The influence of the pharmaceutical industry and the pharmacy sector on Aboriginal and Torres Strait Islander health: a yarning study.

While pharmaceutical companies develop life-saving medicines and the pharmacy sector is integral to healthcare delivery, entities within the medicines sector can also operate as powerful commercial actors. The practices of the pharmaceutical industry and the pharmacy sector warrant scrutiny through a commercial determinants of health lens. This is particularly important for Indigenous peoples, who experience inequities within Western healthcare systems while also holding enduring cultural knowledge of traditional medicines. Despite increasing international attention to the practices of the pharmaceutical industry, the influence of the medicines sector, as a whole, on Aboriginal and Torres Strait Islander peoples in Australia has not previously been examined. This study aimed to examine the systems, practices and pathways through which the pharmaceutical industry and the pharmacy sector may influence Aboriginal and Torres Strait Islander health and wellbeing. We applied the Aboriginal research method of Yarning to explore the perspectives and experiences of ten Aboriginal/Torres Strait Islander and nine non-Indigenous participants with expertise relevant to the pharmaceutical industry and/or the pharmacy sector. Five themes revealed tensions between commercial models within the pharmacy sector and community needs; regulatory marginalization of cultural medicines and the need to protect Indigenous cultural and intellectual property; pharmaceutical industry efforts to partner with Aboriginal organizations; the lobbying power of peak pharmacy sector bodies; and opportunities for genuine collaboration. Strengthening culturally safe practice, embedding pharmacists within Aboriginal Community Controlled Health Services, and elevating Aboriginal and Torres Strait Islander governance across the medicines sector are critical to addressing power imbalances and advancing health equity.