This year the Union for International Cancer Control (UICC) began a new three-year 'Close the Care Gap' campaign designed to raise awareness about the numerous barriers that exist for people around the world in accessing the cancer care they need.
In Australia, data shows that the greatest disadvantage is borne by Aboriginal and Torres Strait Islander people.
Over the next 10 years, low- and middle-income countries will see a disproportionate increase in cancer deaths. Australian data shows that there was a 12 per cent decline in mortality rate in the years 2006-2018 for non-Indigenous Australians while the rate increased by 12 per cent for Indigenous Australians.
This reverse trend, in a country aspiring to a world-class health system, is cause for dismay, and a call to action for many in the cancer community.
VCCC Alliance’s online event for World Cancer Day 2022, led by Professor Sanchia Aranda, past president of the UICC and Deputy Chair VCCC Alliance, and Dr Kalinda Griffiths, VCCC Alliance Research and Education Lead (R&E Lead) for Aboriginal and Torres Strait Islander Health focused on the disparity in outcomes for Australia's First Nations people. The presentations signposted multiple red flags and provided context to why Australia's cancer health system is failing Indigenous Australians.
The Victorian Aboriginal Community Controlled Health Organisation (VACCHO) has taken a solutions approach, partnering with the Menzies School of Health Research to produce the Menzies Desktop Review of the cancer care system. The Review, launched in conjunction with the VCCC Alliance, consolidates the knowledge and evidence for three priority issues in the cancer care system:
The full event broadcast is now available to view on the VCCC Alliance website.
The Menzies Desktop Review of the cancer care system is also now available on the VACCHO website.
Casting light on the complex interplay of all the factors affecting Aboriginal health is crucial to improving outcomes, said Professor Aranda. Access to services is about more than availability, she said. “If we can get it right for Aboriginal people, we can get it right for everyone.”
“If we can get it right for Aboriginal people, we can get it right for everyone.”
Professor Aranda presented evidence of a system resistant to change and a lack of data to effect change.
VACCHO’s Chief of Staff, Troy Walsh, and co-author of the Review, Professor Joan Cunningham from the Menzies School of Health Research spoke about the opportunity to extend real autonomy to Aboriginal Australians.
They revealed that targeted strategies addressing the level of Aboriginal people’s participation in clinical trials and research are required. While some progress has been made in terms of the number of Aboriginal-specific clinical trials being conducted, there remain many gaps.
Improving Aboriginal identification and ensuring culturally safe and effective cancer treatment for Aboriginal people with cancer both require multiple strategies across many levels to improve outcomes. Both service innovation and ongoing research and evaluation are needed.
The Menzies Review maintains that strategies and actions to accelerate progress across the three priority areas must be led by Aboriginal people, as Aboriginal leadership and engagement are essential and indispensable elements for success. And it is critical to ensure that appropriate structures and supports are in place to facilitate the genuine inclusion of Aboriginal people and organisations in determining future directions.
On World Cancer Day, Minister for Health Martin Foley announced funding for VACCHO to develop the Victorian Aboriginal Cancer Journey Strategy in partnership with Victorian Integrated Cancer Services, health services, Regional Cancer Centres and the VCCC Alliance.
Jill Gallagher AO, CEO of VACCHO said, “community-led strategies are paramount to closing the cancer care gap for Aboriginal and Torres Strait Islander peoples. A successful example of this is the Beautiful Shawls Project, which created a culturally safe environment for Aboriginal women during screening.
“VACCHO continues to work with community members with lived cancer experience and key stakeholders to lead sustainable, self-determined, culturally safe cancer efforts along the entire cancer journey.”
Work to support the development of the strategy is underway across VCCC Alliance member organisations. Dr Kalinda Griffiths, VCCC Alliance R&E Lead for Aboriginal Health said the circumstances in which information was collected about Aboriginal people and how it was used over many decades is problematic.
Quality Aboriginal health data is scarce and very new. “The earliest data on Aboriginal cancer survivorship is from 2014," said Dr Griffiths.
“But now we are in the data era. Mapping, screening, the collection of community-level data are opportunities. We have information about the effects of liver, cervical and lung cancer on Aboriginal people. We have the chance to use data for good more generally while remembering the human face, the person behind the data.”
For more information contact Dr Vijaya Joshi, VCCC Alliance Health Equity Manager, [email protected].
READ MORE about how the world marked World Cancer Day.
Banner image: Artist is Rebecca Clayton, Warlpiri
Beautiful Shawl Project referenced in the online event - Gunditjmara Shawl design.
