Achieving Aboriginal health equity through surveillance and support

Indigenous artwork

Artwork represents the CRE-ASH [ATLAS] working with five clinical hubs to make a difference in young people’s lives with regard to STIs and BBVs. The CRE-ASH [ATLAS], represented by the larger central meeting circle, is working with the hubs to share information and to learn from each other. Image: Jordan Lovegrove, Dreamtime Creative, Adelaide

Artwork represents the CRE-ASH [ATLAS] working with five clinical hubs to make a difference in young people’s lives with regard to STIs and BBVs. The CRE-ASH [ATLAS], represented by the larger central meeting circle, is working with the hubs to share information and to learn from each other. Image: Jordan Lovegrove, Dreamtime Creative, Adelaide

Get the latest UQ research news delivered straight to your inbox.

It’s one of the largest surveillance networks of First Nations health services globally.

ATLAS, as it’s known, uses health service data, collected through surveillance, to manage common infectious diseases in Aboriginal and Torres Strait Islander communities.

The Australian-first program is an intricate network spread across the country, but its purpose is simple, says Professor James Ward, Director of The University of Queensland’s Poche Centre for Indigenous Health.

"The health disparity that exists between Indigenous and non-Indigenous peoples is unacceptable. It's been long-standing and our job really is to try and make a difference with our communities we work with,” he said.

Professor Ward is a proud Pitjantjatjara and Nukunu man.

His Indigenous-led health research team work collaboratively to transform Aboriginal and Torres Strait Islander peoples’ experiences of injustice and inequity in health and wellbeing.

The ATLAS team left to right: Dr Clare Bradley, Professor James Ward, Dr Kate Lewis and Mr Alan Ho.

The ATLAS team: Dr Clare Bradley, Professor James Ward, Dr Kate Lewis and Mr Alan Ho.

The ATLAS team: Dr Clare Bradley, Professor James Ward, Dr Kate Lewis and Mr Alan Ho.

They use sentinel surveillance to achieve this, meaning they physically observe infectious diseases across Australia to gain a clearer understanding of the health care issues associated with them.

The researchers have worked with some of the nation's most remote communities, including in Cape York and the Kimberley regions of Queensland and Western Australia respectively.

Through their research, ATLAS was established to reduce the longstanding health disparity among Aboriginal and Torres Strait Islander peoples.

The surveillance network uses health service data to gain greater insights into access to care, testing and management of infectious diseases. 

It provides health services their data in a way that enables them to initiate quality improvement initiatives and to identify both strengths and gaps in their care cascades.

The Poche Centre has received acclaim for its work in health research and has also been granted tens of millions of dollars in funding from governments and philanthropists alike.

"As an Aboriginal man, I feel passionate about this area of research,” Professor Ward said.

“We have endured almost four decades of policy and program failures, and we are here to make a difference. I genuinely believe we can make a difference through research.

“Sexually transmitted infections (STIs), blood-borne viruses (BBVs), and vaccine preventable diseases (VPDs), among Aboriginal communities are between six and 30 times greater than non-Aboriginal populations in Australian cities.

“Our aim is to reduce the longstanding health disparity among Aboriginal and Torres Strait Islander communities through the ATLAS Indigenous primary care surveillance network.”

Member of the ATLAS team conversing with a community member that they visit

Members of the ATLAS team work with the communities they visit.

Members of the ATLAS team work with the communities they visit.

STIs and BBVs are endemic in many remote and regional communities in Australia, with STIs identified as the leading incident morbidity for Aboriginal people aged 15–24 years.

ATLAS was developed in partnership with the Aboriginal Community-Controlled Health Organisation (ACCHO) sector in five clinical hubs, spanning the Kimberley in Western Australia, Cape York in Queensland, urban Brisbane, New South Wales and South Australia.

Primary health care services within the ATLAS network have access to regular analyses and aggregated client population data that can be used for reporting as well as driving continuous quality improvement initiatives for their client population.

UQ’s Poche Centre for Indigenous Health and ATLAS program manager Dr Clare Bradley who works closely with participating sites said key goals for the project are supporting clinicians across a wide range of health conditions and improving patient care.

“In addition to STIs and BBVs, VPDs like influenza and pneumococcal disease will be focus areas as the ATLAS network grows, as they are a great burden on health in the community but are readily preventable through vaccination,” Dr Bradley said.

“We’re also focused on strengthening Indigenous Data Sovereignty and are developing traineeships in the data sciences so that control of health data remains in Indigenous hands.”

This Australian-first initiative led by Professor Ward, Dr Bradley and their colleagues provides state and federal governments with the information required to make informed decisions about policy and practice changes that are needed to Close the Gap in Indigenous health. 

The staggering figures reveal the need for immediate action to improve health outcomes for Indigenous peoples.

The team works to address infectious diseases in some of Australia's most remote areas.

The team works to address infectious diseases in some of Australia's most remote areas.

The team works to address infectious diseases in some of Australia's most remote areas.

One issue that the ATLAS network is working on is infectious syphilis.

During the last decade, an outbreak of infectious syphilis spanning multiple regions of Australia highlighted the need for national coordination to fight the problem.

More than 3600 cases were diagnosed during this period, with more than 65 per cent of cases occurring among people aged 15-29 years residing in remote communities of the Northern Territory, South Australia, Western Australia and Queensland.

Professor Ward said that of the 24 cases of entirely preventable congenital syphilis between 2013 and 2017, 15 (63 per cent) were Aboriginal.

Tragically, eight neonatal deaths have occurred within the context of this outbreak. 

Despite reports of increases of syphilis among non-Indigenous women, Aboriginal women are diagnosed with syphilis at a rate 44 times greater than non-Indigenous women.

Ultimately, Professor Ward and his colleagues aim to produce health research to build on strengths in the sector, as well as address gaps and challenges identified by Indigenous communities, to not only bring awareness to these issues, but help support solutions.

"We have a broad remit working in health research, building the next generation of Indigenous and non-Indigenous researchers to be able to make an impact in communities across Australia," Professor Ward said.


Professor James Ward

Professor James Ward is a Pitjantjatjara and Nukunu man, and a national leader in Aboriginal and Torres Strait Islander research. He is currently the Director of the Poche Centre for Indigenous Health at the University of Queensland. As such he leads a research program focused on urban Aboriginal and Torres Strait Islander health and an infectious diseases research program and associated issues.

Having held various roles in Aboriginal public health policy for both government and non-government organisations, in 2007 he was appointed as the Inaugural Program Head of the Aboriginal Program at the Kirby Institute, University of New South Wales.

In 2012 he moved to Alice Springs to become Deputy Director of the Baker Institutes' Aboriginal Health Program, after which he joined the South Australian Health and Medical Research Institute.

James has been awarded funding applications totalling $23 million since 2013; including $7.14 million as CIA on NHMRC funded grants and has authored 130 publications. He has led national research projects on health services research. His work has influenced policy and practice significantly contributing to national guidelines, policy and practice. During 2020 he has contributed to the national COVID—19 response nationally through membership of the Communicable Diseases Network of Australia and the National Aboriginal and Torres Strait Islander COVID-19 Taskforce.

Professor James Ward

Professor James Ward

Professor James Ward

Imagine a better future with us