Hundreds of delegates, representing a diverse tapestry of Indigenous nations from every corner of the globe, are gathering at the United Nations this week for the world’s largest and most crucial assembly dedicated to Indigenous peoples’ rights and well-being. This significant annual event, the United Nations Permanent Forum on Indigenous Issues (UNPFII), convenes at a particularly precarious moment, with participants facing a global landscape marked by escalating geopolitical tensions, profound technological shifts, and an accelerating climate crisis that disproportionately impacts their ancestral territories and ways of life. The forum provides a vital platform for these communities to assert their inherent rights, share their experiences, and advocate for policies that safeguard their future, often against formidable odds.

This year’s UNPFII is sharply focused on the stark reality of survival amidst widespread conflict and existential threats, underscored by its official theme: "Ensuring Indigenous Peoples’ health, including in the context of conflict." Experts and advocates consistently highlight that Indigenous populations already grapple with systemic health inequities, deeply rooted in the legacies of colonialism, dispossession, and the ravages of climate change. These pre-existing vulnerabilities are now severely compounded by armed conflicts and pervasive militarization, which not only risk widespread ecological degradation but also trigger further displacement of Indigenous peoples from their traditional lands and cultural anchors. For Indigenous communities, health is intrinsically linked to the vitality of their environment, the security of their land tenure, and the exercise of their sovereignty; it cannot be narrowly confined to clinical medical discussions or conventional public health frameworks. Beyond direct warfare, a new wave of resource extraction, driven by the global pursuit of critical minerals essential for the green energy transition, is increasingly implicated in Indigenous rights violations, prompting a renewed and urgent call for climate financing to be directly channeled to their communities, circumventing often inefficient or corrupt state and foreign intermediaries.

Even before the critical diplomatic conversations can commence, many delegates from the Global South confront significant practical barriers, particularly stringent visa restrictions imposed by the U.S. administration. Mariana Kiimi Ortiz Flores, a Na’uu Savi advocate from Mexico and an advocacy assistant at Cultural Survival, recounts how her organization’s efforts last year to bring Indigenous representatives from Africa to the forum were thwarted by denied visa applications. This year, an Indigenous staff member from South America faced a similar rejection, illustrating a persistent pattern that curtails vital participation. Flores notes a broader sentiment of insecurity among Indigenous peoples from the Global South, especially those with distinct physical characteristics, who feel increasingly threatened by a prevailing climate of xenophobia and hate speech directed at Latin American and Indigenous populations.

This challenging environment extends beyond visa hurdles. Last year, Flores’ organization supported Indigenous leaders from Bolivia who attended the forum to protest mining operations on their traditional lands. However, their experience was marred by harassment from a political party leader from Bolivia, coupled with emerging health issues, ultimately leading them to decide against returning. Flores expressed a growing disillusionment: "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 profound, holistic toll that defending ancestral lands against extractive industries takes, impacting not only physical health but also mental and spiritual well-being.

This comprehensive understanding of well-being forms a central tenet of a pivotal 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 asserts unequivocally, "You can’t separate human health from the health of the environment, or our culture or our language." He emphasizes that Indigenous peoples perceive health through a holistic lens, encompassing interconnected physical, mental, spiritual, and environmental dimensions. His report meticulously outlines the Indigenous determinants of health, ranging from secure land tenure and robust governance authority—factors that intrinsically strengthen Indigenous well-being—to critical risk indicators such as land dispossession and exclusion from decision-making processes. Roth critiques the fragmented approaches to Indigenous health often adopted by the U.N. system and national governments, arguing that these siloed strategies consistently fail to adequately address the complex interplay of health problems and their underlying causes.

For instance, biodiversity conservation policies that disregard Indigenous land rights inadvertently miss profound opportunities to restore traditional land tenure, which demonstrably improves ecosystem health while simultaneously enhancing access to traditional foods and medicines. Similarly, mental health interventions that overlook state-sanctioned Indigenous language erasure fail to grasp the immense potential for improving Indigenous mental well-being through language revitalization efforts. Roth succinctly summarizes this interconnectedness: "Indigenous health is not just about healthcare, it’s about land, culture, food systems and community." Demonstrating this integrated 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 all tribal agencies. He cites examples where taking elders on monthly fishing activities is recognized as a vital health intervention, not merely recreation. "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," he explains, highlighting the cultural, social, and nutritional benefits. Roth’s report also advocates for the U.N. to formally recognize the invaluable role of Indigenous midwifery, which has often been suppressed in favor of Western medical practices. This suppression frequently forces Indigenous women into conventional institutions where they encounter systemic racism and "obstetric violence," including procedures performed without their informed consent. He passionately argues, "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."

Another significant report submitted to UNPFII by former Permanent Forum chair Hindou Oumarou Ibrahim, an Indigenous Mbororo from Chad, issues a critical warning about artificial intelligence (AI) as a double-edged sword for Indigenous communities. While she urges governments to support Indigenous peoples in developing AI tools for revitalizing endangered languages and monitoring their vast territories, she simultaneously cautions against an impending era of "digital extractivism." This phenomenon involves generative AI systems and tech companies indiscriminately scraping and commodifying Indigenous cultural content, including invaluable medicinal knowledge, sacred traditional stories, and even sensitive 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—a burgeoning movement asserting communities’ inherent right to own and control their own data—was catalyzed by a disturbing discovery. She found a mining company had extracted sensitive Indigenous cultural practices from an environmental impact statement and was leveraging this information on its website to promote a controversial mining project. "That was very alarming to me," Jennings recalled. "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?" Like Ibrahim, Jennings acknowledges AI’s potential as a powerful tool for tribes, particularly for language preservation or synthesizing complex information. However, she remains deeply wary of the vast amounts of Indigenous data AI systems may be co-opting without explicit consent, as well as the significant environmental risks that massive data centers—the physical infrastructure of AI—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 notes a burgeoning global movement dedicated to embedding best practices of Indigenous data sovereignty across various sectors, from academic research to national and international policy frameworks.

The escalating climate crisis also remains a central focus of this year’s Permanent Forum. A February report, specifically addressing the plight of nomadic peoples, issued a stark warning 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 face increasing loss of access to their ancestral lands and waters. The report’s authors argue compellingly that traditional mobility is a sophisticated, knowledge-based climate adaptation strategy that state policymakers are actively undermining. They cite the example of the Tuareg people in the Sahara Desert, whose ancestral routes are increasingly restricted by militarized frontiers, rendering their lived realities invisible in official data and policy frameworks, despite the desert knowing no borders.

This sentiment resonates deeply with 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 legally designated as communal, it is rapidly being subdivided for various developments and increasingly claimed for carbon offset projects. These initiatives, often presented as environmentally beneficial, paradoxically restrict pastoralists’ access to essential land and curtail their traditional mobility, which is crucial for their survival. "Mobility has everything to do with us adapting to climate change," Anne explained. "Mobility has everything to do with ensuring our livelihoods are secure, our food security is good."

Making substantive progress on complex issues such as Indigenous health, the ethical implications of artificial intelligence, and the defense of territorial rights is further complicated by a persistent, problematic trend within the U.N. 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 and undefined category of stakeholders, Indigenous peoples possess distinct, legally recognized rights under international law, particularly articulated in the UN Declaration on the Rights of Indigenous Peoples (UNDRIP). Geoffrey Roth from the Indigenous Determinants of Health Alliance recounted challenging this very issue at the World Health Organization when the agency categorized an Indigenous initiative merely as an "equity" issue. Roth firmly stated his position to the agency: "This is not an equity issue. 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." He further elaborated that "conflating us with other populations really diminishes our rights and diminishes our ability to maintain our health in our communities." This problematic grouping actively hinders meaningful Indigenous participation, with Roth pointing to the U.N. Convention on Biological Diversity’s IPLC working group as a prime example where he, as an Indigenous person, felt unwelcome and unable to participate effectively. He contends, "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."

Roth’s frustration is widely shared. In a landmark move in 2023, the U.N.’s three paramount 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 U.N. environmental treaties cease using the IPLC acronym entirely. Their collective statement underscored the critical distinction: "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 bureaucratic debate is symptomatic of a growing disillusionment with the U.N. system itself. Cultural Survival’s Mariana Kiimi Ortiz Flores laments that the international institution has been steadily losing its influence and power, largely due to the pervasive willingness of member states to simply disregard its established laws and conventions. Yet, despite these formidable bureaucratic hurdles, the challenges of visa denials, and the overarching geopolitical hostility, Flores articulates a powerful determination shared by countless Indigenous peoples to participate this week. Her words encapsulate their unwavering resolve: "If we as Indigenous peoples don’t do it, no one else will speak for us and defend us." Their presence at the UNPFII remains a testament to their enduring resilience and their steadfast commitment to shaping their own destiny in a world often resistant to their voices.