APY Lands Tuberculosis Outbreak

The Hon. H.M. GIROLAMO (15:17): I seek leave before asking the Minister for Aboriginal Affairs a question about health on the APY lands.

Leave granted.

The Hon. H.M. GIROLAMO: Earlier this year, SA Health declared an outbreak of tuberculosis in the APY lands. The minister last updated the chamber in June this year; however, recent media reports indicate that there are currently 11 active cases of TB in the APY lands, and one person has died. My questions are:

1. When was the minister last briefed on the matter as the Minister for Aboriginal Affairs?

2. What are the latest figures of TB cases in the APY lands?

3. Is the outbreak contained in the APY lands?

4. What extra resourcing has the government put into the APY lands to contain and end this outbreak?

The Hon. K.J. MAHER (Minister for Aboriginal Affairs, Attorney-General, Minister for Industrial Relations and Public Sector) (15:18): I thank the honourable member for her important question. I can inform the member I was last updated towards the end of the first week of August, certainly over the winter break when I visited the TB clinic in Pukatja. I travelled to a number of communities over the winter break in the APY lands and was very fortunate to see the extraordinarily good, hard and dedicated work the SA Health team is doing in the APY lands out of the clinic at Pukatja. I was most pleased to receive an update from those who are in the communities and dealing with the outbreak in the APY lands.

I am advised that more than 700 people have now been screened as part of the efforts to fight the tuberculosis outbreak on the APY lands. When I was there in August, on the day that I visited the clinic they had just that day reached over 500 people screened, which is quite an amazing result to screen such a large number of people. But as I say, I am advised it is now more than 700 people who have been screened.

I am advised that just under $2 million has been invested so far to fight the outbreak, delivering tailored community engagement and education, while providing education and further skills to health practitioners, most of whom, if not all of whom, have not seen an outbreak of tuberculosis in their clinical practice ever before. Certainly, the radiology people, the nurses, the doctor and the community health workers who were at the clinic when I visited in August had not dealt with tuberculosis before, because it's something that we rarely see in Australia today.

I particularly acknowledge the doctor who was in charge of the clinic, Dr Simone Barry, and her team talking about the work they are doing in the community, the further outreach work that is being done by SA Health. I particularly want to acknowledge the work of Damien Shen, a Ngarrindjeri man who worked in the SA Health team during the COVID outbreak, during the pandemic, in the APY lands, who is now continuing his work with the APY community as part of the community outreach team in collaboration with Nganampa Health and local communities.

The work is being led by the Minister for Health and Wellbeing, and I have appreciated discussions and updates from the minister. But as I said, having received an update directly from the health clinic has been very valuable in terms of my understanding of the issues.

The latest update I have in terms of known cases of diagnosed TB is at 17 August, where I am informed there were 13 confirmed active cases linked to this outbreak. I am informed that 13 includes 11 current cases, one historical case and, tragically, one historical death from tuberculosis. In addition to the results known at 17 August, SA TB Services advise that 15 cases of latent tuberculosis have been identified from the 68 contacts that have been screened. Latent tuberculosis is where the initial infection goes unnoticed but individuals remain at risk of developing active tuberculosis disease later in life.

The first tuberculosis case linked with this outbreak, I am informed, was identified in May 2022. Before the current outbreak, the last known case of tuberculosis in the APY lands, I am informed, was in 2018. I am informed the APY cluster involves cases notified in a region that has a significant population flow between South Australia, Western Australia and the Northern Territory.

When I visited the clinic in Pukatja, I was informed that early diagnosis and treatment are the most effective means to prevent the transmission of tuberculosis. The risk of transmission decreases within days of commencing the appropriate antibiotic treatment for TB, but compliance with the treatment is critical. If I am remembering correctly, the health professionals told me it is, I think, one tablet three times a day for six months that is needed as part of the treatment regime. At that stage, they had an almost 100 per cent compliance with the treatment regime, which is a remarkable effort in a place like the APY lands where there is movement with people throughout the APY lands and often health professionals have to meet and treat people in their own homes.

I am also informed that SA Tuberculosis Services and the Aboriginal public health team within SA Health have developed comprehensive plans for ongoing public health actions in the APY lands, including further community engagement, case treatment, contact tracing, active case finding and community-wide screenings.

As I said, the tuberculosis clinic I visited was the one that set up in Pukatja in the central APY lands. I know that the other main area that testing for cases has occurred in has been in Pipalyatjara, over the far west of the APY lands, next to the WA border. I am informed that the Chief Public Health Officer in SA continues to chair regular update meetings with counterparts in Western Australia, Northern Territory, Queensland and the commonwealth.

I am also informed from my visit and from briefings with the health minister that SA Tuberculosis Services continues to work very closely with Nganampa health service, the health service that I think 40 years ago this year was established on the APY lands and remains the primary health carer for Anangu in that part of Australia, to ensure that known cases of tuberculosis are receiving clinical care, including the treatment I mentioned that is extraordinarily successful at this stage, and that ongoing treatment remains the critical element of this response. People not treated for latent TB pose an ongoing public health threat because at any time they can become infectious, which is why this ongoing process continues.