Hundreds of delegates representing Indigenous nations and communities from across the globe are gathering this week at the United Nations for the Permanent Forum on Indigenous Issues (UNPFII), the world’s most significant annual assembly dedicated to Indigenous rights and well-being. This vital forum, which brings together Indigenous leaders, activists, and experts with UN member states and agencies, convenes against an increasingly complex and often hostile international landscape. Participants face myriad systemic obstacles, including the accelerating demand for critical minerals driven by the artificial intelligence boom, stringent visa policies making access to the United States challenging for Global South representatives, and the dual pressures of climate change and green energy initiatives that frequently infringe upon ancestral lands and Indigenous self-determination.

The official theme for this year’s UNPFII underscores a stark reality: "Ensuring Indigenous Peoples’ health, including in the context of conflict." This focus highlights the profound health inequities Indigenous populations endure, exacerbated by legacies of colonialism, climate impacts, and the devastating consequences of armed conflicts and militarization. Experts consistently emphasize that Indigenous health is intrinsically linked to the health of their environments, their ancestral lands, and their inherent sovereignty, resisting compartmentalization into purely clinical or public health discussions. Beyond direct warfare, the forum is also tackling the contentious issue of critical mineral extraction for the global green energy transition, which frequently leads to human rights abuses against Indigenous communities. Delegates are renewing a long-standing call for climate financing to be directly accessible to their communities, bypassing state or foreign intermediaries, to ensure funds are utilized effectively and respectfully according to Indigenous priorities.

Before engaging in crucial diplomatic conversations, many delegates must first navigate significant practical barriers. Visa restrictions, particularly those tightened under previous U.S. administrations, have created substantial hurdles for Indigenous representatives from the Global South. Mariana Kiimi Ortiz Flores, a Na’uu Savi advocate from Mexico working with Cultural Survival, recounted instances where African Indigenous representatives were denied visas last year, and a South American Indigenous staff member faced similar denials this year. Flores noted the growing difficulty of accessing the United States extends beyond visa logistics, citing a palpable "climate of insecurity and hate speech" that disproportionately impacts Indigenous peoples and those from Latin America, making them feel threatened. Last year, Indigenous leaders from Bolivia, who attended the forum to protest mining on their traditional lands, ultimately left early after experiencing harassment from a political party leader, compounded by health concerns. This experience, Flores explained, left them disillusioned, feeling that despite the forum’s stated purpose, state powers continued to overshadow Indigenous voices. The profound toll of defending their lands against extractive industries, she added, impacts them physically, mentally, and spiritually.

This comprehensive understanding of well-being forms a central tenet of a key report by Geoffrey Roth, a Standing Rock Sioux descendant and former vice chair of the Permanent Forum, who now chairs the Indigenous Determinants of Health Alliance. Roth champions a holistic perspective, asserting, "You can’t separate human health from the health of the environment, or our culture or our language." 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 like land dispossession and exclusion from decision-making processes. Roth critiques the fragmented approaches often adopted by the UN system and national governments, arguing that they consistently fail to address the root causes of Indigenous health disparities. For instance, biodiversity policies that neglect Indigenous rights miss vital opportunities to restore traditional land tenure, which could simultaneously enhance ecosystem outcomes and bolster access to traditional foods. Similarly, mental health interventions that ignore state-sanctioned Indigenous language erasure overlook the immense potential for language revitalization to significantly improve mental well-being. "Indigenous health is not just about healthcare," Roth emphasizes, "it’s about land, culture, food systems and community."

The Coquille Indian Tribe in Oregon has already embraced this holistic framework, adopting 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 tribal agencies. He cites examples such as monthly fishing activities for elders, which are recognized not merely as recreational outings but as essential health initiatives. These activities, he explains, are vital for continuing Coquille traditions, improving the mental and behavioral health of elders, and providing traditional sustenance. Roth also advocates for the UN’s recognition of Indigenous midwifery, a practice often suppressed in favor of Western medical models, forcing Indigenous women into mainstream institutions where they frequently encounter racism and "obstetric violence," including procedures performed without informed consent. He highlights that Indigenous peoples have millennia of experience in midwifery, environmental stewardship, and preserving traditional food systems, knowledge that must be respected and integrated.

In a separate report to the UNPFII, Hindou Oumarou Ibrahim, an Indigenous Mbororo from Chad and former Permanent Forum chair, offers a crucial warning regarding artificial intelligence. She describes AI as a "double-edged sword" for Indigenous communities. While acknowledging its potential for good—such as developing AI tools to revitalize endangered languages or monitor ancestral territories—she cautions against an impending era of "digital extractivism." This refers to the alarming trend of 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, echoes these concerns. Her advocacy for Indigenous data sovereignty—the movement asserting communities’ right to own and control their own data—was spurred by a troubling discovery: a mining company had appropriated Indigenous cultural practices from an environmental impact statement and used the information on its website to promote a mining project. "That was very alarming to me," Jennings stated, prompting critical questions about how much information Indigenous communities share in efforts to protect their sacred homelands and how they can govern its use. Like Ibrahim, Jennings sees opportunities in AI for tribes, such as hosting data centers or using AI for language preservation and information synthesis. However, she remains deeply wary of the vast amounts of Indigenous data potentially being co-opted without consent and the severe ecological risks—particularly regarding energy and water consumption—posed by massive data centers on or near tribal lands. "Who has the power and how do we redistribute that power?" she asks, emphasizing that AI can be a tool for both empowerment and harm, and the choice lies in how it is wielded. Jennings notes a growing movement to integrate best practices of Indigenous data sovereignty across academic research, national policies, and international frameworks.

Another critical focus of this year’s Permanent Forum is the escalating climate crisis. A February report specifically addressing nomadic peoples warned that 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 diminishing access to their ancestral lands and waters. The report’s authors argue that traditional mobility is a sophisticated, knowledge-based climate adaptation strategy that state policymakers are actively undermining. They cite the Tuareg people in the Sahara Desert as an example, explaining that while the desert inherently knows no borders, militarized frontiers increasingly restrict ancestral routes, eroding pastoral systems and access to essential services. This effectively renders the lived realities of these Indigenous Peoples invisible within official data and policy frameworks.

These sentiments are 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 highlighted that while 60% of land in Kenya is communally owned, it is increasingly being subdivided for development projects and claimed for carbon offset initiatives, both of which severely limit pastoralists’ access to land and their traditional mobility. "Mobility has everything to do with us adapting to climate change," Anne affirmed. "Mobility has everything to do with ensuring our livelihoods are secure, our food security is good."

Progress on these interconnected issues—Indigenous health, the ethics of artificial intelligence, and territorial rights—is further complicated by a persistent trend within the UN system: the conflation of Indigenous peoples with "local communities." In numerous official policies and initiatives, these two distinct groups are often merged under the acronym "IPLCs" (Indigenous Peoples and Local Communities). However, while "local communities" represents a broad and diverse category of stakeholders, Indigenous peoples hold distinct, legally recognized rights under international law, notably enshrined in the UN Declaration on the Rights of Indigenous Peoples (UNDRIP). Roth of the Indigenous Determinants of Health Alliance recently challenged this practice at the World Health Organization, where an Indigenous initiative was categorized merely as an "equity" issue. "This is not an equity issue," Roth recalled telling 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 asserts that conflating Indigenous peoples with other populations fundamentally diminishes their distinct rights and impedes their ability to maintain health and well-being within their communities. This grouping, he argues, actively hinders authentic Indigenous participation, citing 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, concluding that "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." This sentiment is widely shared. 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 unequivocally demanding that UN environmental treaties cease using the IPLC acronym. Their message was clear: "Indigenous Peoples should not be grouped with an undefined set of communities that may have very different rights and interests."

For advocates on the ground, this ongoing debate is symptomatic of a broader disillusionment with the efficacy and influence of the UN system itself. Mariana Kiimi Ortiz Flores of Cultural Survival observes that the international institution has struggled to maintain its power, largely due to member states’ willingness to disregard its established laws and recommendations. Despite these bureaucratic hurdles, the challenges of visa denials, and the pervasive geopolitical hostility, Flores underscores the unwavering determination of Indigenous peoples to participate in this week’s forum. "If we as Indigenous peoples don’t do it," Flores stated resolutely, "No one else will speak for us and defend us." Their presence at the UN, despite all obstacles, remains a powerful testament to their resilience, advocacy, and enduring commitment to self-determination and the protection of their inherent rights.