On World Hepatitis Day this week NACCHO and Hepatitis Australia called for urgent national action, as Australia approaches its 2030 target to eliminate Hepatitis B and C.
With Hepatitis B and C disproportionately affecting Aboriginal and Torres Strait Islander communities, healthcare organisations are urging stronger, community-led efforts to close the gap in healthcare treatment and access.
Data from the National Aboriginal Community Controlled Health Organisation (NACCHO) reported that the hepatitis diagnosis rate among Aboriginal and Torres Strait Islander people is more than six times higher than the national average.
Aboriginal and Torres Strait Islander people also account for 18 per cent of people living with Hepatitis C and seven per cent with Hepatitis B - despite being only 3.8 per cent of the Australian population - and face a disproportionately higher risk of reinfection.
The federal government is expected to launch new national hepatitis strategies this year, reaffirming its stance on eliminating hepatitis B and C by 2030. This aligns with the World Health Organisation's Global Hepatitis Elimination Strategy, which Australia supported as one of 194 member states that unanimously adopted the commitment.
But healthcare experts say that barriers to hepatitis care faced by vulnerable communities must be addressed first.
Both NACCHO and Hepatitis Australia emphasised that reaching the 2030 target cannot be done without the full involvement of those most affected - such as Aboriginal and Torres Strait Islander communities:
"As a country, we can't claim progress if the most affected communities are still missing out," said NACCHO Chair, Donnella Mills.
"The way forward is in our hands, and with real commitment, we can end viral hepatitis for everyone, leaving no one behind."
Addressing hepatitis in First Nations communities also means recognising the cultural and systemic barriers that affect access to safe and effective healthcare.
"While Australia has made substantial progress in hepatitis C treatment, Aboriginal and Torres Strait Islander people have not had an equal share in these gains," said Dr Megan Campbell, Medical Advisor at NACCHO.
Dr Campbell points to several systemic factors such as limited access to health services, ongoing challenges in accessing culturally appropriate treatment and the hyper-incarceration of Aboriginal and Torres Strait Islander peoples paired with inadequate hepatitis prevention and health care in prisons.
But community-led care might be the solution to this disparity in hepatitis outcomes.
"When communities have the resources and support to drive solutions, we see real progress….Community leadership works; it just needs backing," Dr Campbell said.
NACCHO, as the national peak body representing 146 Aboriginal Community Controlled Health Organisations (ACCHOs) across Australia, believes that ACCHOs are the key to delivering effective care to First Nations communities.
"Our clinics are woven into the fabric of community. We know what works because it's built on culture, trust, and a genuine understanding of our people's needs. When we're supported to lead, the results are clear: health outcomes improve, and gaps start to close," Ms Mills said.
This sentiment is shared by Dr Campbell, who calls for the government and the health sector to "[recognise] the value of the community-controlled model and invest in the solutions that have demonstrated real success".
"To close the gap, we need to ensure that prevention, testing and treatment are strengthened where they are most needed, especially in prisons and, importantly, that ACCHOs are supported to lead this work," Dr Campbell said.
As Australia approaches 2030, Hepatitis Australia chief executive Lucy Clynes, said strategies for hepatitis elimination must reflect Australia's diverse and evolving population.
"The makeup of Australia's population is changing, and so too must our hepatitis response. We need to make sure that we understand who is affected by hepatitis B and hepatitis C, and that we're working with those communities to provide appropriate care and services," she said.
But while significant challenges remain, there have been signs of progress within First Nations communities.
"There are some areas where Aboriginal and Torres Strait Islander communities are doing really well in leading hepatitis elimination," Ms Clynes said.
"Ninety-five per cent of Aboriginal and Torres Strait Islander children are fully vaccinated against hepatitis B by 24 months of age, which is on par with the national average.
"In some cases, where we've really put the resources into community-led action, we're seeing incredible results. For example, the Hep B PAST partnership in the Northern Territory has achieved more than double the care and treatment uptake among Aboriginal and Torres Strait Islander communities compared to the national average."
With Australia in the final countdown towards hepatitis elimination, questions remain about whether the 2030 goal is achievable. But positive signs of progress within affected communities - paired with targeted, culturally responsive approaches - suggest hepatitis elimination is becoming a matter of when, not if.
"Australia has the tools to eliminate these diseases, but we need to make sure we're reaching everyone," Ms Clynes said.
