‘GETTING TO ZERO’ FOR FUTURE GENERATIONS:
An Aboriginal Declaration and Commitment to Eliminating
HIV Stigma and Discrimination, New Infections and AIDS Related Deaths in Our Communities
We, as representatives of First Nations, Inuit and Métis communities, Nations, Peoples and organizations committed to Aboriginal AIDS Awareness Week (AAAW), organized by the Canadian Aboriginal AIDS Network (CAAN), reaffirm our right of self-determination and remind the Government of Canada of their fiduciary responsibilities and obligations under national and international laws concerning the health of Aboriginal peoples in Canada;
We are concerned that Aboriginal Peoples, as approximately 3.8% of the overall population of Canada, are overrepresented in new HIV-positive test reports among all Canadians living with HIV. We join together with our global counterparts, by endorsing and adopting the UNAIDS World AIDS Day ‘Getting to Zero’ global campaign, and declare our multi-year commitment beginning in 2012 towards eliminating HIV and AIDS in our communities.
ABORIGINAL PEOPLES CONCEPTS OF HEALTH AND SURVIVAL IN ‘GETTING TO ZERO’
Aboriginal Peoples’ concept of health and survival is both a collective and individual inter-generational continuum encompassing a holistic perspective incorporating four distinct shared dimensions of life. These dimensions are the spiritual, the intellectual, physical and emotional. Linking these four fundamental dimensions, health and survival manifests itself on multiple levels where the past, present and future co-exist simultaneously.
It is therefore imperative to address these four dimensions and take action to support achieving health in each of them to get to zero HIV discrimination, new infections or AIDS-related deaths. This also includes addressing historical trauma, ongoing colonialism, as well as a commitment to action.
‘Getting to Zero’ is a long-term commitment that must be integrated in the daily practice of our work across Aboriginal communities every day. The Aboriginal AIDS Awareness Week (AAAW) activity guide sets out examples and guidelines for this work. The Chiefs of Ontario resolution 13 – 18 “Greater Involvement of First Nations People Living with HIV/AIDS” passed unanimously June 26, 2013, is an excellent example of how leadership can demonstrate their collective commitment.
OUR RIGHTS AND INTERESTS AS ABORIGINAL PEOPLES IN CANADA
Considering that the United Nations Declaration on the Rights of Indigenous Peoples outlines the rights, responsibilities and principles dealing with human rights and fundamental freedoms towards the attainment of the health and survival of Indigenous Peoples that Canada has endorsed, in accordance, we:
- Declare, affirm and assert that Aboriginal Peoples living with or affected by HIV in Canada are equal in dignity and in rights to all other peoples and, as such, have the right of self-determination and high quality healthcare;
- Declare the right to control and determine preventive and curative culturally respectful health systems and programs in our own communities and the means to train and involve Indigenous peoples in all areas of health;
Affirm the right to the highest attainable physical, mental, social, cultural and spiritual health and survival, commensurate with Indigenous Peoples’ definition of health and well-being.
- Call on Government to recognize the diverse systems of Aboriginal knowledge and practices in health and medicine;
- Promote free access to quality and culturally relevant health care according to individual needs, funded without discrimination, that extends to support services, and to ensure the full accessibility of services including those in isolated, northern, rural and remote regions
- Call for the promotion of adequate harm reduction programs to support substance use responses in Aboriginal communities and territories;
- Invite all Aboriginal Peoples in Canada to support and promote this ‘Getting to Zero’ Declaration and to recognize it as part of the national and global campaign to eliminate HIV and AIDS in our communities, to obtain the largest possible participation in the implementation of future strategies relevant to the health and survival of Aboriginal Peoples in Canada.
BROADER DETERMINANTS OF HEALTH WITHIN AN ABORIGINAL CONTEXT
The health of Aboriginal Peoples in Canada is overwhelmingly affected by determinants beyond the health sector, namely social, economic, environmental and cultural determinants. Negative impacts in all of these areas influence health outcomes and have fuelled the current HIV prevalence rates for Aboriginal peoples in Canada. These link to the consequences of colonization and intergenerational trauma, globalization, migration, cultural continuity, access to territory, poverty and the need for self-determination, and we declare that these broader determinants of health are amenable to intervention to protect and improve the health of Aboriginal Peoples living with and at risk for HIV. Aboriginal health strategies require concerted action on the part of governments and responsible agencies in relation to the social, economic and cultural determinants of the health of Aboriginal Peoples in Canada. Full and meaningful partnerships are required when working with Aboriginal Peoples, with all parties acting in good faith by being transparent in their dealings with Aboriginal communities.
As a means of achieving improved health, we call on our communities and the Government of Canada to act in partnership with Aboriginal leadership within the HIV and AIDS movement to address, among others, the following;
- Repatriation of Aboriginal Peoples removed from family and community;
- Renewal and sustenance of Aboriginal Peoples’ languages and cultures;
- Community recognition that HIV affects us all;
- Increased recognition that the broader spectrum of determinants of health identify factors that lead to disparities in health status and solutions must take these into account.
POLICIES, STRATEGIES AND ACTIONS
Aboriginal HIV and AIDS strategies have been developed at the national and regional level by Aboriginal AIDS service organizations and their partners to address the health needs of Aboriginal Peoples living with or affected by HIV in Canada. However, there is still an enormous gap between policy and action. This gap can be closed with the political will to implement existing policies and strategies. First steps could include recognizing Aboriginal Peoples’ rights to self-determination, and adhering to the principles of holism, meaningful participation, mutual respect and reciprocity, and supporting the validity and revitalization of Aboriginal cultures and institutions.
To achieve our commitment towards the implementation of the Getting to Zero for Future Generations Declaration, policies and programs are needed in the following areas:
- Empowerment strategies for Aboriginal people living with and at risk for HIV through broader adoption and endorsement of the ‘Greater and Meaningful Involvement of People living with AIDS’ (GIPA and MIPA) statements at all levels within our Aboriginal communities;
- Capacity building through human, technical and financial resource development;
- Aboriginal health research programs, including attention specifically to HIV and related issues led by Aboriginal peoples;
- Education initiatives for health service providers to ensure culturally relevant health care delivery for Aboriginal peoples living with and affected by HIV and AIDS;
- Prevention initiatives that respond to the unique dynamics of First Nations, Inuit and Métis peoples and the diversity within Aboriginal communities in Canada;
- Ongoing funding and resources for Aboriginal AIDS Service organizations and national bodies that have a specific mandate to address health and specifically HIV prevalence for Aboriginal peoples.
We call on the various government institutions of Canada to act in partnership with First Nations, Inuit and Métis leadership, communities, nations and organizations, in addressing the unique needs of Aboriginal Peoples by jointly developing new policies and funding new and ongoing programs which will enhance the health and wellness of Aboriginal Peoples in Canada through the Federal Initiative to Address HIV/AIDS in Canada;
Believing that the leadership of Aboriginal Peoples in all aspects of development and implementation of health programs addressing HIV and AIDS is essential to meet the unique health needs of community members currently living with and affected by HIV in Canada, we stand behind and support our champions who are speak openly about HIV and addressing HIV-related stigma and discrimination in our communities;
Reaffirming the indivisibility of human rights with regard to the health and survival of our communities as essential to an effective and meaningful response to the health needs of Aboriginal Peoples living with and at risk of HIV, we call upon all our leadership to stand with us in order to begin a process of ‘Getting to Zero’ and eliminating HIV and AIDS within our communities in Canada.
Aboriginal Peoples Living with HIV and AIDS
Formal and Informal Community Leaders
Staff members of Aboriginal AIDS Organizations across Canada
Text adapted in part from:
United Nations Economic and Social Council, Permanent Forum on Indigenous Issues. (2002). Indigenous Peoples and Health: A Briefing Paper for the Permanent Forum on Indigenous Issues. Annex 1 – The Geneva Declaration on the Health and Survival of Indigenous Peoples.