A range of system-level barriers exist for Aboriginal and Torres Strait Islander people, including individual and institutional racism and discrimination, social factors such as income inequality, limited access to culturally safe services, and low cancer screening rates.[161] It will be important to embed governance structures, partnerships and collaborations to support systematic and ongoing dialogue with Aboriginal and Torres Strait Islander communities, particularly in relation to policy development, program planning, service delivery, evaluation of services, and quality improvements.

This action sets out a system-level, cross-sector approach to ensuring Aboriginal and Torres Strait Islander voices are embedded into policy and decision making across all aspects of cancer control, with a view to incorporating Aboriginal and Torres Strait Islander-led, trauma-aware, healing-informed approaches. It is important to consider the historical intergenerational trauma resulting from government policies, interventions and regulations impacting Aboriginal and Torres Strait Islander people. Any policy changes impacting Aboriginal and Torres Strait Islander people should be co-designed and community-led in a strengths-based approach to address disparities in cancer outcomes, and closely aligned to the National Agreement on Closing the Gap.[8]

This 2-year action may include:

• ensuring Aboriginal and Torres Strait Islander leadership and representation across all levels of governance and policymaking related to cancer prevention and care delivery for Aboriginal and Torres Strait Islander consumers including their carers and families
• training and support for Aboriginal and Torres Strait Islander representatives with lived experience of cancer to become effective advocates in cancer control governing structures
• collaborating and co-designing cancer care with Aboriginal and Torres Strait Islander consumers, communities, representatives, and organisations. This would build on Action 6.2.3 Establish and enhance collaborative partnerships with communities and Aboriginal and Torres Strait Islander-led organisations. This could also extend to matters beyond those specifically addressing Aboriginal and Torres Strait Islander people to ensure a cultural lens is applied
• developing measures of success to track progress in embedding Aboriginal and Torres Strait Islander voices in cancer governance and policy making processes.

This action will influence the success of all other Strategic Objectives in the Plan. It should be implemented across all stages of the cancer care continuum, including prevention and delivery of care, and take into consideration all sectors that interact with cancer care, including support services and allied health.