Abstract: Objectives The aim of the study was to investigate the public health challenge to provide chronic disease management to Indigenous Australians who wish to remain on traditional lands and not cede tenure for health services. Study design Within the context of the United Nations (UN) Declaration on the Rights of Indigenous Peoples (DRIP), this research is intended to reveal health aspects requiring holistic consideration and thus enhance the resilience of Australia's First Nations Peoples. Methods Lead authorship was by an Australian Aboriginal author, using methods of an information and literature review. A case study of chronic kidney disease illustrates the challenges remaining with native title land tenure. Results Despite continuing land tenure challenges, Indigenous Australians have demonstrated resilience and resourcefulness to engage and secure improvements in health and other basic services. Conclusions The Australian Government needs to revisit its duty to respect, protect and fulfil its obligation to the country's First Nations people in a human rights–based approach towards improved, accessible and culturally appropriate health care for chronic diseases.