This NAIDOC Week, the theme is 50 Years of Deadly. For me, those words land with particular weight and few examples better capture that theme than the achievements of Aboriginal community-controlled health services (ACCHSs).

Fifty years ago, Aboriginal communities across the Northern Territory and around the country began doing something governments had never trusted them to do: design, control and deliver their own health services. ACCHSs were born out of the same conviction that drove the land rights movement and the fight against entrenched racism — that Aboriginal people know what their communities need, and have the right to build it themselves.

These services were not just about a new way of delivering services: they were an act of self-determination and a way of providing a voice for the Aboriginal community.

At the time - the 1960s and 1970s - land rights were non-existent, poverty widespread, and our rights as sovereign peoples under continual attack. In health, mainstream services were failing Aboriginal families. Hospitals and other health services were segregated. Primary health care was fragmented, underfunded, and culturally unsafe.

So, community by community, Aboriginal organisations established a new model of community-controlled primary health care. They opened their own services under the principle of health for the people, by the people and of the people.

Central Australian Aboriginal Congress, established in Mparntwe (Alice Springs) in 1973, opened its first clinic in 1975. Over five decades it grew into one of the largest ACCHSs in Australia, serving more than 14,000 people across Mparntwe and remote communities in Central Australia. It is one example among many. Across the Territory and the nation, this is what community control looks like: organisations grown from the ground up, accountable to the people they serve.

Ahead of Congress's fifty-year celebrations, a rigorous analysis of regional health data was commissioned from the Menzies School of Health Research and NT Health. The findings in Central Australia are striking.

Since community-controlled primary health care was established in Central Australia, life expectancy for Aboriginal men there has increased by 18.3 years — from 47.3 years in the mid-1970s to 65.6 years by 2014-18. For women, it has improved by 8.5 years. Infant mortality in Alice Springs has been nearly halved. Premature death fell by more than half between 1999 and 2010. Alcohol-related hospitalisations have declined significantly following years of evidence-based advocacy and policy reform.

We cannot be complacent. Much more needs to be done. But we should also recognise that behind each of these statistics is a family that still has its loved ones and a community that is stronger.

These improvements cannot be explained by changes in the social determinants such as housing, education, income or food security, because these have not seen major improvements. Instead, the health gains track directly with sustained investment in community-controlled primary health care.

And these results are not confined to one service or one region. Across the Territory and across Australia, ACCHSs have grown and found their own ways of delivering on the same fundamental principle. Each service is grounded in its own community, its own culture, its own Country.

As the CEO of the Aboriginal Medical Services Alliance Northern Territory, I see this across our member services every day — in Darwin, Katherine, Tennant Creek, Nhulunbuy, and remote communities across the Top End and central Australia. These services are delivering care that governments alone have never been able to achieve by delivering effective health care in a way that works for their people.

But we cannot rest on this story of success. The health gap remains unacceptably wide. The life expectancy gap between Aboriginal and non-Indigenous Territorians is still around 13.5 years. Overcrowded housing, poverty and the long shadow of colonisation continue to shape the conditions our people live in.

This NAIDOC Week, I think about the founders, leaders and health workers of our first community-controlled services — the Aboriginal people who, in community after community, decided not to wait for governments to fix things because they knew their people deserved better.

As we celebrate 50 Years of Deadly, we should remember that the most significant gains for Aboriginal people have not come from programs designed for us, but from organisations built by us. For 50 years, Aboriginal community-controlled organisations have been leading solutions, speaking out for their communities, and improving lives.

The next chapter should not be about searching for new answers. It should be about backing the successful models that Aboriginal communities have already spent half a century building. That is what deadly looks like.

Donna Ah Chee is the CEO of the Aboriginal Medical Services Alliance Northern Territory (AMSANT).

NAIDOC Week 2026 runs from 6 to 13 July.