It’s not just a matter of making life harder for Native epidemiologists: They argue that the federal government has a Constitutional obligation to collect and share this data. That’s because in acquiring Indigenous lands, US leaders inked hundreds of treaties promising to provide basic services, including health care, to tribes. These treaties led to the creation of the federal IHS, which along with the CDC funds tribal centers that provide free health services. Yet report after report shows Congress failing to support Native health. In 2015, the National Congress of American Indians estimated that the IHS receives less than 60 percent of the money it needs to support its basic services. This year, the agency’s own workgroup found its $6 billion budget would have to be increased eightfold to bring Native health care into parity with the rest of the country’s. (The CARES Act gave the IHS an extra $1 billion.)
Chronic neglect has left Indian Country with an almost total lack of pandemic response infrastructure, says Oglala Lakota doctor Donald Warne, director of the University of North Dakota’s Indigenous Health program. “Most of it needs to be built from the ground up.” Tribal epidemiology centers, Warne says, would be a good place to start.