Senator FAULKNER (New South Wales) (00:10): I seek leave to speak for up to 20 minutes. Leave granted. Senator FAULKNER: I thank the Senate. Indigenous Australians are six times more likely to be blind and more than twice as likely to have poor vision compared to all other Australians. One of the most common forms and causes of Indigenous blindness is the debilitating and entirely preventable disease, trachoma. Tonight I want to highlight the government's efforts to tackle trachoma and speak more broadly about the future challenges we face in addressing Indigenous eye disease. Trachoma is a contagious infection of the eye caused by the bacteria, Chlamydia trachomatis. This bacterium promotes symptoms similar to common conjunctivitis: stinging eyes, sensitivity to light, swollen eyelids and a build-up of conjunctiva. Left untreated, conjunctiva gradually scars the inner eyelid. Repeated infection, especially in childhood, causes the eyelids to distort, turning the eyelashes inward and making them rub against the cornea—a process known as trichiasis. In advanced stages, the scarring becomes so severe that it causes blindness. Trachoma is an intimate disease, passed most often from child to child and from child to mother. It is transmitted through close facial and hand-to-eye contact and by anything that touches infected fluids such as bedding, towels and other such things including flies. Trachoma is a product of poverty and biology, its virulence born of place and pathogen. It lingers where poor sanitation, crowded living conditions and poor access to clean water and health care remain Third World conditions or, sadly, Third World conditions that persist in the First World. More than 150 years since the bacteria prospered in the Dickensian conditions of the industrial revolution and more than 200 years since Napoleon's troops were struck down with blindness during the Egyptian campaign, trachoma remains prevalent amongst the first inhabitants of one of the wealthiest nations on earth. Australia is the only developed country in the world where trachoma continues to cause blindness. Trachoma disappeared from mainstream Australia more than a century ago yet endemic trachoma persists in two-thirds of all remote Indigenous communities. Its persistence is just lamentable given that its treatment and control is relatively simple. The most effective strategy for controlling the spread of the infection is washing children's faces. The most effective treatment is a course of antibiotics. Even in advanced stages a simple medical procedure can correct trichiasis. The fight against trachoma in Australia is part of international efforts to rid the world of preventable blindness. On 16 May 1998, the World Health Assembly adopted a resolution calling for the Global Elimination of Blinding Trachoma—now known by the acronym GET 2020. In 1999, this was accompanied by a new initiative called Vision 2020. It is a collaboration between the World Health Organization and the International Agency for the Prevention of Blindness. Its aim is to end avoidable blindness worldwide by 2020. Conscious of global efforts to address eye health, in 2009 the Rudd government committed itself to the elimination of trachoma by adopting the World Health Organization's SAFE strategy. SAFE stands for: surgery, antibiotics, facial cleanliness and environmental improvement—all measures aimed at the treatment and control of trachoma. This commitment to a global approach to treatment was matched with a dedication of $16 million over four years to tackle trachoma as part of a $58.3 million Indigenous eye and ear health initiative. Funds for trachoma were earmarked to improve disease surveillance and control. Since the introduction of these initiatives real progress has been made in the fight against trachoma. The latest assessment prepared by the National Trachoma Surveillance and Reporting Unit at the University of New South Wales shows that in Western Australia trachoma prevalence decreased by six per cent in 2009-10. In the same period, the prevalence of trachoma decreased in all communities across the Northern Territory with the exception of those around Alice Springs. These findings suggest that with improved detection and management, we are beginning the painstaking work of combating trachoma. However, there is an awful lot of work still to be done if we are to rid Australia of this terrible disease. While levels of trachoma are stable or decreasing in the Northern Territory and Western Australia, results from South Australia are inconclusive. Indeed the latest assessment states that: Of all children screened across all jurisdictions, 11% had trachoma, demonstrating that Australia continues to have endemic levels of infection. This level of infection remains well above the target of less than five per cent, set by both the World Health Organization and our own Communicable Diseases Network. The Roadmap to Close the Gap for Vision, prepared by the Indigenous Eye Health Unit at the University of Melbourne, estimates that $17.4 million is required to extend the SAFE program from 2013 to 2016. The same report estimates a further $5.4 million is required for surveillance from 2017 to 2020. These are effective programs shown to decrease the prevalence of trachoma. In 1901 Andre Cuenod wrote: Trachoma retreats as civilization advances. It is a measure of the imperfection of our civilisation that trachoma remains within our midst, and it is my view that its persistence is a measure of society's apathy and inequity. A civilization of our capacity and compassion must rid itself of this terrible disease. The irony is that Aboriginal people begin life with the world's best visual acuity but by adulthood are six times more likely to be blind. They start well ahead but they finish well behind. Like trachoma, the treatment and prevention of all Indigenous vision loss is within our grasp. Ninety-four per cent of all Indigenous vision loss is preventable or treatable, but only 35 per cent of Indigenous adults have ever had an eye examination. The practice of government is often the art of choosing between competing interests, and one could be tempted to think that perhaps eye health is important but not a life-threatening concern. However, as the team at the University of Melbourne's Indigenous Eye Health Unit point out: Even mild vision loss … increases the risk of dying 2.6 times in mainstream Australia. And even 'mild vision loss prevents independent healthy living'. Vision loss, after diabetes and heart disease, is the equal third leading cause of the gap in health outcomes between Indigenous and non-Indigenous Australians. Vision loss is a more significant, although perhaps less dramatic, impediment to heath equality than trauma, stroke and alcoholism. Eye health care remains one of the most cost-effective health interventions available and the best advice suggests that additional funds of $20 million per year, or a total $70 million, with the program being implemented over five years would close the gap between Indigenous and non-Indigenous Australians. I say that that would be money very well spent. This morning in Melbourne, Mick Gooda, the Aboriginal and Torres Strait Islander Social Justice Commissioner, launched the first annual update on the implementation of the Roadmap to Close the Gap for Vision. As was stressed at that launch, there is broad stakeholder support for the roadmap and what is needed now is the concerted commitment of governments to fully implement its recommendations. I sincerely hope that that commitment will be forthcoming. This evening I have focused primarily on trachoma, but any loss of vision is a disaster of clarity that impedes people's ability to fully participate with the world. Professor Hugh Taylor, a man who has dedicated much of his life to ridding this country and indeed the world of trachoma, once wrote: What is really required to eliminate blinding trachoma in Australia is an ongoing political commitment at all levels of government. On a global scale we clearly have the tools and in Australia the resources are available. What is needed to eliminate trachoma as a blinding problem is sustained political will and the commitment to follow through. The same can be said for all types of preventable blindness. We need to sustain the political will and maintain our commitment to ensure that the clarity of our citizens' sight is not a function of where they live or a function of the colour of their skin.