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Eliminating Hepatitis B Transmission in
Indigenous Australia
THE GAP
“There will be some challenges. Stopping
transmission of Hepatitis B is not as simple as
ensuring blanket vaccine coverage or adequate
testing. It is our view that by approaching this
in an innovative and cohesive way, we will have
the best chance we have ever had of eradicating
the transmission of this disease and significantly
improving the wellbeing of the Indigenous people
affected and their communities as a whole.”
Dr. Jane Davies Menzies School of Health Research
In Australia, the burden of Hepatitis B (Hep B)
disease is disproportionally carried by Aboriginal
and Torres Strait Islander people, with infection
rates three times higher than for non-Indigenous
Australians. In Northern Australia, the rate of
Hep B infection in the Indigenous population
is one of the highest in the world. The Hep B
virus may not initially produce any symptoms,
however, the risk of developing liver cancer is
significantly increased upon infection.
The burden of HEP B disease in Australia is disproportionately carried by
ABORIGINAL and TORRES STRAIT ISLANDER people
3x HIGHERwith infection rates
than non-Indigenous Australians
HEPATITIS B (HEP B) is a growing global public health problem causing serious illness and death from chronic infection, liver cancer and liver disease
IN 2015
people died from HEP B related diseases worldwide
887,000
Worldwide,
2 BILLION PEOPLE have been infected with HEP B
The virus frequently remains undetected until
middle age when it rapidly and often fatally
causes diseases of the liver. For Indigenous
Australians, liver cancer affects people in the
prime of their lives, with death frequently
occurring soon after detection.
Unlike all other types of cancer where rates
are slowly going down, liver cancer is the most
rapidly increasing cause of cancer death. In
the Indigenous Australian population, rates
of liver cancer are 6 times higher than for the
non-Indigenous population. Once liver cancer
is diagnosed, 95% of Indigenous Australian
patients die within five years.
Unfortunately, because of the remoteness of
many Indigenous communities, a diagnosis
with liver cancer also means the end of a
life lived with kin and country, as treatments
are often only available in urban centres or
in some cases, another state. This involves
disconnection from family and friendship
networks, language challenges, and the often-
unfamiliar new world of Western medicine.
OVER HALF OF ALL INDIGENOUS LIVER CANCER CASES ARE DUE TO HEP B INFECTION WHICH IS CONTRACTED AT BIRTH OR IN EARLY CHILDHOOD
In NORTHERN AUSTRALIA the rate of HEP B infection in the Indigenous population is
ONE OF THE HIGHEST IN THE WORLD
LIVER DISEASE is the
3rd LEADING CONDITION CONTRIBUTING TO THE MORTALITY GAPbetween Indigenous and non-Indigenous Australians
LIVER CANCER rates are
6x HIGHER IN INDIGENOUS AUSTRALIANS than non-Indigenous Australians and over half of all Indigenous liver cancer cases are due to HEPATITIS B
Amongst Indigenous Australians, HEP B is the
Liver cancer is the fastest growing cause of cancer death in Australia
LEADING CONTRIBUTORTO LIVER CANCER
IN AUSTRALIA, UP TO
220,000people are currently infected, with approximately
going undiagnosed40%
BRIDGING THE GAP – A COLLABORATIVE EFFORT
Menzies seeks partnership support to realise
an innovative, multi-pronged program to
eliminate Hep B infection transmission in
Northern Australia. This work will be done in
collaboration with the renowned Peter Doherty
Institute for Infection and Immunity, a joint
venture between The University of Melbourne
and The Royal Melbourne Hospital.
This collaborative approach will provide highly-
targeted health interventions at key points in
the lives of individuals infected or at risk of
being infected with the disease. It will result in
longer, healthier lives for all Indigenous people
affected by Hep B infection. It will also lead to a
significant reduction in public healthcare costs.
In addition, there are other important outcomes
that will flow on from the efforts to eliminate
Hep B infection. Healthier adults managing
Hep B infection can stay in their communities
and thereby continue to act as family leaders,
cultural custodians and role models for
young people. They will also be able to
successfully manage Hep B infection and
work at the same time.
THE IMPACT
Our vision is bold. We believe that with
partnership funding, in the next five years we
can eliminate new cases of Hep B infection
in the Northern Territory and ensure that all
ongoing cases of infection are provided with
appropriate levels of care and follow up.
Our approach will be unique in this field; we will
work from a cohesive, integrated space, and
combine genotyping and laboratory data with
in-community education, medical interventions,
vaccination reviews and population movement
surveys to target and manage all cases of
Hep B infection in Northern Australia.
Indigenous researchers will be engaged and
funds provided for professional development
to build Indigenous workforce capacity.
Furthermore, this approach will be able to be
replicated in other communities and regions
both in Australia and around the world.
THIS FIVE-YEAR PROJECT WILL DISRUPT THE CURRENT TRAJECTORY OF POOR HEALTH AND LIFE EXPECTANCY THAT INDIGENOUS AUSTRALIANS ARE EXPERIENCING IN THE FIELD OF HEP B INFECTION AND WILL MAKE A SIGNIFICANT AND ENDURING CONTRIBUTION TO BRIDGING AND ULTIMATELY CLOSING THE GAP
The Australian Government Department of Health recognises Indigenous people as a
PRIORITY POPULATION in their
NATIONAL HEPATITIS B STRATEGY
WE ARE SEEKING $5 MILLION OVER 5 YEARS TO ENSURE THAT:
• • We can continue our ongoing clinical
research program aimed at strengthening
service delivery to remote communities
• • We are able to improve the understanding
of Hep B through the translation of
educational resources into four primary
languages
• • A Northern Territory-wide registry of
Hep B infection status is developed and
hosted at Menzies and the Hep B status
of all Northern Territory residents will be
determined
• • Those who are not infected or immune
are able to be vaccinated
• • Those who are infected are able to be
monitored and treated with antivirals
if necessary
FIVE MILLION DOLLARS WILL ENABLE MENZIES TO ELIMINATE ALL NEW CASES OF HEPATITIS B IN INDIGENOUS COMMUNITIES IN THE NORTHERN TERRITORY AND RENDER HEPATITIS B A DISEASE UNKNOWN TO FUTURE GENERATIONS OF INDIGENOUS CHILDREN
Phone: 0410 634 889 | Email: [email protected]