Survival rates for Aboriginal people with liver cancer are now three times higher than in the mid-2000s, with experts crediting the remarkable improvement in part to a Northern Territory-designed hepatitis B program.

Established in 2018 after years of work with remote communities, Hep B PAST delivers a 'one-stop liver shop', providing blood tests, ultrasounds and follow-up care in a single visit, in partnership with Aboriginal community-controlled health services (ACCHSs).

Data show that the Territory has recorded the largest decrease in hepatitis B mortality of any Australian state or territory. The Aboriginal Medical Services Alliance Northern Territory (AMSANT) and the Menzies School of Health Research (Menzies) argue the Hep B PAST program demonstrates how community-led engagement and properly resourced solutions can improve outcomes.

"This is an NT success story," says AMSANT Chair Rob McPhee. He argues the results show what is possible when Aboriginal-led, community-controlled models are properly resourced.

"We know that Aboriginal people are too often diagnosed later, receive less treatment and experience higher mortality."

Hep B PAST is supported by an app providing hepatitis B education in 11 Aboriginal languages to help people better understand their diagnosis and care needs.

"Hep B PAST shows that when we invest in local leadership, language, trust and community-designed programs, we can turn that story around," Mr McPhee said. "This is exactly what Closing the Gap looks like in practice."

The gains coincide with the expansion of Hep B PAST and its companion workforce training initiative, Managing Hepatitis B, both now nationally recognised as leading models for early detection and culturally safe chronic hepatitis B (CHB) care.

The initiative was co-designed with Aboriginal health workers and has trained more than 200 staff across the Northern Territory. The accredited program has expanded to Far North Queensland and attracted interest from Western Australia.

Aboriginal and Torres Strait Islander people are six times more likely to develop liver cancer and face a 30 per cent higher mortality rate, largely driven by chronic hepatitis B. While overall cancer mortality has declined, liver cancer remains a major burden, particularly in remote communities where access to screening, diagnosis and treatment is limited.

Menzies Professor Jane Davies, who leads Hep B PAST, said the program's focus on early diagnosis and coordinated care is delivering significant improvements.

"The data shows liver cancer survival for Aboriginal people in the NT has tripled since 2006," Professor Davies said.

Since the program expanded, the proportion of people diagnosed with hepatitis B has risen from 60 per cent to 99 per cent, while 86 per cent are now engaged in hepatitis B care, compared with no previously available data.

"This is an extraordinary shift," Professor Davies said, "and it reflects the combined impact of early detection, patient-centred care and the trust and knowledge built through Hep B PAST and targeted workforce training."

At Miwatj Health's Galiwin'ku clinic on Elcho Island, the program has driven a marked increase in people engaging in treatment earlier and with greater confidence.

"We've seen more Yolŋu community members not only starting treatment, but starting sooner — including people travelling from Galiwin'ku to Adelaide for specialist care," said Dr Lou Sanderson, a GP and Director of Medical Services at Miwatj Health.

"In the past, leaving family and Country for unfamiliar treatment was daunting. Through Hep B PAST, people now receive information in language, understand their care, and feel confident to take that next step. It's made a huge difference."

Both AMSANT and Menzies say sustained funding is critical as liver cancer rates continue to rise, with the next round of data expected to show even greater gains.

"We have a proven model that works," Mr McPhee said.

"It is culturally safe, nationally recognised, and delivering real health gains. If we continue to back community-led care, we can save lives, reduce cancer inequalities and support healthier futures for the next generation."