Chrishma D. Perera

Most climate‐resilience health interventions are designed at the global level, with minimal attention to Indigenous communities' needs. The lack of consideration can lead to unintended harm and exacerbate health risks. This study aims to identify the capacities of Indigenous communities that can serve as transformative pathways in safely adopting global climate‐resilient health approaches within Indigenous contexts, ensuring the aims of the Sustainable Development Goals, such as Good Health and Well‐being (SDG3) and Reduced Inequalities (SDG 10). The World Health Organization's climate‐resilient health systems approach was used as a starting point to identify the transformative pathways. We collaborated with the Indigenous Peoples' Observatory Network (IPON) and conducted key informant interviews ( n = 17) with partners who maintain ongoing collaborations with Indigenous communities across 11 countries: Australia, Canada, Fiji, Ghana, India, Kyrgyzstan, Namibia, Peru, South Africa, Sri Lanka, and Uganda. The interview process was guided by two objectives: (i) to identify and examine how transformative pathways contribute to climate‐resilient health systems and (ii) to provide recommendations for strengthening transformative pathways based on key informants' insights. We identified five transformative pathways to support the resilience of health systems to climate change risks: (i) government‐community interactions, (ii) traditional medicine and spiritual beliefs, (iii) experience‐based practices, (iv) community‐based collective actions, and (v) community‐based policies. Based on the key informant interviews, we provide three recommendations to enhance the identified transformative pathways: (i) Indigenous mentorship in knowledge, health education, and research, (ii) identify opportunities to develop an Indigenous inclusive health workforce, and (iii) enhance indigeneity in health policies.

Coastal systems are a major source of food for Indigenous communities. Climate change poses a high risk to coastal communities’ food security. Successful climate change adaptation practices are essential to ensure food security among Indigenous peoples. Yet, limits and constraints challenge climate change adaptation practices. Our study seeks to identify these limits and constraints in the context of food security among coastal Indigenous peoples. We performed a global scale systematic literature review using 155 scholarly articles to examine the constraints and limits to climate adaptation in the coastal food security and Indigenous peoples’ context. The three research questions are as follows: (i) What are the key constraints? (ii) What are the limits? (iii) What are the ways of overcoming the constraints? First, we found that, globally, the main constraints to adapting to climate change in coastal food security settings are related to governance, institutions and policies. Second, most limits are soft, to be solved, compared to hard limits on coastal systems. Third, we unveiled ways of overcoming the constraints, such as restoring coastal food system resilience, improving food accessibility and building the adaptive capacity of Indigenous peoples. The findings of the study provide valuable insights for policymakers, researchers and other relevant stakeholders involved in decision-making regarding coastal food security in the climate change adaptation context.

The spread of COVID-19 in Peru resulted in the declaration of a national health emergency, in which Indigenous peoples were identified as being particularly vulnerable due to their pre-existing poor health indicators and disadvantaged social conditions. The aim of this paper is to examine how the Peruvian government responded to the health and food needs of the Shawi and Ashaninka Indigenous peoples of Peru during the first 18 months of the pandemic (March 2020–August 2021). This study uses both official policy documents and real-world experiences to evaluate policy responses in terms of their immediate impact and their longer-term sustainability and contribution to the improvement of health, well-being and justice for Indigenous communities. Four health and food security responses were evaluated: the Amazon Health Plan and Indigenous Command; food aid; cash aid; and COVID-19 vaccination. We employed the Multidimensional Injustice Framework to analyse the justice implications of the design and implementation of responses. Data collection included 71 interviews with government officials (n = 7), Indigenous leaders (n = 31) and community members (n = 33). The results show how national and regional governments released policies to address the health and food needs of Indigenous peoples directly or indirectly, as part of a broader focus on vulnerable people. However, justice implications were not sufficiently addressed in the design or implementation of the responses. On the distributive dimension, Indigenous communities were prioritized to receive health goods and services, nevertheless, the distribution had shortcomings that impeded their collection and Indigenous food systems and livelihoods were largely overlooked. On the procedural dimension, Indigenous representatives were included to provide culturally sensitive feedback on health interventions, but without funding, and furthermore, the community members had only passive participation. This paper points out the importance of considering and addressing justice implications for more effective and fairer health and food policy responses to current and future health crises.