Hundreds of Indigenous delegates from across the globe are converging this week at the United Nations headquarters in New York for the Permanent Forum on Indigenous Issues (UNPFII), the world’s largest annual gathering dedicated to the rights and well-being of Indigenous peoples. This year’s forum unfolds against a disquieting international backdrop, marked by an accelerating artificial intelligence boom driving unprecedented demand for critical minerals often found on ancestral lands, stringent visa restrictions impeding Global South representation, and the persistent, interconnected threats of climate change and ill-conceived green energy projects that frequently disregard Indigenous land rights and self-determination. The official theme, "Ensuring Indigenous Peoples’ health, including in the context of conflict," underscores a profound concern for survival, as experts highlight that Indigenous communities already grapple with severe health inequities rooted in historical colonialism and exacerbated by environmental degradation. These existing vulnerabilities are further compounded by armed conflicts and pervasive militarization, which not only risk widespread ecological destruction but also precipitate the forced displacement of Indigenous populations from their traditional territories.

For Indigenous experts, health transcends conventional clinical definitions; it is inextricably linked to the environment, land tenure, and inherent sovereignty. Discussions at the forum will therefore move beyond siloed medical or public health frameworks to address holistic well-being. Beyond the immediate specter of warfare, advocates are increasingly voicing alarm over the surge in critical mineral extraction, deemed essential for the global "green transition" but often leading to egregious violations of Indigenous rights. A long-standing call for direct climate financing to Indigenous communities, circumventing state or foreign intermediaries, is also being vigorously renewed, aiming to empower self-determined climate solutions and resilience building.

Before the substantive diplomatic discussions can even commence, many delegates face the formidable practical hurdle of securing entry visas to the United States. Mariana Kiimi Ortiz Flores, a Na’uu Savi advocate from Mexico and advocacy assistant at Cultural Survival, recounts a troubling trend. Last year, her organization prepared Indigenous representatives from Africa to attend the forum, only to see their visa applications denied. This year, an Indigenous staff member from South America encountered the same rejection. Flores observes that access to the United States is becoming progressively more difficult, extending beyond mere visa logistics. "People from the Global South, especially Indigenous peoples that have a certain look like brown skin and certain characteristics, we feel threatened because of the general climate of insecurity and hate speech against Latin people and Indigenous peoples," she states, reflecting a sentiment of growing xenophobia.

Last year, Cultural Survival assisted Indigenous leaders from Bolivia who traveled to the forum to protest mining operations encroaching upon their ancestral lands. However, their participation was cut short by harassment from a political party leader from Bolivia, coupled with emerging health issues, leading them to decide against returning this year. Flores laments, "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." She underscores the comprehensive toll exacted by these struggles, noting that "this struggle of defending their land against this extractive industry is really affecting them not only physically but also mentally, spiritually."

This holistic perspective on well-being forms the bedrock of a critical report authored by Geoffrey Roth, a Standing Rock Sioux descendant, former vice chair of the Permanent Forum, and board chair of the Indigenous Determinants of Health Alliance, an international Indigenous health advocacy nonprofit. Roth emphasizes, "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 systematic exclusion from decision-making processes. Roth argues forcefully that the fragmented approaches to Indigenous health frequently adopted by the UN system and national governments are fundamentally inadequate, failing to address the root causes of health disparities.

For instance, biodiversity policies that neglect to incorporate Indigenous rights invariably miss crucial opportunities to restore Indigenous land tenure, which could simultaneously yield significant ecosystem benefits and enhance access to traditional foods. Similarly, mental health interventions that overlook state-sanctioned Indigenous language erasure fail to grasp the profound potential for improving Indigenous mental well-being through comprehensive language revitalization efforts. "Indigenous health is not just about healthcare, it’s about land, culture, food systems and community," Roth asserts. The Coquille Indian Tribe in Oregon notably embraced the Indigenous determinants of health by ordinance last year, with Roth actively collaborating as chairman of their executive health board to integrate these determinants across all their agencies. He highlights the tangible benefits: "They understand that when they take elders out on a monthly basis to do fishing activities, that is health for those elders. It’s continuing their tradition as Coquille people, and it improves the mental health, behavioral health of those elders that are able to participate in that, let alone the food they catch." Roth’s report further calls on the UN to formally recognize the invaluable role of Indigenous midwifery, a practice historically suppressed in favor of Western medical models, often forcing Indigenous women into conventional institutions where they frequently encounter racism and "obstetric violence," including procedures performed without their informed consent. "Indigenous people have been doing this for thousands of years, not only midwifery, but also caring for the environment and caring for our culture and preserving these food systems," he explains.

In a separate, equally compelling report to UNPFII, former Permanent Forum chair Hindou Oumarou Ibrahim, an Indigenous Mbororo from Chad, issues a stark warning about artificial intelligence, describing it as a double-edged sword for Indigenous communities. While she urges governments to support Indigenous peoples in developing AI tools for vital purposes such as revitalizing endangered languages and monitoring their ancestral territories, she also cautions against an impending era of "digital extractivism." This refers to the alarming practice where generative AI systems and major tech companies indiscriminately scrape and utilize Indigenous cultural content, including invaluable medicinal knowledge, sacred traditional stories, and even sensitive genetic data, often without consent or equitable benefit-sharing.

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’ inherent right to own and control their own data – to a troubling personal discovery. She observed a mining company extracting detailed information about Indigenous cultural practices from an environmental impact statement and subsequently using it on its public website to promote a controversial mining project. "That was very alarming to me," Jennings recalls. "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’s nuanced perspective, Jennings acknowledges AI’s potential as an opportunity for tribes, noting that some might consider hosting data centers or leveraging AI for language preservation or information synthesis. However, she remains deeply wary of the extent to which AI systems may be co-opting Indigenous data without consent, alongside the severe ecological risks that massive data centers pose to tribal lands and critical water resources. "Who has the power and how do we redistribute that power?" she queries, adding, "It can be a tool to power and a tool to harm, but how do we choose to wield it?" Jennings highlights a burgeoning movement dedicated to embedding best practices of Indigenous data sovereignty across various sectors, from academic research to national and international policy frameworks.

Another critical focus of this year’s Permanent Forum is the escalating climate crisis. A February report, specifically addressing the plight of nomadic peoples, warns that rigid state borders and exclusionary "fortress conservation" models are severely curtailing the traditional mobility of pastoralists, hunter-gatherers, and seafarers. This occurs precisely as these communities contend with the severe impacts of climate change and an increasing lack of access to their ancestral lands and waters. The report’s authors argue that traditional mobility represents a deliberate, knowledge-based climate adaptation strategy, which state policymakers are actively undermining and erasing. Citing the example of the Tuareg people in the Sahara Desert, the authors describe how, "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 resonates with Samante Anne, an Indigenous Maasai from Kenya, who recently participated in a virtual panel on pastoralists’ legal rights on behalf of the Mainyoito Pastoralists Integrated Development Organization. Anne points out that while 60% of land in Kenya is officially communal, it is increasingly being subdivided for development projects and claimed for carbon offset initiatives, both of which severely restrict pastoralists’ access to land and their vital traditional mobility. "Mobility has everything to do with us adapting to climate change," Anne emphasizes. "Mobility has everything to do with ensuring our livelihoods are secure, our food security is good."

Making substantive progress on Indigenous health, artificial intelligence governance, and territorial rights is further complicated by a persistent and problematic trend within the United Nations 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. However, while "local communities" represents a broad category of diverse stakeholders, Indigenous peoples possess distinct, legally recognized rights under international law, including the right to self-determination and free, prior, and informed consent. Geoffrey Roth from the Indigenous Determinants of Health Alliance recounts confronting this very issue at the World Health Organization when the agency categorized an Indigenous initiative merely as an "equity" issue. "This is not an equity issue," Roth firmly told 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 contends that "conflating us with other populations really diminishes our rights and diminishes our ability to maintain our health in our communities." This problematic grouping also actively impedes meaningful Indigenous participation, Roth notes, 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 explains. "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 far from isolated. In 2023, the UN’s three most prominent 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 powerful joint statement unequivocally demanding that UN environmental treaties cease using the IPLC acronym entirely. "Indigenous Peoples should not be grouped with an undefined set of communities that may have very different rights and interests," they asserted, underscoring the fundamental distinction.

For advocates working directly on the ground, this ongoing debate about terminology is symptomatic of a broader, growing disillusionment with the effectiveness and influence of the UN system itself. Mariana Kiimi Ortiz Flores of Cultural Survival observes that the international institution has suffered from a persistent willingness by its member states to disregard its own established laws and conventions. "The United Nations as an international institution has been losing its influence and its power," Flores states with concern. Yet, despite the formidable bureaucratic hurdles, the persistent visa denials, and the overarching climate of geopolitical hostility, she emphasizes that she and countless other Indigenous peoples remain resolutely determined to participate in the forum this week. "If we as Indigenous peoples don’t do it," Flores concludes, "No one else will speak for us and defend us."