CA SE STUDY Champions4Change Championing change on rheumatic heart disease Elevating Aboriginal and Torres Strait Islander voices automatically elevates Aboriginal and Torres Strait Islander epistemologies and ontologies – our ways of knowing, being and doing. Cultural strength is part of the foundation of the program.” Vicki Wade, RHD Australia Director Valerina Mungatopi is an Aboriginal health worker and researcher from Milikapiiti on the Tiwi Islands who is working to eliminate rheumatic heart disease (RHD) and acute rheumatic fever (ARF) for her people. Valerina is one of nearly 60 Aboriginal and Torres Strait Islander people who are transforming understandings and experiences of RHD and ARF in their own communities and seeking change at the national and international level through the Champions4Change program, hosted by RHD Australia. RHD is a serious disease of the heart involving damage to one or more of the four small heart valves, which follows one or more bouts of ARF. ARF is rare in most developed countries, but rates among Aboriginal and Torres Strait Islander people are among the highest in the world, especially for those living in rural or remote settings across central and northern Australia. ARF and RHD are fully preventable diseases driven by social and environmental determinants of health, including poor quality housing, overcrowding and poverty, which contribute to an inequitable health burden on Aboriginal and Torres Strait Islander people. 20 Transforming Power: Voices for Generational Change “In some of our communities, ARF is endemic and rates continue to rise,” said Champions4Change coordinator Maida Stewart, a Wemba Wemba/ Wergaia woman who has lived in the Northern Territory for 30 years and works alongside Vicki Wade, a senior Noongar woman and RHD Australia Director, who helped launch the program in 2018. Champions4Change is the first program of its kind in Australia. It works to privilege and promote the voices of its champions, to support them in their lives and work, and to put culture, Country and community at the centre of responses to RHD. The program emerged in 2018 from a review that Vicki led for RHD Australia on self-management of RHD. It identified a clear need for an Aboriginal and Torres Strait Islanderspecific program that had selfdetermination and culture at its heart. Its champions currently represent 27 communities across Australia and include people of all ages who are living with RHD and ARF, as well as parents and other family members, Aboriginal Health Practitioners, environmental health workers, education workers and others. Many have long held leadership roles in RHD and other health issues in their communities.