Hundreds of delegates from Indigenous communities across the globe have arrived at the United Nations, participating in the world’s largest annual gathering dedicated to their issues, yet their arrival is shadowed by an increasingly complex and often hostile global landscape. This year’s United Nations Permanent Forum on Indigenous Issues (UNPFII) confronts a confluence of daunting pressures, including a burgeoning artificial intelligence sector driving new resource extraction on ancestral territories, persistent visa hurdles for delegates from the Global South, and the twin crises of climate change and green energy initiatives frequently clashing with established Indigenous land rights and sovereignty.

The UNPFII’s official theme, "Ensuring Indigenous Peoples’ health, including in the context of conflict," underscores the profound vulnerabilities faced by these communities. Experts highlight that Indigenous peoples already navigate severe health inequities, deeply rooted in the historical and ongoing impacts of colonialism, compounded by the escalating effects of climate change. These existing burdens are further exacerbated by armed conflicts and militarization, which not only threaten lives but also risk widespread ecological degradation and forced displacement from their traditional lands. For Indigenous peoples, health is inextricably linked to the well-being of the environment, the integrity of their lands, and the exercise of their inherent sovereignty, rendering a purely clinical or public health approach insufficient to address their comprehensive needs. Beyond overt warfare, advocates are increasingly concerned by the surge in critical mineral extraction, vital for the global transition to green energy, which often proceeds at the cost of Indigenous rights and environmental justice. A long-standing call for climate financing to be directly accessible to Indigenous communities, bypassing state or foreign intermediaries, resonates with renewed urgency, aiming to empower self-determined adaptation and mitigation strategies.

Before the substantive diplomatic discussions can even commence, many delegates encounter significant practical barriers. Mariana Kiimi Ortiz Flores, a Na’uu Savi advocate from Mexico and an advocacy assistant at Cultural Survival, recounts the distressing trend of visa denials. Last year, her organization prepared Indigenous representatives from Africa to attend the forum, only for their visa applications to be rejected. This year, an Indigenous staff member from South America faced a similar fate. Flores laments the increasing difficulty of accessing the United States, citing not only bureaucratic visa issues but also a broader climate of insecurity and pervasive hate speech directed against Latin American and Indigenous peoples, making delegates with distinct appearances feel particularly vulnerable.

The challenges extend beyond entry. Last year, Flores’s organization facilitated the attendance of Indigenous leaders from Bolivia who sought to protest mining operations on their ancestral lands. However, their participation was curtailed after they reportedly endured harassment from a political party leader from Bolivia, coupled with emerging health concerns. This harrowing experience led them to decide against returning, fostering a deep sense of disillusionment. Flores articulated their sentiment: "The forum is meant to be for Indigenous peoples, but we really felt that that’s not what’s happening anymore and that at the end of the day the states are the ones who have more power over our lives." The struggle to defend their lands against extractive industries, she added, exacts a heavy toll, impacting their physical, mental, and spiritual well-being.

This comprehensive understanding of Indigenous health forms the central pillar of a pivotal report authored by Geoffrey Roth, a descendant of the Standing Rock Sioux, former vice chair of the Permanent Forum, and board chair of the Indigenous Determinants of Health Alliance, an international Indigenous health advocacy nonprofit. Roth unequivocally states, "You can’t separate human health from the health of the environment, or our culture or our language. Indigenous people view health from a holistic perspective." His report meticulously outlines the Indigenous determinants of health, ranging from secure land tenure and robust governance authority, which inherently strengthen Indigenous well-being, to critical risk indicators such as land dispossession and exclusion from decision-making processes. Roth argues that the fragmented approaches often adopted by the UN system and national governments are fundamentally flawed, failing to adequately address the complex interplay of health problems and their underlying systemic causes. For instance, biodiversity policies that neglect Indigenous rights squander vital opportunities to restore Indigenous land tenure, which could simultaneously enhance ecosystem outcomes and bolster access to traditional foods. Similarly, mental health interventions that overlook state-sanctioned Indigenous language erasure miss the profound potential of language revitalization to significantly improve Indigenous mental well-being. "Indigenous health is not just about healthcare," Roth emphasizes, "it’s about land, culture, food systems and community."

Demonstrating this holistic approach, the Coquille Indian Tribe in Oregon formally adopted the Indigenous determinants of health by ordinance last year. Roth, serving as chairman of their executive health board, has been instrumental in integrating these determinants across their various agencies. He highlights how routine activities, such as monthly fishing expeditions for elders, are recognized as vital health practices. "It’s continuing their tradition as Coquille people," he explains, "and it improves the mental health, behavioral health of those elders that are able to participate in that, let alone the food they catch." Furthermore, Roth’s report urges the UN to acknowledge and support the invaluable role of Indigenous midwifery, a practice frequently suppressed or banned in favor of Western medical models. This historical marginalization often forces Indigenous women into conventional institutions where they tragically encounter systemic racism and "obstetric violence," including procedures performed without their informed consent. "Indigenous people have been doing this for thousands of years," Roth asserts, "not only midwifery, but also caring for the environment and caring for our culture and preserving these food systems."

Another significant report submitted to the UNPFII by former Permanent Forum chair Hindou Oumarou Ibrahim, an Indigenous Mbororo from Chad, explores the double-edged nature of artificial intelligence for Indigenous communities. While she advocates for governments to support Indigenous peoples in developing AI tools for revitalizing endangered languages and monitoring their ancestral territories, she simultaneously issues a stern warning about an impending era of "digital extractivism." This phenomenon involves generative AI systems and tech companies indiscriminately scraping Indigenous cultural content, including invaluable medicinal knowledge, traditional stories, and even genetic data, often without consent or fair compensation.

Lydia Jennings, a citizen of the Pascua Yaqui Tribe (Yoeme) and Huichol (Wixárika) and an assistant professor of environmental studies at Dartmouth College, traces her advocacy for Indigenous data sovereignty – the movement asserting communities’ right to own and control their own data – to a disconcerting personal discovery. She found a mining company had extracted sensitive information about Indigenous cultural practices from an environmental impact statement and was exploiting it on its website to promote a mining project. "That was very alarming to me," she recounts, prompting critical questions: "How much information do we share in efforts to protect our sacred homelands? And what are the ways that we can govern how and who uses that data?" Echoing Ibrahim, Jennings acknowledges AI’s potential as an opportunity for tribes, noting interest in hosting data centers or utilizing AI for language preservation and information synthesis. However, she remains deeply cautious about the extent to which Indigenous data may be co-opted by AI systems without proper consent, as well as the severe environmental risks that massive data centers pose to tribal lands and precious water resources. She poignantly asks, "Who has the power and how do we redistribute that power? It can be a tool to power and a tool to harm, but how do we choose to wield it?" Jennings observes a growing global movement advocating for the integration of Indigenous data sovereignty best practices across multiple levels, from academic research protocols to national and international policies.

The climate crisis remains a central focus of this year’s Permanent Forum. A February report specifically addressing nomadic peoples highlighted how rigid state borders and exclusionary "fortress conservation" models are severely curtailing the traditional mobility of pastoralists, hunter-gatherers, and seafarers. This restriction occurs precisely as these communities grapple with the severe impacts of climate change and dwindling access to their ancestral lands and waters. The report’s authors argue that mobility is not merely movement, but a deliberate, knowledge-based climate adaptation strategy that state policymakers are actively undermining. They cite the plight of the Tuareg people in the Sahara Desert as a poignant example, noting that "While the desert knows no borders, contemporary militarized frontiers increasingly restrict ancestral routes and undermine pastoral systems and access to services, rendering these lived realities of Indigenous Peoples invisible in official data and policy frameworks."

This sentiment is strongly echoed by Samante Anne, an Indigenous Maasai from Kenya, who recently spoke at a virtual panel on pastoralists’ legal rights on behalf of the Mainyoito Pastoralists Integrated Development Organization. Anne detailed how, despite 60% of land in Kenya being considered communal, land is increasingly being subdivided for commercial developments and claimed for carbon offset projects. These initiatives, she explained, severely limit pastoralists’ access to vital land resources and impede their traditional migratory movements. "Mobility has everything to do with us adapting to climate change," Anne stressed. "Mobility has everything to do with ensuring our livelihoods are secure, our food security is good."

Making substantive progress on Indigenous health, artificial intelligence, and territorial rights is further complicated by a persistent, problematic trend within the UN system: the conflation of Indigenous peoples with "local communities." In numerous official policies and initiatives, these two distinct groups are frequently merged under the acronym "IPLCs" – Indigenous Peoples and Local Communities. While "local communities" represents a broad and diverse category of stakeholders, Indigenous peoples hold unique, distinct, and legally recognized rights under international law, including the United Nations Declaration on the Rights of Indigenous Peoples (UNDRIP). Geoffrey Roth from the Indigenous Determinants of Health Alliance recounted a direct confrontation with this issue at the World Health Organization when the agency categorized an Indigenous initiative merely as an "equity" concern. "This is not an equity issue," Roth firmly stated to the agency. "We are not just another one of your minority populations. We are rights holders, and this needs to be approached from a rights-based approach."

Roth emphasizes that "conflating us with other populations really diminishes our rights and diminishes our ability to maintain our health in our communities." This grouping also actively hinders meaningful Indigenous participation, Roth asserts, pointing to the UN Convention on Biological Diversity’s IPLC working group as a prime example. "I’ve tried to participate in that group several times, and as an Indigenous person, I don’t feel welcome and I’m not able to participate," he explained. "These (IPLC) institutions are a way to lessen or dilute the voice of Indigenous peoples in these global mechanisms, and that, to me, is unacceptable." He is far from alone in this conviction. In a powerful unified stance in 2023, the UN’s three leading Indigenous rights bodies – the Permanent Forum, the Special Rapporteur on the Rights of Indigenous Peoples, and the Expert Mechanism on the Rights of Indigenous Peoples – issued a joint statement demanding that UN environmental treaties cease using the IPLC acronym entirely. Their declaration unequivocally stated: "Indigenous Peoples should not be grouped with an undefined set of communities that may have very different rights and interests."

For advocates working tirelessly on the ground, this ongoing debate is merely one facet of a growing disillusionment with the effectiveness of the UN system itself. Mariana Kiimi Ortiz Flores of Cultural Survival observes that the international institution has suffered from a pervasive willingness by member states to simply disregard its established laws and declarations. "The United Nations as an international institution has been losing its influence and its power," Flores remarked. Yet, despite the formidable bureaucratic hurdles, the disheartening visa denials, and the overarching climate of geopolitical hostility, she affirms her unwavering determination, shared by countless other Indigenous peoples, to show up and make their voices heard at this critical forum. "If we as Indigenous peoples don’t do it," Flores declares with resolute conviction, "No one else will speak for us and defend us."