Yolŋu elder and Aboriginal health worker George Gurruwiwi vividly recalls the devastating impact of hepatitis B on his community in Galiwin’ku two decades ago. He remembers attending numerous funerals, a constant reminder of the chronic hepatitis B deaths that plagued the Elcho Island community.
“Especially here, Elcho, and other parts of the community, it’s avoidable death, a lot of death out here,” Gurruwiwi reflected. “We [were] doing ceremony after ceremony.”
At first glance, recent hepatitis B data for the Northern Territory might seem alarming. According to figures from NT Health, diagnoses nearly tripled between 2022 and 2024. However, healthcare workers suggest this is a positive sign, indicating the Northern Territory is at the forefront of hepatitis B care in Australia.
Transformative Changes in Hepatitis B Care
Gurruwiwi has witnessed a significant decrease in hepatitis B deaths in his community in recent years. Since 2019, he has been a crucial partner in the NT hepatitis B prevention program HEP B PAST, working to enhance access to testing and treatment in Arnhem Land.
“I mentor through a cultural perspective, through kinship,” he explained. “The difference is people understand.”
Falling Mortality Rates
Seventy percent of individuals with hepatitis B in the Northern Territory are Indigenous, based on data from the World Health Organization (WHO) Collaborating Centre for Viral Hepatitis. The region is also home to a unique strain of hepatitis B, known as C4, which has only been diagnosed in Aboriginal people, particularly in the NT.
Hepatitis B can lead to severe liver degradation and, in some cases, liver cancer if untreated. While non-chronic infections can be cured, most cases in the NT are chronic and require regular check-ups to monitor liver function.
Anngie Everitt, who runs a hepatitis clinic in Darwin, noted that the primary transmission route in the NT is from mother to child during birth. “It’s babies, it’s people that either contract from birth, or at a really young age, that are most likely to develop chronic hepatitis B, which requires lifelong treatment,” she said.
According to WHO research, since 2011, the Northern Territory has recorded the biggest decrease in hepatitis B mortality rates of any Australian state or territory.
Innovative Approaches to Treatment
Professor Jane Davies of the Menzies School of Health Research leads the HEP B PAST program, which has gained national recognition for its innovative approach to hepatitis B care. Launched in 2018, the program visits remote Aboriginal communities to provide comprehensive care, including diagnosis and surveillance services, all in a single day.
The program also features an app that translates healthcare information into 11 different Indigenous languages. “You can imagine being told you have this chronic condition, that you could get liver cancer, that you need care every six months — that can be really scary, [and] that can be even scarier if it’s not in your first language,” Professor Davies said.
National Recognition and Future Implications
The HEP B PAST program has been recommended in national strategies as a successful model that could be implemented in other regions to help eradicate hepatitis B in Australia. Professor Davies highlighted the significant improvements in data, indicating the Northern Territory has closed the gap in hepatitis care.
“Ten years ago we definitely were not meeting national strategy targets for people being diagnosed, for them being engaged in care and for them being on treatment … [but] very recently we’re able to say we’re achieving the national strategy targets,” she said.
Professor Davies further noted, “That means that we have 99 percent of people diagnosed … and the national target is 80 percent. We have 86 percent of people engaged in care and the national target is 50 percent, and we have 24 percent of people on treatment and the national target is 20 percent. So we’re now, for all of those targets, meeting them.”
The progress in the Northern Territory serves as a beacon of hope and a model for other regions grappling with hepatitis B. As the NT continues to lead the nation in care and prevention, the strategies implemented here may well pave the way for a broader national effort to combat this chronic illness.
