Pharmac proposes removing priority access of type 2 diabetes meds for Māori, Pasifika
Associate Professor Dr Ryan Paul, a clinician and technical expert advisor to Te Tiratū, has expressed serious concern in an interview with 1News about proposed changes to funding criteria for type 2 diabetes medicines. He warns that removing ethnicity-based access pathways could deepen existing inequities for Māori and Pacific peoples.
The proposed Pharmac changes would expand general access to medicines such as empagliflozin, liraglutide, and dulaglutide, but would remove targeted pathways that currently acknowledge the higher burden of diabetes, cardiovascular disease, and kidney disease experienced by Māori and Pacific populations.
Te Tiratū co-chair Glen Tupuhi notes that equity-focused pathways were introduced because the health system has repeatedly failed to deliver fair outcomes for Māori, who are diagnosed earlier, experience more severe disease, and have higher rates of premature mortality from preventable long-term conditions.
Māori clinicians and health leaders have cautioned that the proposed shift could undo one of the most effective equity interventions introduced in recent years.
The consultation closes on 28 May 2026.
Māori health leaders warn proposed Pharmac changes could deepen inequities and cost lives
Te Tiratū has spoken with Whakaata Māori with serious concerns about proposed changes to access criteria for funded type 2 diabetes medicines, warning the removal of ethnicity-based pathways could worsen long-standing inequities for Māori and Pacific peoples.
The proposed changes by Pharmac would widen general access to medicines including empagliflozin, liraglutide and dulaglutide, but remove the current pathway that recognises the disproportionate burden of diabetes, cardiovascular disease and kidney disease experienced by Māori and Pacific communities.
Te Tiratū co-chair Glen Tupuhi says equity pathways exist because the health system has consistently failed to deliver equitable outcomes for Māori, who are diagnosed younger, experience more severe illness, and die sooner from preventable chronic conditions.
Associate Professor Dr Ryan Paul, clinician and expert technical advisor to Te Tiratū, said he was “really gutted” by the proposal, particularly given the success of the current pathway in improving equitable access to life-saving medicines for Māori and Pacific whānau.
Māori clinicians and health leaders warn the proposal risks reversing one of the most successful equity interventions introduced in recent years.
The consultation closes on 28 May 2026.
Pharmac proposes removing priority access of type 2 diabetes meds
Te Tiratū Iwi Māori Partnership Board co-chair Glen Tupuhi and expert advisor, researcher Dr Leanne Te Karu have spoken to RNZ about growing concerns over Pharmac’s proposal to remove ethnicity-based access criteria for type 2 diabetes medicines, despite new evidence showing significant life-saving benefits for Māori and Pacific communities.
In the interview, Dr Te Karu said the original criteria were introduced because Māori and Pacific peoples were not receiving equitable access to treatment through the health system, despite experiencing higher rates of diabetes, earlier onset disease, and more severe complications.
She said the medicines had been shown to improve equity outcomes and narrow survival gaps, warning that removing the criteria before systemic inequities are addressed risks widening disparities again.
Te Tiratū co-chair Glen Tupuhi said that treating everyone the same within an inequitable system does not create fairness, but instead entrenches inequity. Te Tiratū is filing a submission to Pharmac calling on it to reconsider the proposal and ensure equity remains central to decision-making for whānau experiencing the highest health burden.
Pharmac proposal to remove ethnicity criteria criticised
Pharmac is facing strong criticism in NZDoctor and Pharmacy Today over a proposal to remove ethnicity as a criterion for access to several diabetes medicines, with opponents warning the change could lead to more Māori and Pacific deaths and deepen long-standing inequities in the health system.
The proposal would amend Special Authority settings that currently prioritise access for groups disproportionately affected by type 2 diabetes, including Māori and Pacific peoples who experience higher rates of earlier onset and more severe complications.
Te Tiratū Iwi Māori Partnership Board was quoted by both publications because we say removing ethnicity equity criteria raises serious concerns about whether Pharmac is meeting its obligations under Te Tiriti o Waitangi to achieve equitable Māori health outcomes.
We are warning that “treating all universally in the system does not create fairness. It entrenches inequity.”
Our board is calling for Pharmac to retain ethnicity-based access criteria, publish its equity impact analysis before consultation proceeds, clearly demonstrate how Māori health outcomes would improve under the proposed change, and engage directly with iwi Māori partnership boards, Māori clinicians and Māori health providers.
Submissions on the consultation close on 28 May 2026 leaving just 13 days for feedback on a proposal that critics say could reshape access to essential diabetes treatment.
Push back on Pharmac move to remove equity access criteria for lifesaving medicines
MEDIA STATEMENT
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Thursday 14 May 2026, 6:00 PM
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One of the largest Iwi Māori Partnership Boards in the country, Te Tiratū that represents 121,300 Māori is calling on Pharmac to immediately reconsider proposals to remove ethnicity equity criteria from access to SGLT2 inhibitors and GLP-1 receptor agonists that are internationally recognised treatments for type 2 diabetes, heart failure and chronic kidney disease.
Te Tiratū warns the proposal risks reversing one of the few medicines policy decisions in Aotearoa specifically designed to address entrenched inequities in diabetes, cardiovascular disease and chronic kidney disease for Māori.
Pharmac has opened public consultation today on proposals to remove Māori and Pacific ethnicity from Special Authority access criteria for these medicines – despite the criteria being introduced in 2021 following sustained advocacy from Māori clinicians, researchers and Indigenous health leaders.
The ethnicity criteria were implemented because evidence showed Māori and Pacific peoples were significantly less likely to receive modern diabetes and cardiovascular medicines, despite carrying a substantially higher burden of disease and experiencing earlier and more severe complications.
Te Tiratū Co-Chair, Glen Tupuhi says the proposal ignores the overwhelming evidence that Māori experience significantly higher rates of diabetes, cardiovascular disease and kidney disease, while continuing to face systemic barriers accessing medicines and treatment.
“These medicines save lives and prevent devastating complications for whānau,” he said. “Māori are diagnosed younger, become sicker earlier, and die sooner from preventable chronic illnesses. Equity pathways exist because the health system has not delivered equitable outcomes for Māori.”
Te Tiratū says the proposal is particularly concerning because the strongest emerging evidence for SGLT2 inhibitors is now in chronic kidney disease (CKD), including for people without diabetes.
They are around twice as likely to live with diabetes compared to non-Māori, experience cardiovascular disease at significantly higher rates, and face chronic kidney failure at disproportionately higher levels.
Diabetes often emerges around a decade sooner for Māori than in non-Māori populations, contributing to earlier onset of complications such as heart failure, kidney disease, amputations and premature death. Māori experience approximately 3.5 times higher mortality from diabetes-related causes and are significantly more likely to progress to end-stage renal failure, even when living with the same diagnosis.
The Waitangi Tribunal’s Health Services and Outcomes Inquiry (Wai 2575), including Wai 2919 filed by Associate Professor Leanne Te Karu, has documented “prescription inequity” within the New Zealand health system, including under-access to diabetes, cardiovascular and renal medicines for Māori.
Dr Leanne Te Karu, author of Te Tiratū’s recent position statement on 12-month prescriptions and claimant in Wai 2919 has consistently highlighted the impact prescription inequity has on Māori health outcomes.
Her research references the “missing million prescriptions” analysis, highlighting the scale of inequitable prescribing relative to Māori health need.
“Restricting equitable access to SGLT2 inhibitors and GLP-1 medicines risks widening the very inequities the health system has acknowledged for years,” said Dr Te Karu.
Te Tiratū says removing ethnicity equity criteria raises serious concerns about whether Pharmac is meeting its obligations to achieve equitable Māori health outcomes under Te Tiriti o Waitangi.
“Treating all universally in the system does not create fairness. It entrenches inequity,” said Glen Tupuhi.
The Iwi Māori Partnership Board is calling on Pharmac to:
•Retain ethnicity equity criteria for access to these medicines;
•Publicly release equity impact analysis before consultation proceeds;
•Demonstrate how Māori health outcomes will improve if the criteria are removed;
•Engage directly with Iwi Māori Partnership Boards, Māori clinicians and Māori health providers;
•Uphold Te Tiriti obligations in medicines policy and funding decisions.
Te Tiratū says any proposal affecting equitable access to medicines must be assessed against the reality that Māori continue to experience some of the highest rates of avoidable illness, preventable hospitalisation and premature death in Aotearoa.
“Māori die at least seven years earlier.1 So these decisions are not abstract policy choices. They will directly affect whether whānau avoid dialysis, amputations, heart attacks and early death,” he said.
Te Tiratū is developing resources to support whānau, Māori health providers, clinicians and community leaders to make informed submissions ahead of the consultation deadline of 5:00pm, Thursday, 28 May, opposing the removal of equity access criteria.
It will also brief all 14 Iwi Māori Partnership Boards nationally, the Hauora Iwi Leaders Group within the National Iwi Leaders Forum, the Hauora Māori Advisory Committee to Minister Brown, the Attorney General, the Chief Ombudsman, the Human Rights Commission, and Members of Parliament on the adverse impact the proposal could have on Māori health outcomes.
Dr Leanne Te Karu
Frontline reality for whānau in Waikato
The Waikato Local has covered Te Tiratū Iwi Māori Partnership Board’s latest Stakeholder Forum for Hauora Māori Providers in Tainui Waka rohe.
They say the system is under growing strain, as rising demand and increasingly complex needs push services to their limits.
Thirty-two representatives from iwi, hauora and community organisations were in the room, spanning kaumātua support, whānau ora, primary health and grassroots mentoring.
Across the forum, providers said they are “holding the line” but the current approach is not sustainable.
They are calling for greater alignment across the system, earlier investment, and a stronger focus on what is already working in communities.
Iwi Māori Partnership Board calls for equity-led delivery in earlier bowel screening
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Monday 30 March 2026, 5:00 AM
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Te Tiratū Iwi Māori Partnership Board (IMPB), one of the largest in Aotearoa representing 121,300 whānau across the Tainui waka rohe, supports lowering the national bowel screening age to 58. It says the change will save lives, but only if equity for our Māori and Pacific whānau are central to how the programme is delivered.
Board member and clinician, Dr Mataroria Lyndon says the expansion is a positive move, but the data shows Māori and Pacific peoples are still being left behind at every stage of the screening pathway.
“Lowering the screening age is progress because it will help catch more cancers earlier. But the reality is stark. Around 60% of wāhine Māori and 50% of tāne Māori with bowel cancer are diagnosed before age 60, compared with about 30% in non-Māori. That means that even with screening starting at 58, a substantial proportion of Māori bowel cancers are likely to develop before people become eligible for screening.”
“Screening at 58 is better than 60, but it is not enough. The earlier we can detect bowel cancers among whānau Māori and Pacific, the more lives we can save. Ideally, the screening age should be lowered further and paired with equity-focused outreach and support.”
Data from the Te Tiratū IMPB priorities summary report highlights the scale of the challenge in the Waikato rohe. As at June 2023, 40.6 percent of the eligible Māori population in Waikato District had been screened for bowel cancer, compared with 57.4 percent of non-Māori.[1] Screening rates are lowest in younger age groups, where the largest numbers of Māori stand to benefit from earlier detection.
An average of 161 Māori die from cancer each year in Waikato District, and Māori are around twice as likely as non-Māori to die from any cancer. Dr Lyndon says these inequities reinforce the need for screening programmes that are not only broader but better designed.
“Expanding eligibility on its own is not enough. Equity must be built into delivery. That means services must be accessible, culturally appropriate, and actively reach whānau who are currently missing out.”
He acknowledged the leadership of kaupapa Māori providers in the region, including Taakiri Tuu wellness and diagnostic centre built and operated by Te Kōhao Health, who are already working to improve early detection and outcomes through whānau-centred models of care within the community.
“What we are seeing locally is what works. Māori providers are engaging our people in ways the mainstream system often cannot. They are trusted, connected, and delivering services that reflect the realities of our people’s lives. That is where continued investment and support are critical.”
Dr Lyndon says younger Māori remain a key priority, particularly given the evidence that bowel cancer can present earlier and progress more rapidly.
“The evidence is clear. Māori are more likely to develop bowel cancer at younger ages and experience worse outcomes. That means earlier screening must be paired with proactive outreach and support, especially for those in younger age groups who are currently underrepresented in screening programmes.”
Lowering the screening age is consistent with what the evidence has been telling us. Rates of colorectal cancer before age 50 have been increasing, with Māori experiencing faster growth compared to non-Māori. Findings published in the New Zealand Medical Journal show Māori are more likely to be diagnosed before screening begins, highlighting the urgency of earlier, equity-focused intervention.
Te Tiratū IMPB says it will continue to work alongside iwi, Hauora providers and hapori across the Waikato to ensure the expansion of bowel screening delivers meaningful gains for Māori.
“This is an opportunity to do things differently. We support the intent to extend access, but success will be measured by whether it actually reduces inequity. That requires sustained focus, investment, and accountability.”
[1] Source: https://tetiratu.co.nz/2024/09/30/hauora-maori-priorities/
Ngāti Kahungunu and Māori health partners unite to shape new iwi health authority
MEDIA STATEMENT
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Thursday 19 March 2026, 10:00 AM
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Ngāti Kahungunu Iwi Incorporated (NKII) is proud to announce a formal commitment to work collectively with Hauora Māori service providers, regional Taiwhenua, Post-Settlement Governance Entities (PSGEs), and the Tihei Takitimu Iwi Māori Partnership Board to advance the establishment of the Kahungunu Health Authority (KHA).
Since an initial announcement in September 2025, these parties have collaborated to bring clarity to how the KHA could operate as a separate, independent body designed to achieve better outcomes for whānau.
The KHA will be established to supplement, rather than duplicate, the work of the existing regional Māori health entities. While these entities work from within the public health system to support and deliver health services, and influence investment and accountability, the KHA sits outside the system.
This independence gives it strategic freedom to design and scale innovative models of care, partner with private sector operators, and mobilize iwi resources in a way the public sector system may be too risk-averse to adopt.
Bayden Barber, Chair of Ngāti Kahungunu Iwi Inc, emphasises the need for this dual-tiered approach.
“The health sector is in crisis, and our statistics continue to languish. By standing together with our regional partners, we’re creating a powerful political force grounded in rangatiratanga. NKII remains the constitutional voice for Treaty and cultural matters, while the KHA carries the technical expertise and political freedom to challenge the system and demand better opportunities and outcomes for our people.”
Central to this development will be a dedicated working group of twenty-five whānau members who expressed their commitment during recent wānanga to help drive the kaupapa forward. This group will ensure the design of the KHA remains rooted in the voices and aspirations of the people it serves.
Speaking on behalf of all parties, Tihei Takitimu Co-Chairs Kerri Nuku and Lewis Ratapu highlighted the critical importance of unity in the current climate.
“At a time when the rights and interests of Māori are being constantly challenged, kotahitanga is our greatest strength. We must move forward together to protect the health of our people.
Our role will be to ensure the public system lifts its performance and remains accountable, while the KHA pushes the horizon of what’s possible from the outside. Together, we create a ‘productive tension’ that ensures the system never settles for ‘good enough’.”
The parties will work on a robust governance structure that harnesses the deep knowledge and networks of Hauora providers and PSGEs to ensure all voices are amplified. This unified front positions Kahungunu as a leader shaping the future of Māori health on its own terms.
‘Fails Māori’ Māori health advocates slam Pae Ora amendment bill
Whakaata Māori has reported on opposition from Te Tiratū Iwi Māori Partnership Board to changes proposed in the Pae Ora (Healthy Futures) Amendment Bill, which has now passed its second reading in Parliament but is not yet law.
Te Tiratū says the amendments would weaken the role of Iwi Māori Partnership Boards and sideline iwi authority within the health system. The boards were established under the Pae Ora (Healthy Futures) Act 2022 to ensure Māori communities have a formal role in health planning, priorities, and accountability.
Te Tiratū Co-Chair Tipa Mahuta said the proposed changes would dilute the influence of iwi in health decision-making and weaken the protections intended to give effect to Te Tiriti within the health system.
“This government talks about strengthening Māori voices, but these amendments sideline our authority. Iwi Māori Partnership Boards exist to ensure equity and accountability in health, not just to provide advice when convenient. We need genuine power, not paper pathways,” Mahuta said.
Mahuta said weakening Section 30 of the Act would reduce Māori decision-making and strip away important protections linked to Te Tiriti. She said evidence gathered through Te Tiratū’s work shows that iwi-led planning improves access, outcomes, and efficiency across health services.
“Our reports clearly show that iwi-led solutions improve access, outcomes, and efficiency across health services. From chronic disease management to cancer screening, the evidence demonstrates that local, Māori-led planning works. Yet the proposed reforms ignore this capability entirely.”
Pae Ora Bill weakens Māori voice, erodes accountability
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Wednesday 4 March 2026, 4:00 PM
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Te Tiratū Iwi Māori Partnership Board, representing over 121,000 Māori in the greater Waikato region, warns that the Pae Ora (Healthy Futures) Amendment Bill threatens to sideline Māori authority and strip Te Tiriti protections from New Zealand’s health system.
“This government talks about strengthening Māori voices, but these amendments sideline our authority. Iwi Māori Partnership Boards exist to ensure equity and accountability in health not just to provide advice when convenient. We need genuine power, not paper pathways,” said Te Tiratū Co-Chair Tipa Mahuta.
Drawing on the value of locality evidence from its Community Health Plan, Hauora Māori Priorities Summary, and Monitoring Reports on Te Whatu Ora, Te Tiratū believes weakening Section 30 of the Act reduces Māori decision-making, strip Te Tiriti protections, and deepen existing health inequities leading to poorer health outcomes for whānau.
“Our reports clearly show that iwi-led solutions improve access, outcomes, and efficiency across health services. From chronic disease management to cancer screening, the evidence demonstrates that local, Māori-led planning works. Yet the proposed reforms ignore this capability entirely.”
During last night’s debate, Te Pāti Māori MP Hana Maipi-Clark representing the Hauraki-Waikato Māori electorate warned that the Bill removes Māori influence and accountability from health governance.
“Iwi Māori Partnership Boards represent the community voice and Māori-led structures that ensure equity and accountability in our health system and this bill removes their influence.”
“Clause six removes the duty to maintain systems capable of understanding mātauranga Māori, kaupapa Māori services, and cultural safety and clause 33 strips equity and Te Tiriti expertise from public health advisory structures, including the Iwi Māori Partnership Boards. This is not tidying up legislation; it is dismantling accountability.”
Green MP Hūhana Lyndon added that IMPBs were originally designed to co-steer the system alongside Te Aka Whai Ora Māori Health Authority and Te Whatu Ora, but the amendments push them into the “back seat”:
While Labour argued “Why is the Government scared of local health services having to turn up to an iwi board and explain why they are not achieving outcomes for Māori? That is community accountability.”
Te Tiratū Iwi Māori Partnership Board point to the power of locally-led Māori responses during COVID-19 that were faster and more effective than centralised approaches.
“Our work shows the same principle applies across ongoing health inequities: whānau-led, evidence-driven governance delivers results,” Mahuta said.
Te Tiratū emphasises that Māori economic development depends on healthy, supported whānau. Empowered IMPBs drive workforce development, innovation, and local health infrastructure investment, aligning with Government economic goals.
“IMPBs play a critical role in ensuring Māori voices and mātauranga Māori shape health decision-making. Te Tiratū’s monitoring and priority reports provide actionable insights that improve outcomes and deliver stronger returns on taxpayer investment,” Mahuta said.
“The Crown’s duty to partner with iwi under Te Tiriti o Waitangi is non-negotiable. Reducing the role of the IMPBs risks repeating decades of systemic failure and wasted resources.”