A regional public health emergency has been declared in four northern Manitoba First Nations.Leaders in the Island Lake First Nations say opioid use, toxic drug supply, HIV, hepatitis C and homelessness have reached a crisis point. The four communities are Red Sucker Lake, Wasagamack, Garden Hill and St. Theresa Point, which are represented by the Anisininew Okimawin Grand Council.Leaders gathered in Winnipeg Thursday, calling for prevention, treatment, housing, harm reduction and long-term funding for Anisininew-led care.“We are not arriving late to this declaration,” said Grand Chief Alex McDougall of the Anisininew Okimawin Grand Council. “We are standing with our relatives across the province and asking the federal and provincial governments to meet that moment with the urgency it demands. Our message today is not an attack on any government. It is an invitation.”“We should not have to ask different levels of government and jump through several different hoops just in order to get to the resources that are needed for families,” added Assembly of Manitoba Chiefs (AMC) Grand Chief Kyra Wilson. The Anisininew Okimawin Grand Council is calling on Ottawa and the Manitoba government to recognize the regional public health emergency.It also wants multi-year funding for medicine, harm reduction and treatment across the four Nations; investment in prevention infrastructure such as a regional hospital; and funding for First Nations policing for community-led prevention, harm reduction, and anti-exploitation measures.In May, Manitoba declared a public health emergency over HIV rates higher than elsewhere in Canada. Rates are highest in the southwest and northern parts of the province, with Indigenous Peoples disproportionately affected by the virus.In Garden Hill Anisininew Nation, officials say an HIV outbreak was declared in January, with 11 new diagnoses since the start of 2025.Councillor Harvey Little also raised concerns about drugs entering the fly-in community.“We need to bring back the searches at the airport,” Little said. “These are our airports, the four communities, and this is the daily battle that we face.”In Red Sucker Lake, Chief Samuel Knott says the emergency has been lived by families for years, and one shared needle can carry multiple diseases into an overcrowded home.“A child in Red Sucker Lake should not know what a needle looks like before they know how to read,” said Knott.Meanwhile, health workers with the Manitoba Anisininew Mobile Addictions Network say their outreach model is already helping people access care, but they are limited due to the need for more capacity.“We have almost 60 people waiting for treatment with us,” said Kirsty Muller. “We are currently at capacity for what we are safely able to take on and that is in our Garden Hill community alone, not to mention our other communities.”In a statement, Minister of Housing, Addictions and Homelessness Bernadette Smith said she met with Grand Chief McDougall to talk about this in late June, and that over the past year, the province has supported Indigenous-led organizations in opening 1,200 treatment spaces, along with creating virtual RAAM drop-in clinics and investing in the Minoayawin Mobile Outreach Program.