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Targeted Call for Research - public call for research priorities in Aboriginal and Torres Strait Islander health

This submission reflects the views of
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Director Aboriginal and Torres Strait Islander Health Cairns and Hinterland HHS, RN, MAICD
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Specific Questions
1. What is the research priority (a significant research knowledge gap or unmet need) you are nominating? How would a TCR in this area greatly advance our understanding of this issue? (200 word maximum): 
The unexplored potential of Aboriginal and Torres Strait Islander Medicine (A&TSI Med) and Traditional Ecological Knowledges (TEK) is major and pertinent research knowledge gap and unmet need. TEK of Australian ecology, which A&TSI Peoples have developed over tens of thousands of years is mostly transferred orally and it is not embedded nor valued within Western systems such as, schooling and academia so is at high risk of being lost and is under-utilised. As a priority A&TSI Med and TEK needs to be thoroughly investigated, and documented to show how they currently contribute towards improving health outcomes as well as strengthening its impact within sustainable development. The establishment of a Centre of Research Excellence A&TSI Med and TEK (CRE A&TSI Med & TEK) is essential. CRE A&TSI Med & TEK should have three primary aims: - to build the evidence base within Western Science through collaboration with A&TSI Nations and Experts; - develop a system for quality monitoring the standards and qualifications of A&TSI Med practitioners; and - build capacity by providing a structured forum which facilitates equitable collaboration between Experts in A&TSI Med & TEK and academic and health institutes, governments, professional streams and other stakeholders.
2. What are the relevant Australian Government Priorities, and/or Ministerially-agreed State and Territory health research priorities linked to your nominated priority? (200 word maximum): 
* Progressing TEK is an overall development aspiration of Aboriginal and Torres Strait Islander Nations. * Improving the rapport and cultural responsiveness of the Australian Health System for Aboriginal and Torres Strait Islander Peoples which will enhance access, to seek treatment and gain early diagnosis, as well as reduce Discharge Against Medical Advice (DAMA). A&TSI Med and TEK research and implementation of findings will lead to holistic sustainable local community development initiatives improve many social determinants (e.g enterprise, job opportunities, improved food security), which leads to improvements in overall wellbeing therefore decreasing Potential Preventable Hospitalisations (PPH), and reduce avoidable mortality, reduce obesity and improve nutrition, improve mental health and reduce risk of suicide and self-harm. DAMA and PPH are key performance indicators within national health agreements. * Sustainable economic opportunities by conducting research and development within a niche strength of Aboriginal and Torres Strait Islander Nations and broaden the economic base of Aboriginal and Torres Strait Islander small vulnerable economies. Close the Gap Strategic area for Action - Economic Participation. * Improved and sustainable employment opportunities through research and development in an emerging industry. Close the Gap Target Employment. * Innovation in care and service provision to gain improved efficiencies in health service delivery.
3. How would a TCR in this area contribute to Aboriginal and Torres Strait Islander health and improve health outcomes for the individual and/or community? (200 word maximum): 
(Individual) * More job opportunities and potential to monetise existing skills and knowledge of Aboriginal and Torres Strait Islander Medicine Experts. * Increase skill set of Aboriginal and Torres Strait Islander Health Workforce. * Improved health outcomes and more comfortable patient journeys as an improved evidence base will enable consistent access to health services, instead of adhoc, non-coordinated and non-integrated access to A&TSI Med and Western Health Services. * Improved health outcomes through sustainable development such as, improved food security, improving functional interdependence through valuing role and relationships, and improved social and emotional wellbeing as a result of non-Indigenous valuing ATSI Med and TEK. (Community) * Research and Development within A&TSI Med and TEK knowledge areas which the community have confidence in and have aspirations to continue and strengthen for future generations. Aboriginal and Torres Strait Islander Nations fear this knowledges may be lost. * Evidence base to contribute to and drive local, regional and national sustainable development, through improving social, economic and environment outcomes. * Evidence base will assist with communicating and collaborating aspirations and sustainable development between A&TSI Nations, and non-Indigenous Australians people and institutions, given the polar methodologies for ontology, pedagogy, language and collectivist/individualist cultures and economic development.
4. How will the TCR reduce the burden of disease on the health system and Australian economy? (200 word maximum): 
A&TSI Med & TEK has the potential to significantly contribute to improving efficiency and efficacy of the Australian Health System for A&TSI Peoples as well as non-Indigenous Australians. Some potential benefits include: exploring medicinal properties of native Australian ecology; create sustainable employment and industries; improve food security; improve overall community and individual social and emotional outcomes through self-determination and progressing First Nations aspirations. Exploring then implementing ATSI Med & TEK research findings is currently not quantified, however due to the its sustainable nature there is significant potential across social, economic and environment outcomes, including direct improvement of individual health outcomes therefore reducing the burden of disease through improved early childhood development, pregnancy and childhood development, adult health, and successful ageing. Young people learning ATSI Med & TEK improves healthy eating, decrease sedentary lifestyle, improve brain and social development through an engaging teaching methods. For adults with existing or who are at risk of acquiring chronic disease or other conditions this TRC will lead to improved access through strengthening the cultural responsiveness of health services. Which also enables early diagnosis, and holistic treatment plans which incorporate Aboriginal and Torres Strait Islander cultural lifestyles due to improved therapeutic engagement.
5. Are there any reports or findings that support your nomination for the suggested topic? (200 word maximum): 
The following citations outline: - New Institutional Economics for A&TSI Small Vulnerable Economies enables sustainable development; - International recommendations in relation to Traditional Medicines and First Nations self-determination and development; and - Two examples of TEK collaboration with Western Science innovating sustainable development within A&TSI Nations. International Centre for Trade and Sustainable Development (ICTSD) 2011, Options for dealing with trade and development challenges of Small and vulnerable economies, Session 9: Economic Growth symposium presentations, ICTSD Global Platform on Climate Change, Trade and Sustainable Energy, Durban. Duncan, R 2004, “Agricultural and resource economics and economic development in Aboriginal communities”, The Australian Journal of Agricultural and Resource Economics, vol. 47, no.3, pp. 307-324. Beijing Declaration Adopted by the WHO Congress on Traditional Medicine, Beijing, China, 8 November 2008. WHO 2000, General Guidelines for Methodologies on Research and Evaluation of Traditional Medicine, Geneva, WHO/EDM/TRM/2000.1 United Nations 2007, Declaration on the Rights of Indigenous Peoples General Assembly Resolution 61/295 Adopted 13 September 2007, UN Doc: A/RES/61/295, Annex. Mackey, B., & Claudie, D. (2015). Points of Contact: Integrating traditional and scientific knowledge for biocultural conservation. Environmental Ethics, 37, 341–357. Turpin G, Ethnobotantist Current Pilot Project: Medicinal plants of the Mbabaram peoples https://www.jcu.edu.au/australian-tropical-herbarium/gerry-turpin

Page reviewed: 30 August, 2018