A healthy Tokelau today and tomorrow – a whole of government approach

Apia, 24 August 2016
Te Ulu o Tokelau, Afega Gaualofa: "A brilliant plan that does not get implemented is like admiring a school of fish from afar."
Tokelau’s aspirations to better protect the health and future of its isolated community took a strategic and pragmatic whole of government step forward today.

In opening Tokelau’s Public Service (TPS) senior managers meeting this morning, the Ulu o Tokelau, Afega Gaualofa highlighted the important plans in place to address health, “Through your [TPS] advice, Tokelau has approved the Health Strategic Plan 2016-2020.”

During his opening address, he added a piece of advice, “A brilliant plan that does not get implemented is like admiring a school of fish from afar. But, Tokelau has the belief and its hopes that you will take us to the fishing ground where the catch will be bountiful for our people.”

The isolated three-atoll nation with no inter-atoll transport system is challenged by the increasing burden of non-communicable diseases and complications. It is increasingly threatened by communicable disease outbreaks, more frequent natural disasters and climate change, and critically vulnerable to the new strains of global super bugs causing tragic devastation in other parts of the world.

It is why Tokelau’s leadership took the rare step, at the General Fono in March this year, to adopt an all of government ‘Health for All’ approach.
The Director of Health, Dr. Silivia Tavite acknowledged the significance of the General Fono decision.

“The decision by our leaders is a historical one for Tokelau. This indicates their commitment to improve the quality of health care services for our people," she said.

The ‘Tokelau Health Strategic Plan 2016-2020’ has the vision of ‘A Healthy Tokelau: Today for Tomorrow’. The vision also looks beyond its national boundaries by linking and aligning its mission to the global sustainable development framework, Agenda2030, specifically Sustainable Development Goal (SDG) 3: Good Health and Well Being.

To achieve its vision and improve the quality of life for the people of Tokelau, the strategy prescribes “providing an efficient and effective healthcare system,” said Dr. Tavite.

“So this week, the whole sector has been brought together here in Apia to look at not only the Strategy, but also the annual work plans to give an opportunity to all staff, including those from the villages, to have an input into the draft implementation plan.

“The aim is that by the end of this meeting, we will have much more firmer plan where everyone will be on the same page. Within the sector, each individual and unit will understand where they fit, their roles and responsibilities so that wherever we are, we know the part we play in achieving our targets and goals.”
Te Ulu o Tokelau and Dr Silivia Tavite.
Delivery of the aspirations, missions and goals of the strategy revolves around four central pillars: Clinical Services; Governance and Corporate Services; Public Health; and Infrastructure Development.

Underpinning all four pillars is the National Referral Hospital based in Nukunonu.

The hospital will allow supporting infrastructure (ICT, transport) and strengthen health capacity and capability within Tokelau. In essence it will build resilience into Tokelau’s health system by complementing the important roles played by Samoa and New Zealand.

However, according to Mrs Tavite, “The establishment of the referral hospital plan is one small component of the work that we need to do.”
Tokelau’s ultimate goal is “improved quality of life of the people of Tokelau” which will be achieved when it delivers affordable, equitable and sustainable health care services.

Which is why the Apia meeting this week is an important consolidating platform.

“The main purpose of the Apia meeting is for us to firm up our plans from a ‘health provider’ perspective. With that achieved, it will enable us to go back with clarity and share that information with the communities and three Taupulega because for service delivery within the three villages – we need their support and contributions in order to achieve the goals and sustainability spelt out in the strategic plan.

“So that’s the first and most important step if the Implementation Plan is to succeed – we need to strengthen our partnership and develop a more intimate and relationship with our three communities.”


Te Ulu o Tokelau, Afega Gaualofa (centre) surrounded by the Senior Management Team and other members of the Tokelau Public Service today.