Indigenous Health Special Issue 2025: carving our path with spirit, strength and solidarity

Abstract

This Special Issue of the Medical Journal of Australia builds on the work undertaken with the Lowitja Institute — Australia's only Aboriginal Community Controlled Research Institute — for the inaugural issue in 2024.¹ This publication has again been timed to coincide with NAIDOC week, whose 2025 theme “The next generation: strength, vision and legacy” aligns with the MJA's purpose, in this issue, to prioritise, platform, and celebrate Aboriginal and Torres Strait Islander leadership and excellence through health, clinical and academic dialogue. This editorial is a reflective piece by the Guest Editors, where we consider the vision and impact of this Special Issue.

As it is in our cultures, we commence by reflecting on a story, a story about a journey, our journey, one that acknowledges our ancestors and our Elders, one that is more than 60 000 years old, and one that guides us on our path forward. Perseverance in the face of adversity is no novel concept for our People. Resilience has been the reality for many Aboriginal and Torres Strait Islander Peoples and Communities for millennia, and this Special Issue seeks to honour that resilience. From extreme climate shifts to megafauna, these vast experiences, borne from Mother Earth, posed many challenges for our ancestors. Yet none were more menacing than the colonial barbarism that followed. The abhorrent physical violence of yesteryear has largely faded, making way for a more subdued, yet equally abhorrent epistemic violence, one that seeks to subjugate and oppress our knowledges. To oppress our knowledges is to invalidate our experiences. To invalidate our experiences is to erase our cultures. To erase our cultures is to dehumanise us. The longevity of our ancient cultures, despite widespread active attempts to erase them, is testament to their strength and beauty, something that should be cherished and celebrated, rather than diminished and oppressed.

A global shift in knowledge production, recognition and dissemination threatens to invalidate and ignore decades of humanitarian-based advancement work undertaken with and by countless Aboriginal and Torres Strait Islander Peoples and Communities. The role of research and scholarship in this climate is central to realising epistemic justice, which cannot be overstated. Following the inaugural Special Issue on Indigenous Health, the MJA continues to stand beside Aboriginal and Torres Strait Islander Peoples and Communities in the ongoing fight for recognition, reconciliation and self-determination. Given the global and local amplification of epistemic violence experienced by Indigenous Peoples, this fight is important now more than ever. A contemporary silencing of Aboriginal and Torres Strait Islander scholarship is neither crude nor fortuitous, but purposeful, systematic and pervasive. Hard-fought human rights gains by our predecessors and Elders, coupled with greater emphasis on dominant Western scientific critique and epistemic pluralism, have enabled an environment where Indigenous scholarship can flourish, sit alongside Western knowledges, and strengthen global scholarship for the benefit of all. Yet despite this mutually beneficial potential, recent local and international political activity has sought to undo, ignore and abolish the path that so many have arduously and persistently carved, against all odds.

For this Special Issue, the MJA once again engaged a panel of Guest Editors, including a mix of future and current leaders in the fields of public health, psychology, medical education, and clinical medicine. The Guest Editors took on the collective care and responsibility of defining the scope and aims of the Special Issue, assessing and selecting its content, determining its editorial requirements, and nominating peer reviewers, with the support of the MJA editorial team.

As with the inaugural Special Issue in 2024, which was a partnership with the Lowitja Institute, the editorial practices to develop this Special Issue draw on Aboriginal and Torres Strait Islander ways of knowing, being and doing. A call for papers was made in October 2024, with content eligible for consideration if it addressed an area of health and wellbeing that is a priority to Aboriginal and Torres Strait Islander communities, was led by Aboriginal and Torres Strait Islander authors (first or last authors), included an ethical research statement that addressed the Consolidated criteria for strengthening reporting of health research involving Indigenous peoples (CONSIDER) statement,² and described the positionality of the author team. Authors were also given the opportunity in their articles to acknowledge the Indigenous knowledges that informed their work and to include their Language Groups in the authorship line. These practices uphold what Indigenous people have called for in ethical publishing practices.^{3, 4} The Guest Editors were not involved in editorial decision making about submissions that they authored.

The active pursuit and development of the MJA to partner with the Aboriginal and Torres Strait Islander Guest Editors (as leaders of this Special Issue), and commit to an annual Indigenous Health Special Issue, which is highly subscribed by submitting scientists and scholars, represents the solid (structural), trusted establishment of Blak space in the Australian scholarly community. Furthermore, it exemplifies the significance of equity in scholarly publishing and dissemination, which is to apply the proper resourcing for fair and just outcomes for scholarship that advances the health of Aboriginal and Torres Strait Islander Peoples and Communities. Such equity in publishing ironically highlights the vast inequities in health and health care, a reflection of broader society, and a daily reality for many of our People. Equitable scholarly publishing also enables epistemic pluralism, where Indigenous ways of knowing are not just broadcast, but equally validated by the scholarly academy. Following a resolute inaugural Special Issue, in honour of the late Dr Lowitja O’Donoghue AC CBE DSG, this second Special Issue is a celebration of our spirit, strength and solidarity as Aboriginal and Torres Strait Islander Peoples.

The opening article by Watego and colleagues⁵ presents a perspective that offers a framework for the formulation of an Indigenous antiracist training approach within health care. This methodological framework addresses the structural grounding of race and highlights the need for institutional transformation, through centring Indigenous realities and perspectives. The article problematises the contradictory aspiration to eliminate racism in health care: a system informed by structures that have enabled the propagation of a racial hierarchy. The authors remind us that although attention to approaches that address racism at an individual or group level have been prioritised, “The effectiveness of antiracist strategies must be judged on their ability to disrupt and provoke transformative institutional change. Interventions that gauge effectiveness by how carefully strategies cater to white feelings and fragility — thereby obscuring white complicity — can never meaningfully address the foundational function of race and racism in shaping the health system”.

A reliance on critical allies, who walk forward with us, carrying the lantern of hope while we traverse through the dark murky waters of colonial rule, has always been an essential part of realising an agenda where self-determination and sovereignty are centred. Those allies, who often bear relative power and privilege, have too experienced a progressively unrelenting tide of ideological domination that seeks to suppress those who do not conform to the social hierarchy. We are forever grateful for those who are willing to stand beside us and demonstrate civil courage in the pursuit of human rights and scholarly recognition. In addition, a bright, vibrant, and passionate new generation of Aboriginal and Torres Strait Islander young people provide much hope for what is an uncertain future.

So it is that with our path shrouded in ideological domination, we have sought and have carved our own path forward; one where our voices are not just heard, but are central; one where the knowledge and wisdom of our Elders can guide the next generation; and one where our ways of knowing, being, and doing can be safely applied across an array of contexts, for the benefit of all.

We express our sincere gratitude to all the authors and reviewers who thoughtfully contributed to producing this Special Issue.

No relevant disclosures.

Commissioned; not externally peer reviewed.