Health Transformation Lead Negotiator, Alvin Fiddler and Health Transformation Special Advisor, Ovide Mercredi discussing the Health Transformation Department at NAN and how it came to be.

Mandated by Nishnawbe Aski Nation (NAN) Resolution 16/04 Call for Declaration of Public Health Emergency, the Sioux Lookout Chiefs Committee on Health and the NAN Executive declared a Health and Public Health Emergency for First Nations across NAN territory.  This Declaration was not made lightly.  It was forced into existence by decades of perpetual crisis and persistent health care inequities at the NAN community level.  The Declaration is an assertion of the inherent Treaty rights of NAN members to equal opportunities for health, including access to appropriate, timely, high-quality health care, regardless of where they live, what they have or who they are.

In order to exercise our self-determination over health we need to bring back accountability, responsibility and resource allocation to our communities.  This involves changing the current colonial system to a new system that is based on the needs and priorities of our communities.

Following the Declaration, a meeting took place on March 31, 2016 between First Nation leadership and the Ontario Minister of Health and the Federal Minister of Health. The parties agreed to continue with an on-going relationship to develop and oversee transformative change in First Nations health with a focus on NAN communities. This led to the execution of a trilateral commitment document: The Charter of Relationship Principles Governing Health System Transformation in NAN Territory (the Charter) which was mandated by NAN Resolution 17/21. The Charter was signed by the Parties (Grand Chief Alvin Fiddler, Minister Jane Philpott and Minister Eric Hoskins) on July 24, 2017. 

The Charter marks the commitment of the Parties to a NAN process towards health transformation. In addition to outlining the guiding principles, it sets out the following vision for system-wide change whereby First Nations have equitable access to care delivered within their community.  It ensures that communities will be engaged at all levels so that their voices are heard and incorporated into community-based programming.

In order to support the NAN Health Transformation process, the governments agreed to several actions, including:

  • Developing new approaches to improve the health and health access, including access at the community level.
  • Supporting the ability of First Nations communities and organizations to deliver their own services.
  • Proposing policy reform and exploring legislative changes to design a new health system for NAN territory, including sustainable funding models and decision-making structures.
  • Removing barriers caused by jurisdiction, funding, policy, culture and structures so that First Nations can deliver better plan, design and manage their own services.
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