Infectious diseases in Northern Australia

This issue of Microbiology Australia covers biomedical research and workforce training in Northern Australia and our northern neighbouring countries. The north of Australia is a tropical region and has a larger representation of Australian First Nations peoples than other States and Territories of Australia. In Australia, Aboriginal and Torres Strait Islander people represent 3.2% of the total Australian population. However, in the Northern Territory, the Australian census (2021) shows that approximately 26.3% of the total population identify as Aboriginal and Torres Strait Islander. This underpins the need for Northern Australia to have continued funding to enable health research, workforce training and health and community services that address the currently unmet and still growing needs of this population demographic.

In Australia the National Agreement on Closing the Gap for Aboriginal and/or Torres Strait Islander peoples has 17 national socioeconomic targets (https://www.closingthegap.gov.au/national-agreement/targets) across areas that have an impact on life outcomes for Aboriginal and Torres Strait Islander people. All the targets are important, but three targets are highly relevant to the work of clinicians and researchers writing in this issue: Target 1, Everyone enjoys long and healthy lives; Target 2, Children are born healthy and strong; and Target 7, Youth are engaged in employment or education.

In 2009, Microbiology Australia in its 50th year published an issue titled ‘Indigenous Health’ (Volume 30, Number 5, November 2009). It contained many articles that remain relevant to research and health challenges in Northern Australia. The first article in that issue was written by the then Chief Executive Officer of the CRC for Aboriginal Health Mick Gooda. Mick Gooda’s paper laid out the framework for how successful research can be conducted with input from Aboriginal and Torres Strait Islander peoples: a framework that would lead to improving the flow of health information into primary healthcare delivery. The original CRCs were based in Darwin at the Menzies School of Health Research (1997–2009) and in 2010 transitioned to the Lowitja Institute in Melbourne, which continues today as Australia’s National Institute for Aboriginal and Torres Strait Islander Health Research.

Research and training opportunities for local people in Northern Australia and neighbouring countries are vital to continuing the health and wellbeing of people in both urban and regional and remote locations. Strong, knowledgeable, and well developed programs are being run to attract future leaders in biomedical research and health workforce in hospitals, clinics, and Aboriginal and Torres Strait Islander Community Controlled Health Organisations. This is a necessity to ensure a long-term sustainable approach to combating the current and future health needs of the north. This issue covers some of the different training and education initiatives in north Australia presented in the articles, Bridging the gap between science and indigenous cosmologies: Rheumatic Heart Disease Champions4Change (Vicki Wade and Maida Stewart), Building health workforce capacity in Northern Australia (Michael Johnston, Heidi Smith-Vaughan, Sophie Bowman-Derrick, Jayde Hopkins, Kelly McCrory, Raelene Collins, Robyn Marsh, Kalinda Griffiths and Mark Mayo) and What does microbiology have to do with the Hearing for Learning Initiative (HfLI)? (Amanda J. Leach).

As elsewhere in Australia, in Northern Australia the COVID-19 pandemic caused serious concerns for First Nations communities. The health messaging about the COVID-19 infection and vaccination was sometimes not appropriate for the population. The article Vaccine success and challenges in northern Australia (Bianca F. Middleton, Jane Davies and Rosalind Webby) discusses some of the challenges faced by communities.

Evidence to be gathered from the study A project to validate the GLU test for preterm birth prediction in First Nations women (Kiarna Brown, Holger W. Unger, Margaret Peel, Dorota A. Doherty, Martin Lee, Agatha Kujawa, Sarah Holder, Gilda Tachedjian, Lindi Masson, Jane C. Thorn, John P. Newnham and Matthew S. Payne) will inform health service providers and address Closing the Gap strategy Target 2, whereby children are born healthy and strong.

Biomedical research in Northern Australia and neighbouring countries and other tropical regions of the world continues to develop and produce new knowledge. In these tropical regions the social determinates of health play a big role in health outcomes: from poverty, reduced health service delivery, remoteness, shorter life expectancy, social and emotional wellbeing, and economic growth. Infectious diseases represent many challenges including pathogen identification, optimum treatment and increasing antimicrobial resistance. Climate change is occurring on a global scale and with projected increases in temperature and severe weather events, the endemic regions for some infectious agents is predicted to expand into newer areas and affect a larger population of people. It is therefore important we try to fill knowledge gaps in our understanding of these diseases. Research on infections in this issue includes Skin health in northern Australia (Hannah M. M. Thomas, Stephanie Enkel, Tracy McRae, Victoria Cox, Heather-Lynn Kessaris, Abbey Ford, Rebecca Famlonga, Rebekah Newton, Ingrid Amgarth-Duff, Alexandra Whelan and Asha C. Bowen) and Melioidosis in northern Australia (Josh Hanson and Simon Smith). The increasingly established use of technologies such as whole genomic sequencing, is helping us better understand the epidemiology, virulence and evolution of the organisms that cause these diseases. This is reflected in the articles Molecular epidemiology of tuberculosis in northern Australia (Ella M. Meumann and Arnold Bainomugisa) and Staphylococcus aureus and Streptococcus pyogenes in the north: distinctively different (Deborah Holt and Philip Giffard).

Northern Australian researchers continue to strengthen ties with our collaborators in near-neighbouring countries in Strong relationships between the Northern Territory of Australia and Timor-Leste (Nevio Sarmento, Tessa Oakley, Endang Soares da Silva, Ari Tilman, Merita Monteiro, Lucsendar Alves, Ismael Barreto, Ian Marr, Anthony D. K. Draper, Gloria de Castro Hall, Jennifer Yan and Joshua R. Francis) to better understand and tackle the health challenges in our tropical region of the world.

This issue covers and discusses a broad range of health challenges faced in Northern Australia, with articles providing strong research plans, outcomes, generated knowledge and research translation from teams of dedicated researchers. The issue also outlines training and education pathways to mentor and deliver future leaders in the health and biomedical research workforce.