Introduction by Croakey: Effective partnerships between government and Aboriginal community controlled organisations during COVID-19 not only offer lessons for future pandemic control for Indigenous communities but also for how the National Agreement on Closing the Gap could operate.
That’s one of the takeaways in submissions from Aboriginal and Torres Strait Islander organisations to the Federal Government’s COVID-19 Response Inquiry, Alison Barrett reports below.
See also this earlier Croakey report on submissions to the inquiry from a range of other Aboriginal and Torres Strait Islander organisations.
Alison Barrett writes:
Aboriginal and Torres Strait Islander led and governed responses to the COVID-19 pandemic were critical in minimising the impact of the pandemic on First Nations people and communities, according to submissions to the Federal Government’s COVID-19 Response Inquiry.
“The community-controlled health sector, in partnership with governments, led a highly effective response to the COVID-19 pandemic”, the National Aboriginal Community Controlled Health Organisation (NACCHO) said in their submission.
The establishment of the Aboriginal and Torres Strait Islander COVID-19 Advisory Group (Advisory Group) in March 2020 – co-chaired by NACCHO and the Australian Government’s Indigenous Health Branch – enabled culturally safe and targeted measures that “set an excellent standard in terms of equity of access,” NACCHO wrote.
Key targeted measures included prioritised access to immunisations, boosters and antiviral treatments, as well as changes in scope of practice to support the Aboriginal Health Practitioner workforce deliver immunisations across all jurisdictions.
A submission by the Aboriginal and Torres Strait Islander COVID-19 Molecular Point of Care Testing Program echoed these sentiments, writing that the establishment of the Advisory Group “provided a foundation for an Aboriginal and Torres Strait Islander led COVID-19 response”.
Under the guidance of the Advisory Group, the COVID-19 Point of Care Testing Program – funded by the Department of Health and Aged Care and co-led by the Kirby Institute and Flinders University International Centre for Point-of-Care Testing – became the “world’s largest decentralised SARS-CoV-2 molecular POC testing network.”
Over 100 health services in regional and remote Aboriginal and Torres Strait Islander communities – including both Aboriginal community controlled and government health services – participate in the Program.
It enabled rapid responses to positive test results, including safe isolation, and overcame some of the challenges accessing pathology labs in regional and remote Aboriginal and Torres Strait Islander communities.
An evaluation of the Program found that it “averted” between 23,000 and 122,000 COVID infections that “would be likely to have arisen in the 40 days after the first infection was identified”.
Sustainability
According to NACCHO, the strength of its partnership with the Department of Health and Aged Care during the pandemic is a good example of how the National Agreement on Closing the Gap “was envisaged to operate”.
They said they would “welcome an increase in the use of partnership approaches such as this in line with Priority Reform One [to strengthen and establish formal partnerships and shared decision-making], including in the establishment of the Australian Centre for Disease Control”.
The Advisory Group and COVID-19 Point of Care Testing Program have also demonstrated sustainability – the Advisory Group transitioned to the National Aboriginal and Torres Strait Islander Health Protection (NATSIHP) sub-committee of the Australian Health Protection Principal Committee (AHPPC) in October 2022 as a means of providing an ongoing voice about health issues that impact Aboriginal and Torres Strait Islander People.
Using the infrastructure implemented during the Point of Care Testing Program, in 2022, the Program expanded for other priority infections including influenzas A and B and respiratory syncytial virus as well as COVID.
According to the Point of Care Testing Program COVID-19 response submission, NATSIHP continues to provide advice and governance to what is now called First Nations POC Testing Program.
Closing the Gap priorities
In their submission, NACCHO made some recommendations for the management of future pandemics, including that:
- Any interventions to address future pandemic responses align with the National Agreement on Closing the Gap and its four Priority Reform Areas.
- Investment in community-led quarantine facilities may help overcome some of the challenges in isolating effectively in Aboriginal and Torres Strait Islander communities.
- Funding that is currently provided to Primary Health Networks to deliver services to Aboriginal and Torres Strait Islander communities should be redirected to the ACCHO sector – in line with Priority Reform Two of the National Agreement to build the Aboriginal and Torres Strait Islander community-controlled sector.
They noted that while there was a strong partnership at Commonwealth levels, the state and territory peak community-controlled organisations reported that shared decision making occurred at “crisis point” rather than in advance to prevent crises.
They also said the COVID response “failed to address or adequately consider the social determinants of health”, in particular around housing security.
Similar to NACCHO’s submission, the First Peoples Disability Network (FPDN) Australia submission highlighted how the Australian Government’s response to the COVID-19 pandemic, as well as any natural disaster or emergency, could better align with the National Agreement on Closing the Gap.
In particular, FPDN called on the Federal Government and Australian Bureau of Statistics to “ensure comprehensive approaches to data collection”, in line with National Agreement Priority Reform Area Four – Improve and share access to data and information to enable Aboriginal and Torres Strait Islander communities make informed decisions.
They said the Government “cannot seriously and meaningfully create ‘mechanisms to better target future responses to the needs of particular populations’ if the data that is required in order to identify those needs simply does not exist in the first place”.
Intersectionality
Additionally, FPDN’s submission said it is critical for governments to consider the “concept of intersectional disadvantage” when developing emergency plans.
“For First Nations persons with disability, sources of discrimination and disadvantage are fundamentally intertwined,” FPDN wrote.
As widely reported throughout the pandemic, collaboration with target audiences is required for effective communications. The FPDN noted that much of the public guidance material on COVID-19 was not accessible to people with disability.
“Specialised, local community-managed organisations are best placed to understand and respond to the specific needs of their communities,” according to FPDN.
They encourage the Government to formulate their pandemic and emergency responses to be consistent with “core obligations under the Convention of the Rights of Persons with Disabilities, Closing the Gap Agreement and the Disability Sector Strengthening Plan”.
See Croakey’s extensive archive of articles on COVID-19.
