A critical Tiriti analysis of the New Zealand Cancer Control Strategy

Objectives: Te Tiriti o Waitangi is foundational to health policy in Aotearoa (New Zealand). Systemic breaches of te Tiriti have contributed to enduring health inequities between Māori (the indigenous peoples of New Zealand) and other New Zealanders. There are significant inequities in cancer morbidity and mortality rates between Māori and non-Māori. With the development of a new Cancer Control Strategy underway in Aotearoa it is timely to critically review the current Strategy with a view to strengthen efforts to minimise the harm of cancer through stronger alignment to te Tiriti responsibilities. Design: Within this paper the authors undertake a critical Tiriti analysis of the current New Zealand Cancer Control Strategy. This process involves interrogating the policy against the preamble, and the articles of the Māori text of te Tiriti; focussing on kāwanatanga (governance), tino Rangatiratanga (sovereignty), ōritetanga (equity) and wairuatanga (spirituality). Results: We found that the Strategy contained little tangible connection to te Tiriti or other Māori health strategic documents. The significance of such a gap can be clearly seen in the continuing inequities of access and outcomes for Māori with cancer. Conclusions: We recommend that future cancer control strategies in Aotearoa be developed with te Tiriti and tikanga (Māori protocols) as the central considerations. Strengthening Indigenous content in policy is likely to improve the efficacy of health policy for Indigenous peoples and reorientate health policy to address enduring health inequities.