E/C.19/2025/5

^[5] United Nations Department of Economic and Social Affairs. 25^th Session of the United Nations Permanent Forum on Indigenous Issues. New York: United Nations, 2025. https://social.desa.un.org/issues/indigenous-peoples/unpfii/25th-session. https://social.desa.un.org/issues/indigenous-peoples/unpfii/25th-session

^[6] World Health Organization. Background Document: Global Programme of Action on Gender Mainstreaming in Health. Geneva: World Health Organization, 2023. https://cdn.who.int/media/docs/default-source/documents/gender/gpa---background-document.pdf?sfvrsn=c0f22e35_1

^[7] The Indigenous Determinants of Health framework is comprised of three UNPFII-sponsored studies: a) Freddy Condo, Hannah McGlade, and Geoffrey Roth, Indigenous Determinants of Health in the 2030 Agenda for Sustainable Development (New York: United Nations Permanent Forum on Indigenous Issues, 2023. https://docs.un.org/en/E/C.19/2023/5 b) Geoffrey Roth, Improving the Health and Wellness of Indigenous Peoples Globally: Operationalization of Indigenous Determinants of Health (New York: United Nations Permanent Forum on Indigenous Issues, 2024) https://docs.un.org/en/E/C.19/2024/5; c) Geoffrey Roth, Evaluating Institutional Structures to Improve the Health and Wellness of Indigenous Peoples Globally: The Indigenous Determinants of Health Measurement Instrument (New York: United Nations Permanent Forum on Indigenous Issues, 2025 https://docs.un.org/en/E/C.19/2025/5

^[8] United Nations Permanent Forum on Indigenous Issues. “Recommendation 7: Member States and UN Entities.” UNPFII. Accessed 22 January 2026. https://unpfii.desa.un.org/recommendations/member-states-un-entities-10

^[9] United Nations Permanent Forum on Indigenous Issues. “Recommendation 9: Member States and UN Entities.” UNPFII. Accessed 22 January 2026. https://unpfii.desa.un.org/recommendations/member-states-un-entities-11

^[10] United Nations Permanent Forum on Indigenous Issues. “Recommendation 20: Member States (COP Decision / SCBD).” UNPFII. Accessed 22 January 2026. https://unpfii.desa.un.org/recommendations/member-states-cop-scbd

^[11] United Nations Permanent Forum on Indigenous Issues. “Recommendation 27: UN Ocean Conferences.” UNPFII. Accessed 22 January 2026. https://unpfii.desa.un.org/recommendations/un-ocean-conferences

^[12] United Nations Permanent Forum on Indigenous Issues. “Recommendation 29: PAHO/WHO Member States.” UNPFII. Accessed 22 January 2026. https://unpfii.desa.un.org/recommendations/paho-who-member-states

^[13] World Health Organization. The Health of Indigenous Peoples: Resolution WHA76.16. Geneva: World Health Organization, 2023. https://apps.who.int/gb/ebwha/pdf_files/WHA76/A76_R16-en.pdf

^[14] World Health Organization. World Report on Social Determinants of Health Equity. Geneva: World Health Organization, 2025. https://www.who.int/publications/i/item/9789240107588

^[15] Hanieh Moghani, Hannah McGlade, and Geoffrey Roth. Impact of Colonization and Armed Conflicts on Indigenous Peoples’ Rights: The Imperative of Peacebuilding. E/C.19/2025/7. Report to the United Nations Permanent Forum on Indigenous Issues, New York: United Nations Economic and Social Council, 2025. https://docs.un.org/en/E/C.19/2025/7

^[16] Nicole Redvers et al., The Determinants of Planetary Health: An Indigenous Consensus Perspective, The Lancet Planetary Health 6, no. 3 (2022): e156–e163, https://doi.org/10.1016/S2542-5196(21)00354-5

^[17] Convention on Biological Diversity. Biodiversity and Health: Decision CBD/COP/DEC/16/19, Conference of the Parties to the Convention on Biological Diversity at its Sixteenth Meeting. 2024.

^[18] Convention on Biological Diversity. Traditional Knowledge, Innovations and Practices. Accessed 5 January 2026. https://www.cbd.int/traditional/default.shtml

^[19] Indigenous and Community Conserved Areas Consortium. “Indigenous Peoples and Local Communities at CBD SB8J-1.” ICCA Consortium, 19 December 2025. https://www.iccaconsortium.org/2025/12/19/indigenous-peoples-and-local-communities-at-cbd-sb8j-1/

^[20]Aluki Kotierk. Statement of the UNPFII Chairperson at the CBD Article 8(j) Meeting. United Nations Permanent Forum on Indigenous Issues, 29 October 2024. https://tinyurl.com/7fv9be66

^[21] Global Governance Project. 2026. Meaningful Indigenous Representation Across the Globe: A Call to Action. Accessed 5 January 2026. https://www.globalgovernanceproject.org/meaningful-indigenous-representation-across-the-globe-a-call-to-action/geoffrey-roth/

^[22] PBS NewsHour. Indigenous people reflect on meaning of their participation in COP30 climate talks. PBS, 23 November 2025. https://www.pbs.org/newshour/world/indigenous-people-reflect-on-meaning-of-their-participation-in-cop30-climate-talks; Mongabay. 2025. “What Was Achieved for Indigenous Peoples at COP30?” Mongabay, November. https://news.mongabay.com/2025/11/what-was-achieved-for-indigenous-peoples-at-cop30/; Pereira, Jullie. 2025. “Despite Record Turnout, Only 14% of Indigenous Brazilians Get Access to COP30 Decision-Making Spaces.” Climate Change News, 13 November 2025. https://www.climatechangenews.com/2025/11/13/despite-record-turnout-only-14-of-indigenous-brazilians-get-access-to-cop30-decision-making-spaces

^[23] Roth, Geoffrey Scott, Alejandro Bermudez Del Villar, Amina Amharech, Lala Forrest, and Matthew Carvalho. 2025. “Implementing Indigenous Rights through Climate–Health Governance: Advancing the Indigenous Determinants of Health Framework within the UNFCCC.” Frontiers in Climate 7 (1697881). https://doi.org/10.3389/fclim.2025.1697881

^[24] Lala Forrest, “Climate Resilience Won’t Save Us, but Indigenous Peoples’ Sovereignty Might,” Indian Country Today, 8 December 2023, https://ictnews.org/opinion/climate-resilience-wont-save-us-but-indigenous-peoples-sovereignty-might/

^[25] Amharech, Amina. "UN FFS+4- Ms. Amina Amharech, Amazigh Leader. Opening Remarks at the Indigenous Peoples-led Session." YouTube video, 6:15. July 31,2025. https://www.youtube.com/watch?v=cfKsc7PqM_o

^[26] Medina-Tayac, Sebastian. "2025 UN Food Systems Summit—Mr. Sebastian Medina-Tayac, Piscataway, Indigenous Peoples-led Session." YouTube video, 6:14. 30 July 2025. https://www.youtube.com/watch?v=9RD9l22S1O8

^[27] World Health Organization and Government of India. 2025. Second WHO Global Summit on Traditional Medicine: Restoring balance — The science and practice of health and well-being, 17–19 December 2025, New Delhi, India. TM-Summit.org. https://tm-summit.org/

^[28] Indigenous Determinants of Health Alliance. 2025. Strategy Statement on the 2nd WHO Global Traditional Medicine Centre Summit and Indigenous Peoples’ Rights in Traditional Medicine Governance. 15 December 2025. https://tinyurl.com/p57fdy8n

^[29] World Health Organization, Indigenous Leadership and Views Must Shape New Global Health Action Plan, 6 May 2025, https://www.who.int/news/item/06-05-2025-indigenous-leadership-and-views-must-shape-new-global-health-action-plan; Global Governance Project. 2026. Meaningful Indigenous Representation Across the Globe: A Call to Action. Accessed 5 January 2026. https://www.globalgovernanceproject.org/meaningful-indigenous-representation-across-the-globe-a-call-to-action/geoffrey-roth/. United Nations Permanent Forum on Indigenous Issues. 2025. Report on the Twenty-Fourth Session (21 April–2 May 2025). Economic and Social Council Official Records, 2025 Supplement No. 23 (E/2025/43 – E/C.19/2025/8). United Nations. https://docs.un.org/en/E/2025/43

^[30] World Health Organization. "Commercial Determinants of Health." Fact sheet. https://www.who.int/news-room/fact-sheets/detail/commercial-determinants-of-health

Tags: Global governance