NZ leads call to improve health for Indigenous people

An open letter published on 1 June 2018 in a leading international medical journal, Lancet Oncology, calls on the World Health Organization (WHO) and Governments to prioritise health improvements for Indigenous peoples worldwide.

New Zealand has joined forces with Australian and Pacific colleagues to challenge the WHO to increase its focus in a call for indigenous health rights. Cancer experts and Indigenous health leaders have joined together to push for an international step change in cancer control for indigenous people.
The significance of the letter has been recognised by the Director General of the WHO, Dr Tedros Adhanom Ghebreyesus, who has written a response in the same issue of the Lancet Oncology. Dr Tedros acknowledged that progress on Indigenous health had been slow.
“Health equity for the current generation cannot wait, and we cannot fail future generations of Indigenous people,” Dr Tedros writes.

Lead author of the joint letter Professor Diana Sarfati from the University of Otago, Wellington, says that cancer policy needs to have a clear focus on Indigenous populations to ensure these health inequities are addressed.

“While there has been tremendous progress in preventing, diagnosing and treating many cancers, the potential of this progress has yet to be fully realised by the Indigenous peoples in our region. Large disparities remain in many countries.

“We have identified issues - from lack of effective cancer prevention strategies, unequal access to and through cancer treatment and support services, and variable monitoring of cancer outcomes for Indigenous peoples, and these need to be addressed,” she says.

In many countries, Indigenous people are still invisible in health data, or the data relating to them are inaccurate and misleading.

“We need targeted strategies and plans to support the general and cancer-related health of Indigenous peoples, and also routine reporting on the health status of Indigenous populations in general, and on cancer outcomes specifically,” Professor Sarfati says.

Bridget Robson, Associate Dean Māori at UOW adds that Indigenous peoples of the Pacific, Australia and Aotearoa have the right to participate in developing and determining cancer control priorities and strategies that affect them.

“Governments should be facilitating appropriate collection of health-related data for Indigenous peoples, but most importantly we need to work with Indigenous communities and address the situation with practical and positive solutions,” she says.

Dr Nina Scott, who leads Hei Āhuru Mōwai – the New Zealand Māori Cancer Leadership Group, says “New Zealand is certainly no exception, but has led the way in researching unfair differences in cancer care between its indigenous and non-indigenous people.”

“Māori have longer wait times for treatment, poorer quality of care and a much lower chance of surviving and higher risk of dying from cancer. Institutionalised racism, resulting in less national effort put into Māori cancer control is at least recognised as an issue in New Zealand,” she said.

Background
In New Zealand, cancer is a critically important health issue for Māori, who have much higher rates of several major cancers such as lung, breast, stomach and liver cancer. Survival from cancer for Māori tends to be poorer than non-Māori. This situation is reflected around the world where major health issues and disparities among Indigenous peoples are not being addressed.

In February 2018, around 150 people from Australia, Pacific and Aotearoa (New Zealand) and representatives of global organisations attended a symposium to share insights, learn from each other and bring together collective strength and expertise to build a shared agenda for addressing cancer among Indigenous peoples. The symposium was part of the University of Otago, Wellington’s Public Health Summer School.

The following declaration was prepared as a result of the symposium:

Full Declaration (English version),

Declaration (te reo Māori version)

Cancer and Indigenous People Symposium talks

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