The Eora Nation is bounded by the three great rivers of the Sydney basin and has been home to generations of Aboriginal and Torres Strait Islander peoples well before Australian settlement. This Action Plan is named the Eora Action Plan as it was launched on the Eora nations land at Darling Harbour, Sydney on the 17th July 2014.
We acknowledge traditional owners and custodians of land, Elders both past and present, and acknowledge the remarkable part you have all played in keeping communities strong, resilient and engaged, to the threat and impacts of HIV. We would also like to acknowledge the leaders, the pioneers of the HIV response in Aboriginal and Torres Strait Island communities – those who have left us and those who continue to advocate and positively influence the policy and program agenda.
The Eora Action Plan voices the concerns of Aboriginal and Torres Strait Islander peoples about HIV and its potential impact on our communities. In particular, it seeks to bring greater attention and efforts to the prevention of HIV, including best clinical care and management of Aboriginal and Torres Strait Islander Peoples living with HIV. This Action Plan is informed by the undersigned partners and framed in the context of the UN Declaration on the Rights of Indigenous Peoples (UNDRIP).
At a time when Australia has endorsed targets set out in the United Nations Political Declaration on HIV and AIDS (UNPD), the Eora Action Plan sets some strategic targets. These targets include: reducing the sexual transmission of HIV by 50 per cent, reducing HIV transmission through injecting drug use by 50 per cent, eliminating all mother to child transmissions, and having all people living with HIV in low and middle income countries on antiretroviral treatments by 2015. The UNPD also proposes a world HIV response of ‘combined prevention’ and harm minimisation programs with wide availability of HIV treatment.
Australia has commenced work to apply the goals of the UNPD. Additionally, the AIDS 2014 Melbourne Declaration calls for “the eradication of discrimination against people living with or at risk of HIV, to ensure equal access for all people to HIV prevention, treatment and care”. The needs of Aboriginal & Torres Strait Islander peoples are to be considered for these targets to be met.
For 30 years the Australian Aboriginal and Torres Strait Islander population has remained resilient to the impact of HIV. This can be attributed to the internationally acclaimed partnership response that has resulted in best practice prevention, treatment care and management strategies. However the time has come for scaling up action in this area of health.
In 2014, it is unacceptable that:
Other sexually transmissible infections (STI) diagnosis rates among Aboriginal and Torres Strait Islander peoples are reported at between 6 and 35 times higher than non-Indigenous Australians
- In the last ten years the proportion of newly diagnosed HIV cases attributable to injecting drugs is four times higher in Aboriginal and Torres Strait Islander peoples compared to non-Indigenous Australians
- HIV cases among Aboriginal and Torres Strait Islander women is reported at four times the rate of non Indigenous Australian women
- Aboriginal and Torres Strait Islander peoples are 14 times more likely to be imprisoned than non-Indigenous Australians and there are limited harm reduction strategies implemented in Australian prisons to prevent HIV transmission
- Lack of data on Aboriginal and Torres Strait Islander peoples living with HIV and their experiences in health care and in particular, antiretroviral treatments presents significant challenges in mounting an effective response within the Treatment as Prevention agenda.
The Eora Action Plan has been prepared to demonstrate leadership, partnership and commitment. All organisations involved in HIV prevention, including government, have a responsibility to work in partnership with Aboriginal and Torres Strait Islander peoples and communities to achieve these goals and actions. For the Eora Action Plan to be effective and to progress towards its targets, additional funding sources will be required.
To further Australia’s commitment to the 2011 UNPD on HIV by working towards applying the targets within an Aboriginal and Torres Strait Islander culturally respectful and sensitive framework. Specifically we will aim to by 2017:
- Reduce the number of newly diagnosed HIV cases among Aboriginal and Torres Strait Island peoples by 50%;
- Eliminate all mother to child HIV transmissions among Aboriginal and Torres Strait Islander peoples;
- Ensure antiretroviral treatments are available and accessible and correctly utilised by 80% of Aboriginal and Torres Strait Islander peoples living with HIV;
- Move toward reducing rates of other STIs in Aboriginal and Torres Strait Islander communities by 50%;and
- Reduce rates of sharing injecting equipment by 80% among Aboriginal and Torres Strait Islander peoples who inject drugs.
- To ensure timely diagnosis and linkage to care with equitable access and engagement in health services for Aboriginal and Torres Strait Islander peoples living with HIV. These health services must be systemically non-discriminatory, and encompass Aboriginal and Torres Strait Islander cultural values and practices – culturally respectful and safe. Care and support must be extended to an individual’s immediate family affected by HIV.
- To eliminate stigma and discrimination within and external to our communities, particularly towards gay men , other men who have sex with men, sistergirls, brotherboys , people who inject drugs and people who engage in sex work.
- Promote and include HIV on the national Aboriginal and Torres Strait Islander health agenda and incorporate this Action Plan in its entirety in all policy pertaining to Aboriginal and Torres Strait Islander peoples and HIV.
- Reduce vulnerability to HIV by implementing evidence-based, high impact strategies to reduce rates of other STIs in Aboriginal and Torres Strait Islander communities.
- Reduce vulnerability to HIV among people who inject drugs by strengthening and addressing this within a harm reduction framework.
- Ensure the central involvement and participation of Aboriginal and Torres Strait Islander peoples in the design, development, implementation and evaluation of culturally respectful and relevant HIV prevention, treatment, care and support programmes that engage young people and acknowledging the wisdom of their Elders.
- Enhance and build on knowledge about Aboriginal and Torres Strait Islander peoples living with HIV. Specifically acquiring information that enables us to understand diagnosed and undiagnosed cases of HIV in the community and engage with health services and health professionals or workforce.
- Enhance engagement with remote communities and increase access to HIV prevention and testing services.
- Ensure all services are accountable for making their services accessible to and culturally appropriate for Aboriginal and Torres Strait Islander peoples.
- Report annually on progress against our goals and actions to ensure accountability using a secure and dedicated website and in public forums, such as the annual Australasian HIV Conference.
The partners of the Eora Action Plan are committed to ensuring Aboriginal and Torres Strait Islander peoples remain central to the HIV response and ensuring all responses are conducted in an inclusive, culturally appropriate and sensitive manner.
The Eora Action Plan was written by the Australian Aboriginal and Torres Strait Organising Committee of the Sydney International Indigenous Pre Conference 2014 –
Our Story, Our Time, Our Future.