This paper examines the threats to Indigenous water rights and territories in the Andean countries. It analyzes how water and water rights are embedded in Indigenous territories, and how powerful actors and intervention projects tend to undermine local societies and indigenous livelihoods by developing large-scale water infrastructure. Three cases illustrate the encroachment process. In Colombia, the Embera Katio people’s water territory is colonized by a large-scale hydropower development project. In Ecuador, large-scale drinking water development for megacities aims the water belonging to the Oyacachi community’s indigenous highland territory. In Peru, communal water rights of the Colca Valley indigenous peasantry are under threat because of large-scale irrigation development. As the cases show, Indigenous peoples and communities actively contest the undermining and subordination of their water and territorial rights through a myriad of multi-scalar livelihood defense strategies. The challenges that indigenous peoples face to defend their water-based livelihoods are, however, enormous and growing every day.

Aim: We aim to evaluate the prognostic effect of Epstein-Barr virus (EBV) infection on overall survival (OS) in Peruvian women with cervical cancer. Methods: We conducted a retrospective cohort study. Polymerase chain reaction technique was used in paraffin-embedded tumor tissue for the detection of EBNA-1 and LMP-1. We used a multiple Cox proportional-hazard regression to estimate adjusted hazard ratios (aHR) for death and 95% confidence intervals (95% CI). In order to model continuous variables without categorization, we used a multivariable fractional polynomial approach. We performed a stability analysis using bootstrapping for internal validation. Results: A total of 99 patients with cervical cancer were included. The prevalence of EBV in cervical cancer specimens was 22.2% (n=22). The 1-year and 5-year OS rates were 81.8% (95% CI 58.5-92.8) and 45% (95% CI 23.9-64.1) in the EBV-positive group compared to 78.8% (95% CI 67.7-86.4) and 37.8% (95% CI 25.7-49.8) in the EBV-negative group, respectively. In the multivariate analysis, positive EBV status was an independent prognostic factor for improved OS (aHR: 0.32; 95% CI 0.16 to 0.67; p=0.002) compared to negative EBV status. Conclusions: EBV status is an independent prognostic factor for OS in cervical cancer. Evaluation of EBV status could be used as a clinical prognostic biomarker and to improve currently available prognostic models such as the FIGO system. Future prospective studies will be needed to validate these theories.