Eye disease effort undermined by 'glacial' leadership

A NATIONAL strategy to eradicate the blinding eye disease trachoma in remote indigenous Australia is failing to achieve its objective because of bureaucratic bungling and indifference by NSW, which has Australia's biggest indigenous population.

John Funder, a medical researcher and former director of the Baker Institute in Melbourne, said NSW Health bureaucrats had been ''sitting on their hands for three years'' instead of embracing the ''Closing the Gap'' strategy to wipe out trachoma.

Australia is the only developed country with the disease, which is regarded by the World Health Organisation as an indicator of indigenous healthcare. Trachoma is easily treated with antibiotics.

The Rudd government made $16 million available to wipe out trachoma as part of a $58 million package to address indigenous eye care. ''But progress is glacial,'' Professor Funder said. ''NSW has not got off its backside.''

He said ''blockages'' to progress had occurred between mid-level federal and state bureaucrats who ''meet every three months, fail to resolve their differences and then agree to meet in another three months''.

''The duplication, but more importantly the stagnation, is terrible'', he said.

The indigenous eye health unit at Melbourne University estimates 20,000 indigenous Australians, including 5000 children, are at risk of contracting trachoma in remote communities. Hugh Taylor, who heads the unit, said trachoma could be eliminated in five years with proper funding and co-operation.

Professor Funder said he had concluded the ''appalling'' Commonwealth-state relationship was an impediment to an effective strategy, even though there had been agreement ''at the very top'' on the need to eliminate the disease.

Inquiries by Fairfax Media reveal that significant progress to reduce trachoma rates has been made in the Northern Territory, Western Australia and South Australia but Queensland, home to the nation's second-biggest indigenous population, and NSW failed to embrace comprehensive screening and preventive measures.

In contrast, NT Health accepted the Rudd offer and has introduced treatment strategies that have led to a fall in rates from 20 per cent to 11. Officials say the program has been effective but significant work remains to be done.

In the same period NSW has haggled with Canberra over the scope and timing of screening programs and only recently reached agreement on how to proceed.

Research by Melbourne University's indigenous eye care unit found rates of preventable eye disease were at alarming levels in most states.

Two-thirds of remote communities surveyed have endemic trachoma. Blinding cataracts are 12 times more common in indigenous adults, 40 per cent of whom have not yet had corrective surgery.

Professor Taylor said no big investigation had been undertaken recently in western NSW, where the late Fred Hollows found trachoma was a significant issue in the 1970s.

A spokesman for NSW Health confirmed that discussion had begun on plans to screen trachoma only last year.

''Because the trachoma strategy was a new program, steps were taken to ensure the program was feasible, ethical and undertaken with appropriate community consent and engagement,'' the spokesman said.

He said the NT and WA were more advanced because they were extending existing screening programs.

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