Thank you very much, and good morning. On behalf of the national chief and the national executive of the Assembly of First Nations, thank you very much for inviting us here to speak. I'd like to acknowledge, of course, that we're gathered here in traditional Algonquin territory and thank them for allowing us to gather here and do this work today.
I want to say at the outset that I'm joined by some very capable and knowledgeable staff who are here supporting me: Judy Whiteduck, Marie Frawley-Henry, and Jennifer Robinson. So I want to acknowledge them in reference to pulling this together.
It is my pleasure to speak before you today on the government's role in addressing prescription drug abuse in first nation communities.
First, I want to speak to the framework in which we operate. The UN Declaration on the Rights of Indigenous Peoples, in article 23, states:
Indigenous peoples have the right to determine and develop priorities and strategies for exercising their right to development. In particular, indigenous peoples have the right to be actively involved in developing and determining health, housing and other economic and social programmes affecting them and, as far as possible, to administer such programmes through their own institutions.
Secondly, it has long been the goal of the Assembly of First Nations to close the gap in health outcomes between first nations and the general Canadian population. We're pleased to see that this objective is shared by Health Canada as demonstrated by the expressed mandate to address health barriers, disease threats, and maintain levels of health comparable to other Canadians. So we're simpatico.
While we clearly share the similar objectives, the facts remain that first nations people continue to suffer disproportionately with poor health, both mentally and physically.
Thirdly, any consideration of the government's role in addressing prescription drug abuse has to begin with an understanding of the history of colonialism and its effects on first nations and their interactions with the government. In Canada, this history includes legislation such as the Indian Act, the creation of the reserve system, the various legal status apparatus in which we operate, residential schools, the sixties scoop, inadequate services to those living on reserves, continued racism, and the lack of understanding of their experiences or consideration of the effects of all these experiences.
Further, we also need to acknowledge the connection between historical, cultural, economic, political, and legal factors affecting the well-being of first nations people, namely, through the social determinants of health. While the social determinants of health approach is necessary in policy discussions and the government's role in addressing prescription drug abuse, it's not efficient in and of itself and must be implemented in accordance with the values, attitudes, and aspirations of first nations peoples. This is in addition to the utilization of traditional and western practices and service delivery aimed at first nations. Programs and services designed without first nations involvement simply will not work for us. Programs and services must be community-based and community-designed with a strong understanding of the diverse needs, because no two communities are the same.
The system of health we need to create and the system of health care must ensure that the sustainability of resources is matched to population growth and health needs. Additionally, policies and programs must be consistent with the inherent treaty and aboriginal rights as defined in section 35 of the Constitution Act.
So with respect to mental wellness, over the years first nation communities and leadership have been calling for a coordinated and comprehensive approach to mental wellness programming. This has been evident by the numerous resolutions that have been passed at our assemblies that give us our mandate and policy direction. Other national initiatives and organizations such as the Mental Health Commission of Canada have also identified the description of a continuum of mental wellness services for first nations as a high priority. We've worked closely with them in developing strategic directions that state things such as the recognition of distinct cultures and mental health needs of first nations, Inuit, and Métis outlines the importance of a distinction-based program within mental health. The strategy was released in May 2012.
However, it is imperative that this process be undertaken through a coordinated approach that involves the full participation of first nations as partners at every level of the process. For example, the Assembly of First Nations has partnered with the first nations and Inuit health branch to jointly develop a first nations mental wellness continuum framework ensuring that the unique needs of first nations in remote, rural, and isolated communities are taken into consideration. As a result, we expect and anticipate the government will work together with us in support of first nations mental wellness approaches along that continuum.
The government's role in addressing non-insured health benefits includes the need to improve access to that program, regardless of where first nations reside.
More importantly, we want to register the current and alarming state of the non-insured health benefits program, which demonstrates more than ever the need for profound changes in the administration of these benefits to meet the needs of first nations and not merely the fiscal interest of the country.
In 2011, the Assembly of First Nations requested that the Senate Standing Committee on Social Affairs, Science and Technology undertake a comprehensive review of the non-insured health benefits. This request was denied.
As a result, in 2012, the chiefs in assembly requested the Standing Committee on Health undertake this review. Again, this request was denied. This led to a further resolution from our chiefs, mandating the AFN to call for a joint review of the non-insured health benefits program, in collaboration with Health Canada. This request is ongoing. We wrote to the minister in January 2013, requesting action on the resolution. The letter called for a meeting between the national chiefs and the minister to begin discussions on conducting a comprehensive joint review of the program. We have just been informed that in the very near future, the national chiefs and the Minister of Health will be meeting for the first time to begin to do this work.
Another key issue relates to OxyContin, a long-acting oxycodone drug that was discontinued in Canada in 2012. Following the withdrawal, the generic oxycodone recently became available in Canada, and Health Canada approved new generic formulations of it. These new formulations are addictive, and they are not tamper resistant. As such, they will impact first nations that are struggling with this ongoing addiction. The misuse of oxycodone is merely one aspect of a larger health crisis within our communities. It has disastrous consequences all across first nations, and I think most notably in Northern Ontario, as has been demonstrated through the media.
Therefore, sustainable and sufficient investments must be made across a broad range of social and health services, including basic infrastructure such as housing and others, and the ability to access mental health support services and addiction recovery services.
Currently, our engagement with the government is occurring through partnerships and strategies that include a multi-pronged approach on preventing prescription drug abuse. The AFN works with the first nations and Inuit health branch's program areas, which include prescription drug abuse strategies to specific first nation communities in the areas of prevention, treatment, and enforcement. These include the first nations and Inuit mental wellness strategic action plan, the national anti-drug strategy, the national native alcohol and drug abuse program, and the national youth solvent abuse program.
In addition to our partnership with the first nations and Inuit health branch, we have also participated on the prescription drug abuse coordinating committee with the Canadian Centre on Substance Abuse. To date, projects such as Honouring Our Strengths—as we referred to earlier, which was produced in partnership with FNIHB and the National Native Addictions Partnership Foundation—and First Do No Harm are the most recent efforts to jointly develop a first nations mental wellness continuum framework that illustrates that the foundation of a systems-based approach to prescription drug abuse programs begins with individuals, families, and communities as well as many other key stakeholders and players.
More recently, we participated in a symposium held last month with Minister Ambrose to discuss resource gaps and opportunities for collaboration in the areas of prevention, treatment, and enforcement related to prescription drug abuse. We welcome continued engagement and encourage continued collaborative efforts to address prescription drug abuse within the mental wellness continuum so that first nation communities can adapt, reform, and realign their mental wellness programs and services according to their priorities.
We continue to call for flexible and sustainable long-term funding to ensure that the solutions to prescription drug abuse are community-driven, so that our families can continue to heal from the impacts of colonization and move forward on the path to mental wellness.
Finally, we reiterate our call for a joint review on the non-insured health benefits program. First nations are the youngest, fastest-growing populations in Canada. This work is in all of our interest. Strong and healthy first nations make for a strong and healthy Canada.
Thank you very much.