Eliminating Hepatitis B Transmission in

Indigenous Australia

THE GAP

“There will be some challenges. Stopping

transmission of Hepatitis B is not as simple as

ensuring blanket vaccine coverage or adequate

testing. It is our view that by approaching this

in an innovative and cohesive way, we will have

the best chance we have ever had of eradicating

the transmission of this disease and significantly

improving the wellbeing of the Indigenous people

affected and their communities as a whole.”

Dr. Jane Davies Menzies School of Health Research

In Australia, the burden of Hepatitis B (Hep B)

disease is disproportionally carried by Aboriginal

and Torres Strait Islander people, with infection

rates three times higher than for non-Indigenous

Australians. In Northern Australia, the rate of

Hep B infection in the Indigenous population

is one of the highest in the world. The Hep B

virus may not initially produce any symptoms,

however, the risk of developing liver cancer is

significantly increased upon infection.

The burden of HEP B disease in Australia is disproportionately carried by

ABORIGINAL and TORRES STRAIT ISLANDER people

3x HIGHERwith infection rates

than non-Indigenous Australians

HEPATITIS B (HEP B) is a growing global public health problem causing serious illness and death from chronic infection, liver cancer and liver disease

IN 2015

people died from HEP B related diseases worldwide

887,000

Worldwide,

2 BILLION PEOPLE have been infected with HEP B

The virus frequently remains undetected until

middle age when it rapidly and often fatally

causes diseases of the liver. For Indigenous

Australians, liver cancer affects people in the

prime of their lives, with death frequently

occurring soon after detection.

Unlike all other types of cancer where rates

are slowly going down, liver cancer is the most

rapidly increasing cause of cancer death. In

the Indigenous Australian population, rates

of liver cancer are 6 times higher than for the

non-Indigenous population. Once liver cancer

is diagnosed, 95% of Indigenous Australian

patients die within five years.

Unfortunately, because of the remoteness of

many Indigenous communities, a diagnosis

with liver cancer also means the end of a

life lived with kin and country, as treatments

are often only available in urban centres or

in some cases, another state. This involves

disconnection from family and friendship

networks, language challenges, and the often-

unfamiliar new world of Western medicine.

OVER HALF OF ALL INDIGENOUS LIVER CANCER CASES ARE DUE TO HEP B INFECTION WHICH IS CONTRACTED AT BIRTH OR IN EARLY CHILDHOOD

In NORTHERN AUSTRALIA the rate of HEP B infection in the Indigenous population is

ONE OF THE HIGHEST IN THE WORLD

LIVER DISEASE is the

3rd LEADING CONDITION CONTRIBUTING TO THE MORTALITY GAPbetween Indigenous and non-Indigenous Australians

LIVER CANCER rates are

6x HIGHER IN INDIGENOUS AUSTRALIANS than non-Indigenous Australians and over half of all Indigenous liver cancer cases are due to HEPATITIS B

Amongst Indigenous Australians, HEP B is the

Liver cancer is the fastest growing cause of cancer death in Australia

LEADING CONTRIBUTORTO LIVER CANCER

IN AUSTRALIA, UP TO

220,000people are currently infected, with approximately

going undiagnosed40%

BRIDGING THE GAP – A COLLABORATIVE EFFORT

Menzies seeks partnership support to realise

an innovative, multi-pronged program to

eliminate Hep B infection transmission in

Northern Australia. This work will be done in

collaboration with the renowned Peter Doherty

Institute for Infection and Immunity, a joint

venture between The University of Melbourne

and The Royal Melbourne Hospital.

This collaborative approach will provide highly-

targeted health interventions at key points in

the lives of individuals infected or at risk of

being infected with the disease. It will result in

longer, healthier lives for all Indigenous people

affected by Hep B infection. It will also lead to a

significant reduction in public healthcare costs.

In addition, there are other important outcomes

that will flow on from the efforts to eliminate

Hep B infection. Healthier adults managing

Hep B infection can stay in their communities

and thereby continue to act as family leaders,

cultural custodians and role models for

young people. They will also be able to

successfully manage Hep B infection and

work at the same time.

THE IMPACT

Our vision is bold. We believe that with

partnership funding, in the next five years we

can eliminate new cases of Hep B infection

in the Northern Territory and ensure that all

ongoing cases of infection are provided with

appropriate levels of care and follow up.

Our approach will be unique in this field; we will

work from a cohesive, integrated space, and

combine genotyping and laboratory data with

in-community education, medical interventions,

vaccination reviews and population movement

surveys to target and manage all cases of

Hep B infection in Northern Australia.

Indigenous researchers will be engaged and

funds provided for professional development

to build Indigenous workforce capacity.

Furthermore, this approach will be able to be

replicated in other communities and regions

both in Australia and around the world.

THIS FIVE-YEAR PROJECT WILL DISRUPT THE CURRENT TRAJECTORY OF POOR HEALTH AND LIFE EXPECTANCY THAT INDIGENOUS AUSTRALIANS ARE EXPERIENCING IN THE FIELD OF HEP B INFECTION AND WILL MAKE A SIGNIFICANT AND ENDURING CONTRIBUTION TO BRIDGING AND ULTIMATELY CLOSING THE GAP

The Australian Government Department of Health recognises Indigenous people as a

PRIORITY POPULATION in their

NATIONAL HEPATITIS B STRATEGY

WE ARE SEEKING $5 MILLION OVER 5 YEARS TO ENSURE THAT:

• • We can continue our ongoing clinical

research program aimed at strengthening

service delivery to remote communities

• • We are able to improve the understanding

of Hep B through the translation of

educational resources into four primary

languages

• • A Northern Territory-wide registry of

Hep B infection status is developed and

hosted at Menzies and the Hep B status

of all Northern Territory residents will be

determined

• • Those who are not infected or immune

are able to be vaccinated

• • Those who are infected are able to be

monitored and treated with antivirals

if necessary

FIVE MILLION DOLLARS WILL ENABLE MENZIES TO ELIMINATE ALL NEW CASES OF HEPATITIS B IN INDIGENOUS COMMUNITIES IN THE NORTHERN TERRITORY AND RENDER HEPATITIS B A DISEASE UNKNOWN TO FUTURE GENERATIONS OF INDIGENOUS CHILDREN

Phone: 0410 634 889 | Email: Colin.baillie@menzies.edu.au