10.3 Key Issues and Lessons Identified

Indigenous Australians were found to be more vulnerable than the general Australian population to complications from the pandemic (H1N1) 2009 virus, with disproportionately high rates of complication and a six-fold death rate compared with non-indigenous Australians. The reasons for these more serious outcomes are likely to be multi-factorial and include social and cultural factors as well as the physical environment. Information on Indigenous populations of other parts of the world and early recognition of this threat to Indigenous Australians aided Australia’s response. The disease burden for this group may have been even higher without this prioritised attention.

Another pandemic is also likely to disproportionately affect this group. Plans need to incorporate this expectation and include appropriate responses that incorporate Indigenous-specific cultural, social and environmental values. There needs to be good linkage between jurisdictional and national-level planning and implementation of a response in urban, regional and remote settings. The logistics of remote area access should feature in emergency plans, as should the need to involve members of the Indigenous health and social sectors, as well as community leaders.

There were difficulties in providing personal protective equipment, medication and vaccine to Indigenous Australians in remote areas. The solutions that were put in place during the 2009 pandemic to overcome the logistical transport challenges need to inform future plans.

There was a limited trained workforce for the pandemic response in remote community settings. Surge capacity to support the established clinical workers who were already delivering healthcare services in Indigenous communities would have been a great advantage.

Once established, the IFN proved to be a useful mechanism and communication channel to ensure a nationally coordinated response for Indigenous Australians. Consideration should be given to maintaining it or establishing a similar forum, to inform planning and response. Representation of network members on key national and jurisdictional bodies was critical. These included the Interjurisdictional Pandemic Planners Working Group (IPPWG), the GPRT, the National Immunisation Committee and the AHPC as required. The IFN provided strategic advice and support to the Indigenous health sector and to the DoHA, which ensured that the needs of the Indigenous primary healthcare sector were incorporated into the national response. This type of network was also operational at jurisdictional level in many states and territories.