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Draft Road Map 3: A Strategic Framework for Improving Aboriginal and Torres Strait Islander Health through Research submission

This submission reflects the views of
Organisation Name: 
Australian Medical Association Ltd.
Personal Details
Specific Questions
Question 1A: Is the proposed objective of Road Map 3 relevant?: 
Question 1B: Why/why not? Please provide further comments to support your response to Question 1A.: 
The AMA agrees that the proposed objective is relevant however believes that only identifying community driven research fails to capture the importance and necessity of Aboriginal and Torres Strait Islander peoples involvement at all levels of the research process. While the AMA commends the NHMRC expanding the functions of the Principle Committee Indigenous Caucus (PCIC), inclusion of Aboriginal and Torres Strait Islander researchers, and Aboriginal and Torres Strait Islander representation on application review processes in the overall objective or within the interrelated components, ensures that these essential elements remain priorities.
Question 2A: Are the three priority areas of Road Map 3 accurate?: 
Question 2B: Why/why not? Please provide further comments to support your response to Question 2A: 
While the AMA acknowledges that a number of leading health issues have been identified, including RHD, Ear Health (addressed in our Report Card on Indigenous Health in 2016 and 2017 respectively), and Kidney Health (a potential future Report Card emphasis), there are also several glaring omissions, including: • under Item 4.3 - a failure to address women and girls health. While maternal health is mentioned, there is a need to promote better literacy of foetal origins of adult disease. Investments in family planning services, pregnancy planning, the health of girls and young women, better antenatal care, better intrapartum care and better support of the mother-child unit to age 2yo are all important examples of primary prevention of Diabetes, Hypertension, Obesity, etc.; • under Item 4.3.1 – while the ‘social determinants of health’ examples provided are clearly not intended to be exclusive, the addition of nutrition, food security, or nutritional literacy should be considered for inclusion. We know that optimal nutrition, or lack thereof, contributes significantly to malnutrition, overweight and obesity, and the development of chronic diseases, with disproportionate rates reported among Aboriginal and Torres Strait Islander people. With reduced support for preventative health initiatives demonstrated by a number of governments, the AMA would encourage the continued explicit promotion of those social determinants with the largest impact for improved health outcomes; and • under 4.3.2 – the syphilis outbreak occurring in multiple States, and particularly across northern Australia, as well as disproportionate levels of other Sexually Transmissible Infections (STI) among Aboriginal and Torres Strait Islander people, demonstrate continued failures of the health system and warrant the inclusion of STIs as a priority research topic. The AMA also supports the recommendation raised by AIDA in their submission, that the NHRMC consider the interrelated nature of the priority areas. The AMA further suggests that additional consideration could be given to research that addresses the relationship of these priority areas.
Question 3A: Are there any further priority areas to add? Please provide further details: 
Acknowledging the recommendations above, the AMA has no additional changes to the current priority areas.
Question 4: Is there anything missing from Road Map 3? Please provide further details: 
The AMA is in agreement with AIDA that the Road Map 3 should explicitly address, or provide appropriate reference to data sovereignty and intellectual property considerations for all research undertaken with, in or about Aboriginal and Torres Strait Islander communities.
Question 5: Are there any other comments you would like to make regarding Road Map 3? Please provide details: 
The AMA strongly supports the submissions presented to the NHMRC public consultation process by AIDA and [REDACTED], with specific acknowledgment that the overwhelming majority of research conducted in Aboriginal and Torres Strait Islander communities is conducted by non-Indigenous people. We agree that to achieve the goals of this strategic framework, stronger emphasis is needed to promote and advance Aboriginal and Torres Strait Islander leadership in research. There is an opportunity for Road Map 3 to include explicit targets to develop Indigenous researchers and/or to expand on the NHMRCs Targeted Calls for Research. In noting this, the AMA also strongly supports AIDAs recommendation to “…enable communities to directly engage/commission research relevant to them via the NHMRC.” The AMA agrees that such a process would give Aboriginal and Torres Strait Islander communities greater influence and autonomy over the research conducted within their community.

Page reviewed: 31 July, 2018