University of Auckland Faculty of Medical Health Sciences research fellow, Dr Kimiora Henare, is addressing workforce challenges in the delivery of precision oncology for Māori.
Dr Hēnare – who has received a Health Research Council Māori Emerging Research Leader grant, worth almost $650,000 over 48 months – says genomic-based cancer treatment, or precision oncology, is still a topic in need of discussion for Māori.
He says genomic-based testing isn’t easily accessible for Māori, which he attributes to systemic inequities in the New Zealand health system and the negative experiences of Indigenous Peoples who have engaged in genetic and genomic research globally.
His research focuses on addressing potential workforce challenges related to the delivery of precision oncology, an approach where doctors and patients choose treatments based on the DNA signature of an individual patient’s tumour.
Precision oncology involves treatments that are tailored to the genetic makeup of a patient’s tumor. By analysing the genetic changes of a patient’s cancer, doctors can identify specific medicines that offer the best responses.
However, Dr Hēnare says that introducing the ground-breaking approach to decision-making requires a skilled workforce capable of navigating complex genetic data and clinical evidence, and doing-so in a timely and culturally safe way.
“The ultimate goal is to eliminate health inequities for Māori before they can even start,” he says.
“But a problem we face is that by introducing cool and new technology, we’re implementing it into a system that already under-delivers in terms of good Māori health outcomes.
“So, a large focus is not only learning about what capabilities are needed, but also to understand what capacity needs to be protected, and what needs to be resourced and supported to make sure that this is sustainable.
“There are still crucial gaps in our knowledge that can be addressed through research. But research also creates an opportunity to build expertise and leadership.
He says it’s crucial to build Māori expertise and leadership among oncology services as well as the research community supporting those services.
“We have an opportunity to create environments where Māori brilliance can shine, allowing them to share their whakaaro with a diverse range of experts, whether in clinical settings or the community. This approach is instrumental in fostering leadership.”
He says that also includes Tangata Tiriti.
“We’re integrating Māori health perspectives and Te Tiriti o Waitangi principles into health research, recognising their absence in traditional biomedical training pathways,” Hēnare says.
“I’m fortunate to work in a team that understands their role within a Tiriti context. For tangata tiriti, our obligation to Te Tiriti is defined in Article 1. For tangata whenua, our rights to make decisions over our taonga, are enshrined in Article 2. So in the delivery of precision oncology, it’s about understanding our individual roles in teams that best reflect our society, and together ensuring equitable outcomes.”
Dr Hēnare’s project will also explore the current pathway to the Molecular Tumor Board (MTB) and develop strategies to sustain a culturally competent workforce. He will create a roadmap for growing the expertise necessary in this cutting-edge field.
