In reply: Household infrastructure in Aboriginal communities and the implications for health improvement

In reply: A primary objective of our evaluation1 was to identify methodological deficiencies for the purpose of improving data quality in subsequent surveys. These deficiencies, described in detail in our evaluation report and referred to by Torzillo and Pholeros, are also described in our Medical Journal of Australia article.2

Our assessment (reinforced by reference to subsequent survey findings) was that the data were of sufficient quality to be useful for the purpose for which they were collected — to guide and monitor a substantial maintenance and building program. Torzillo and Pholeros appear to have missed this point. Their analogy with a clinical therapeutic trial where the survey is equated with a placebo is absurd, all the more so for the reference to the HealthHabitat work as being "an effective agent [that] is already licensed". This "effective agent" has, to my knowledge, never been subjected to external evaluation or peer review — some licensing process!

With regard to ethics, a fundamental aim of the survey was to identify areas of greatest need, and allow the allocation of resources on an equitable basis to improve Aboriginal housing standards across the Northern Territory. In an environment of massive need and limited resources, this is arguably a more ethical approach than that of HealthHabitat, where, in 2001, intensive input was delivered to only four out of hundreds of Aboriginal communities in the NT.