The Tiwi Program

The incidence of end-stage renal disease (ESRD) among aboriginals in the Northern Territory is 12 to 20 times higher than in the white population and is increasing at an alarming rate.

These problems are especially serious among the Tiwi people who live on the Bathurst and Melville islands off the Northern Territory coast.

The incidence of ESRD among Tiwi people is 2,700 per million and they have one of the highest cardiovascular disease (CVD) mortality rates in Australia.

A renal and cardiovascular treatment program was initiated in the Tiwi community and 2000 people were screened and one quarter of the population was treated with Coversyl (perindopril), provided free of charge by Servier.

After two years there was a marked fall in blood pressure and the progression of kidney disease had been slowed considerably. Before the medication program was introduced, around six Tiwi adults reached end-stage kidney failure per year. In subsequent years this dropped until the last year when there were only two. Similarly deaths had peaked at 22 before the program but had fallen every year to a record low of 11 by the end of the program.

The calculated financial savings from dialysis delayed or avoided was impressive and exceeded the cost of delivering the program many fold. This experience stimulated the extension of chronic disease outreach programs in other communities and regions and led to changes in the guidelines for management in Aboriginal Health Services across the nation. The extended experience has stimulated development of programs internationally.

"This program supported by Servier had major implications for the health of Aborigines and the Australian community at large"
Dr Wendy Hoy, Professor of Medicine,
Director, Centre for Chronic Disease, The University of Queensland