Australia will not end rheumatic heart disease for Aboriginal and Torres Strait Islander people by 2030 with half-measures, short-term funding or more talk. At Parliament House on Wednesday, the launch of the Parliamentary Friends for Ending Rheumatic Heart Disease put governments on notice: back community-controlled, community-led solutions for the long term, or keep failing a target the nation has already agreed must be met.
Co-chaired by Matt Smith MP, Julian Leeser MP and Allegra Spender MP, the Parliamentary Friends group was launched in partnership with the National Aboriginal Community Controlled Health Organisation (NACCHO) and the RHD Alliance. The event reinforced a clear national message: Aboriginal and Torres Strait Islander communities are already leading the solutions, and the evidence is showing that Community Control does it better.
Rheumatic heart disease remains entirely preventable, yet it continues to disproportionately affect Aboriginal and Torres Strait Islander people. NACCHO’s ARF and RHD Program summary shows that in 2024, 93 per cent of acute rheumatic fever diagnoses were for Aboriginal and Torres Strait Islander people, 78 per cent of people living with rheumatic heart disease on jurisdictional registers were Aboriginal and Torres Strait Islander, 53 per cent were under 35, 82 per cent lived in remote or very remote communities, and 65 per cent were women.
NACCHO is leading Australia’s first Aboriginal and Torres Strait Islander community-controlled, sector-led ARF and RHD Program. The program supports 29 ACCHOs reaching more than 100 clinics and homelands, with approximately 100 full-time equivalent roles across clinical, community and environmental health. Since 2022, participating services have identified and treated more than 23,000 skin infections, and in 2024, 46.1 per cent of eligible ACCHO patients received at least 80 per cent of prescribed secondary prophylaxis, compared with 32.4 per cent nationally. That is what community-led delivery looks like when it is properly backed.
NACCHO Chief Executive Officer Dawn Casey said the launch should end any doubt about what needs to happen next.
“Let’s stop pretending we do not know what works. We do. Community Control does it better, and the evidence is already there in the outcomes ACCHOs are delivering,” Ms Casey said.
“If governments are serious about no new cases of rheumatic heart disease for Aboriginal and Torres Strait Islander people by 2030, then they need to stop funding this work in short bursts and start backing the community-led solutions that are already making a difference.”
“That means full action on the Priority Reforms under the National Agreement on Closing the Gap, sustained long-term investment, and real commitment to the environmental determinants of health, improving housing and access to culturally safe primary health care services that keep people well in the first place.”
“Community-led is not the add-on. It is the answer. Back it properly, or we will keep missing targets that should have been met years ago.”
Left to Right: Allegra Spender MP; Georgina Byron AM; Vicki Wade; Matt Smith (Back); Dr Dawn Casey PSM; Julian Leeser MP; Dr Bo Remenyi.
Left to Right: Georgina Byron AM – CEO, Snow Foundation; Vicki Wade – Menzies School of Health Research; Dr Dawn Casey- CEO, NACCHO; Dr Bo Remenyi – Paediatric Cardiologist, Royal Darwin Hospital.
NACCHO’s own program framework is clear about what is required to meet the 2030 commitment: address the upstream determinants of ARF and RHD, secure long-term sustainable funding across the care pathway, put people and culture at the centre of care, strengthen primary care and collaboration with specialist services, ensure access to essential medicines, improve accountability, and fully enact the Priority Reforms of the National Agreement on Closing the Gap.
That work must also reach the environmental conditions that continue to drive preventable illness. Aboriginal and Torres Strait Islander people experience a 2.2 times higher burden of diseases with an environmental link. Targeted investment in remote and very remote communities offers the greatest return on investment. Aboriginal and Torres Strait Islander people in remote communities are hospitalised for environmentally linked conditions at 2.3 times the rate of non-Indigenous Australians, with those hospitalisations alone costing the health system at least $200 million a year. Nationally, environmentally attributable hospitalisations for Aboriginal and Torres Strait Islander people are estimated to cost between $360 million and $710 million a year. Closing the gap in environmentally attributable hospitalisation rates could save the hospital system between $185 million and $330 million per year, significantly more than the cost of the proposed investment.
For NACCHO, the case is straightforward: if Australia is serious about ending rheumatic heart disease, it must invest for the long term in safe housing, reliable household infrastructure, hygiene infrastructure, environmental health programs, culturally safe primary care and the Aboriginal and Torres Strait Islander workforce that communities trust. That is how we move from commitment to delivery. That is how Australia meets the 2030 target.
The Parliamentary Friends group provides a bipartisan platform to keep rheumatic heart disease on the national agenda, elevate Aboriginal and Torres Strait Islander leadership, and maintain pressure for action that matches the evidence. The launch also included a preview of Take Heart: Songlines, the third film in a documentary series highlighting the impact of rheumatic heart disease on Aboriginal and Torres Strait Islander communities and the strength of community-led solutions.
