Breaking Down the Silence: Call for Action to Address Access Disparities to Transplantation in Indigenous Māori Peoples With Kidney Failure

Māori are the Tangata Whenua, the Indigenous People, of New Zealand. They arrived more than 1,000 years ago, traveling from their Polynesian homeland of Hawaiki. In 2020, New Zealand’s Māori ethnic population was estimated to number 850,500 (approximately 16.7% of the national population). Like many Indigenous peoples around the world, Māori face some of the worst health inequalities of any ethnic group. The overall life expectancy at birth is 73.4 years for Māori men and 77 years for Māori women, compared with 80.3 and 83.5 years for non-Māori men and women, respectively. Among all chronic illnesses, disparities in incidence, access to care, and health outcomes between Māori and non-Māori peoples are most marked for chronic kidney disease (CKD). The excess risk of CKD and progression to kidney failure with replacement therapy in Māori is at least 3 times the rate observed in age- and sex-matched New Zealand European adults (in 2019, the incidence of kidney failure with replacement therapy in these groups was 256 and 72 per million population, respectively). While the number of prevalent Māori patients with kidney failure continues to rise yearly, Māori receive kidney transplants at only one-fifth the rate of non-Māori populations...