First Peoples’ Cultural Medicines Hub
Supporting Aboriginal and Torres Strait Islander people’s rights to access, maintain and strengthen Cultural Medicines, healing practices and knowledge systems.
The Hub brings together Indigenous-led research, resources and guidance to support culturally safe practice, informed decision-making and respectful engagement with First Peoples’ Cultural Medicines.
Our work centres Aboriginal and Torres Strait Islander governance, knowledge authority and community priorities, while supporting health services, practitioners and policy makers to understand and uphold the cultural, ethical and practical responsibilities involved in this important area of health and healing.
What we do
First Peoples’ cultural medicines (cultural medicines) have always been part of Aboriginal and Torres Strait Islander health and wellbeing, practiced for tens of thousands of years and embedded in connection to Country, culture, and community. Despite this, the contemporary health system has often lacked safe, consistent ways to recognise and support cultural medicines alongside biomedical paradigms of care. This has led to missed opportunities for culturally safe conversations, and in some cases, risks where First Nations people accessing health care feel unable, unsafe and unsupported to disclose their use of cultural medicines.
The Cultural Medicines Hub was developed in response to this gap, guided by Aboriginal and Torres Strait Islander leadership and research. It builds on broader medicines policy work that recognises traditional and cultural healing practices and knowledge protection are integral to health outcomes.
The Cultural Medicines Program was developed with Aboriginal and Torres Strait Islander leadership and research to respond to these gaps. The Program aims to:
- Centre First Nations knowledge and decision-making.
- Promote culturally safe, pluralistic care that supports both cultural and biomedical practices.
- Provide practical resources for clinicians, health services and communities.
- Inform policy, workforce training and system change to support access, recognition and intellectual property protection.
For details on how we have conceptualised cultural medicines as a distinct medical paradigm, see the description provided with Zyana Gall’s artwork.
Domains of Cultural Medicine
Zyana Gall, Truwulway and Litamirimina woman, Lutruwita (Tasmania)
Learn more about this Artwork
Our approach
Our approach is grounded in Aboriginal and Torres Strait Islander leadership, cultural governance and the authority of Elders, knowledge holders, communities and Community Controlled Health Organisations. The Hub is guided by Indigenous Data Sovereignty and Indigenous Cultural and Intellectual Property principles, recognising that Cultural Medicines knowledge is held within First Peoples’ knowledge systems and must be protected, respected and governed accordingly.
We work through co-design, research and partnership to develop practical resources that support culturally safe conversations about Cultural Medicines in health care. This includes working with Elders, community members, Aboriginal Community Controlled Health Services (ACCHOs), clinicians, researchers and policy partners to ensure resources are useful, respectful and responsive to community priorities.
Our approach also recognises that Cultural Medicines are part of a distinct medical paradigm, and that Aboriginal and Torres Strait Islander peoples should be supported to access Cultural Medicines in ways that are safe, self-determined and connected to Country, culture and community. Building on evidence that many Aboriginal and Torres Strait Islander peoples use Cultural Medicines when they have access to them, the Hub supports health services and practitioners to strengthen trust, improve communication and reduce risks created when people feel unable or unsafe to disclose Cultural Medicines use.
Through this work, we aim to support broader medicines policy, workforce capability and system change so that Cultural Medicines are better understood, appropriately recognised and respectfully supported across health and healing contexts.
Indigenous leadership and Governance
The First Peoples’ Cultural Medicines Hub is led by Dr Alana Gall, a Truwulway and Litamirimina woman from Lutruwita/Tasmania and Senior Lecturer in Indigenous Traditional Medicine at Southern Cross University. This work forms part of Dr Gall’s NHMRC-funded program, Tunapri Ngini, Tunapri Rrala, which means Old Knowledge, Strong Knowledge in palawa kani.
The Hub is guided by strong Indigenous governance structures to ensure the work remains accountable to Aboriginal and Torres Strait Islander peoples, communities and knowledge systems. This includes governance from Elder Aunty Theresa Sainty, who provides cultural guidance as Elder Governor for the program, and a Co-Design Research Group made up of Aboriginal and Torres Strait Islander community members, health professionals, researchers and partners who help guide the direction, priorities and outputs of the work.
Together, these governance structures support the Hub to uphold Indigenous Data Sovereignty, Indigenous Cultural and Intellectual Property, cultural authority and community-led decision-making throughout all stages of the work.
You can hear more about the Cultural Medicines Hub and the work behind it in the video on this page.
Research informing the Hub
The First Peoples’ Cultural Medicines Hub is informed by a growing body of Indigenous-led research on Aboriginal and Torres Strait Islander Cultural Medicines, cultural healing practices, health service access, policy and systems change. This research helps ensure the Hub is grounded in evidence, community priorities and First Nations ways of knowing, being and doing.
This section brings together summaries of related research, along with links to full-text articles where available, to support health professionals, services, policy makers, researchers and communities to better understand the evidence base informing this work.
Traditional, complementary and integrative medicine (TCIM) use among Indigenous peoples with diabetes in Australia, Canada, New Zealand and the United States
- TCIM is frequently used alongside conventional diabetes care.
- Use is motivated by holistic health beliefs. People choose TCIM for whole-of-life wellbeing, to restore balance, maintain strength, and because conventional care can feel too biomedical or fragmented.
- Cultural continuity and identity drive TCIM engagement. Practices such as bush medicine, ceremonies, spiritual healing support cultural connection, intergenerational knowledge transfer, and community wellbeing, not just symptom relief.
- Wide variety of therapies were reported such as herbal/botanical medicines, nutritional supplements, spiritual and faith-based healing, ceremonial practices, massage/bodywork and practitioner-based traditional therapies.
- Non-disclosure to clinicians is common as many users do not tell healthcare providers about TCIM use. Reasons include fear of judgment, belief clinicians don’t need to know, or thinking TCIM is separate from clinical care.
- The review found heterogeneous study designs, variable definitions of TCIM, small samples and limited rigorous evaluation of effectiveness or safety for diabetes-specific outcomes. This opens up an opportunity to create TCIM care pathways for specific conditions and needs.
- Health systems need culturally safe approaches where clinicians are empowered to proactively ask about TCIM in non-judgmental ways, incorporate cultural safety, and collaboration with cultural practitioners where appropriate.
First Peoples’ cultural medicines: a review of Australian health policies using an Indigenous critical discourse analysis approach
- Cultural medicines are widely used but often not discussed in clinical settings. Many Aboriginal and Torres Strait Islander people continue to use cultural medicines, but may not feel safe, or feel that they would be dismissed, disclosing this to health professionals.
- Health professionals want to know more about cultural medicines to feel confident in working pluralistically.
- Safe conversations improve care. When culturally safe environments are created, patients are more likely to share information about cultural medicine use supporting safer, more holistic care.
- Communities are not seeking to replace western medicine, but to use both systems together in ways that respect cultural knowledge and improve outcomes.
- Gaps or inadequate policy guidance at the health professional level and the health system level can risk unsafe care and work against promoting Indigenous rights and determinants of health.
- Only 9 of 52 national health policies explicitly mention cultural medicines. Key national bodies related to First Nations health system and medicines strategies or accrediting health professional workforce policies give weak or ambiguous guidance to health practitioners.
- Pharmacy guidelines give the most practical detail where the Pharmaceutical Society of Australia guidance includes the most comprehensive descriptions (definitions, reasons for use, recording in health records, cultural safety advice) though still limited on clinical decision rules.
- Disproportionate responsibility is placed on Indigenous practitioners where policies repeatedly single out Aboriginal and Torres Strait Islander health practitioners as the ones to advocate or advise on cultural medicines, increasing cultural/colonial load.
- Most policies lack actionable clinical guidance where cultural medicines are mentioned, instructions are generally vague where few policies explain how clinicians should respond, assess interactions, or support access.
Use and Access of Cultural Medicines by First Peoples in Australia: National Insights and Implications for Health Sovereignty
- Cultural Medicines are widely used. Highest use is of Country as medicine (71–89% in last 12 months) and smoking ceremonies (60.2% in last 12 months).
- There is strong unmet demand for traditional healers where only 9.7% report easy access to traditional healers, yet approximately 94% of those without access would use healers if available.
- Physical medicines are commonly used but access varies by type with external applications most used (42.2% last 12 months) with ingested and inhaled medicines used less. Many without access would use them if available.
- Native foods remain important but availability is uneven. There is high engagement with plant, aquatic and animal bush foods but 53.8% report only limited access and many would use foods if accessible.
- Smoking ceremonies are widely practised, song‑based healing and dance show slightly lower recent participation.
- Across domains participants most frequently want access through Aboriginal Community Controlled Health Services (ACCHS).
- Many patients qualitatively reported that Cultural Medicines work “often better than commercial products” for their bodies and minds.
- Many respondents reported qualitatively that they do not disclose cultural medicines use as they fear being judged, dismissed or ridiculed, but sometimes do report when they want their doctors to support them to monitor interactions (e.g. anaesthesia before surgery).
- Key structural barriers are also identified as causing limited access to Cultural Medicines since colonisation. Factors include displacement off Country or away from family, environmental degradation, as well as Cultural Medicines perceived to lack evidence as defined in western research practices and hierarchies (but Cultural Medicines have 50,000–60,000+ years of use as evidence of safety and efficacy) and misappropriation and poor policy/regulatory protections.
Using Indigenous and traditional medicine knowledge in research and development for drug discovery: hypothetical case vignettes
- Indigenous Knowledge and Traditional Knowledge have long contributed to medicine, science and global health, including through the use of medicinal plants.
- These knowledge systems are often used in pharmaceutical research and drug discovery without adequate recognition, consent, protection or benefit sharing for the knowledge holders.
- The paper uses two hypothetical case vignettes to show different ways medicinal plant knowledge can enter research: one through living, orally shared, community-held Indigenous Knowledge, and one through historical written sources where the original knowledge holders may be unclear or unacknowledged.
- Community-held Indigenous Knowledge requires relationships, trust, cultural authority and free, prior and informed consent. It cannot be treated as information that can simply be extracted and used by researchers.
- Historical or archived medicinal knowledge still raises ethical responsibilities. Even where knowledge appears in public texts, researchers need to consider provenance, custodianship, cultural authority, accountability and benefit sharing.
- Indigenous Knowledge and Traditional Knowledge can strengthen research by helping identify plants with therapeutic potential more efficiently than random screening approaches.
- Important cultural and practical knowledge can be lost when medicines are removed from their original context, including knowledge about harvesting, preparation, dosage, relationships with Country and whole-of-system healing.
- Current research, regulatory and laboratory systems are often not designed to work well with Indigenous medicines, especially where medicines are used as whole plants, mixed preparations or within holistic healing systems.
- Ethical research and development involving Cultural Medicines needs to move away from extractive models and towards Indigenous-led, culturally safe and reciprocal approaches that embed Indigenous governance, Indigenous Data Sovereignty, free, prior and informed consent, and fair benefit sharing.
- The paper calls for a two-ways knowing approach to drug discovery, where Indigenous and Western knowledge systems can work together without compromising the integrity, authority or cultural responsibilities of Indigenous Knowledge systems.
Resources
A number of different practical resources have been developed and continue to be developed based on the research collection findings.
How to use these resources
- Clinicians: Download the key principles and cultural medicine cards to guide safe conversations and clinical decision-making. Use the scorecard to assess organisational readiness.
- Health services and policymakers: Use the database and publications to inform policy, workforce training and integrated care pathways.
- Communities and cultural practitioners: Partner with us to co-design resources, validate content and guide how knowledge is recorded and shared with appropriate ICIP protections.
Key principles for working with First Peoples’ using Cultural Medicines
Health services and ACCHOs can download these key messages to support culturally safe conversations about First Peoples’ Cultural Medicines. The key messages were developed through Indigenous-led analysis of survey data collected from Aboriginal and Torres Strait Islander community members and health sector participants, followed by review and endorsement.
The development process included detailed qualitative analysis of survey responses, synthesis of high-level themes across community and health sector data, and review by Indigenous members of the research team to ensure the key messages aligned with the deeper findings. The draft messages were then shared with the Co-Design Research Group and discussed in a governance meeting, where the group endorsed the combined key messages for inclusion on the NACCHO website. The messages were further refined to ensure they are clear, practical and appropriate for ACCHOs and health services.
We recognise that health systems need to be more responsive to, and inclusive of, Cultural Medicines, while also respecting that local communities have their own protocols, knowledge authorities and relationships with traditional healing and medicines. These key messages are intended to support clinicians and health services in the first instance, while broader work continues around Indigenous Cultural and Intellectual Property, systems influence, and place-based Cultural Medicines programs and partnerships.
Please let us know if these are useful in your practice and with your organisation and reach out with any feedback you have and whether further products can be co-designed to support organisation policy and clinical practice regarding cultural medicines.
Cultural Medicines Database
The Cultural Medicines Database has been developed to provide a centralised collection of resources relating to Aboriginal and Torres Strait Islander Cultural Medicines, healing practices and knowledge systems. It brings together publicly available publications, reports, resources and other materials identified through the Cultural Medicines research program.
The database was developed over time by searching for and collating references to Cultural Medicines across publicly available sources. Each item was then assessed using a traffic light system that considered the extent of Cultural Medicines content, how accessible the resource is, and the reliability and appropriateness of the content. Resources authored or led by Aboriginal and Torres Strait Islander people, communities or organisations were considered especially important, given the need to privilege First Nations knowledge authority in this space.
The database went through several layers of review before being included on the Hub. Only resources assessed as amber or green have been uploaded. This means the database is not intended to include every resource ever written about Cultural Medicines, but to provide a practical and carefully reviewed starting point for health services, practitioners, policy makers, researchers and communities.
We recognise that Cultural Medicines knowledge is sensitive and place-based, and that communities, families and knowledge holders may have different views about how particular resources should be accessed, described or shared. If you believe a resource should not be included, needs to be described differently, or if you know of a relevant resource that should be considered for inclusion, please contact us.
Contact
We are continuously updating the Cultural Medicines Hub and invite clinicians, health services, researchers and cultural practitioners to contact us with any questions and feedback at medicines@naccho.org.au
