Interview with Dr Colin Tukuitonga: from crisis to action in Pacific communities

Colin Tukuitonga

Published 6 December 2018.
Citation: Tukuitonga C. Interview with Dr Colin Tukuitonga: from crisis to action in Pacific communities. Public Health Res Pract. 2018;28(4):e2841827.

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About the author/s

Colin Tukuitonga | Director-General, Pacific Community, Noumea, New Caledonia

Corresponding author

Colin Tukuitonga |

Competing interests

None declared.


The island communities in the Pacific contribute very little to global carbon emissions, yet they are among the most vulnerable to the effects of climate change. Dr Colin Tukuitonga, a general practitioner by training, was born and raised on Niue Island in the Pacific. He has held senior public health roles in the New Zealand Government and, since 2014, has served as Pacific Community Director-General. He spoke to us about how climate change is affecting the health of people living in Pacific Island countries and the relevance of Australia’s climate change policy responses to these neighbouring countries.

Full text

Key points

  • Climate change exacerbates existing health issues in Pacific communities, including access to clean water and occurrence of communicable diseases such as dengue
  • Pacific communities are taking action to mitigate and adapt to the adverse effects of climate change on health. However, financial assistance from countries such as Australia and New Zealand is critical to helping them build resilience

Q: Tell us about your organisation, the Pacific Community (SPC), its role in the Pacific and, more specifically, its work in assisting Pacific communities to respond and adapt to climate change.

A: SPC was established in 1947 to provide development assistance to member states, based on science and technical knowledge. The scope of work is broad and extends across 27 different sectors such as agriculture, fisheries, human rights, public health and others. SPC is the largest of the Pacific regional organisations, with 26 members.

In climate change, SPC works mainly to assist member states with mitigation and adaptation activities to ensure food and water security, to conduct surveillance and manage outbreaks of communicable diseases, to reduce risk of disasters and to build resilient communities. Our activities include improving food security by providing climate- and pest-resistant hybrids of staple food crops and supporting greater use of renewable energy. A key part of the support is capacity building to enable member states to plan, manage, implement and evaluate interventions across all sectors affected by climate change.

We work across a range of sectors on activities designed to help our member states mitigate and adapt to climate change. In the health sector, for example, we have worked to secure water supplies in Kiritimati Island, Kiribati, and improve access to clean and sustainable drinking water for an estimated 3000 people, including four schools and the hospital for the Line and Phoenix Island Group.

Q: In your observations, how is climate change affecting health in the Pacific Islands?

A: Climate change affects the entire range of social and economic determinants of health. Disasters such as cyclones, flooding and droughts are often the most visible, but rising sea levels and ocean acidification are equally problematic because of the negative impact on coastal environments. Most people are unaware that Pacific communities rely largely on the sea for their livelihoods, and 80% of the protein for Pacific communities comes from fish and other seafood. Ocean acidification (and marine pollution) threatens the marine environment. Coral bleaching is a serious threat in many parts of the Pacific.

We have already seen several communities relocated as a result of sea-level rise. Displacements and relocations create uncertainty, distress and anxiety in affected communities. Extreme weather events such as cyclones cause death and injury across all affected islands. In addition, extreme temperatures cause adverse heat-related health impacts and increased incidence of respiratory diseases. I’m concerned that the full impact of climate change on health is yet to be fully recognised.

Q: What are the immediate priority actions that are needed here?

A: Our most immediate priority is to ensure that people are protected from the threats of cyclones and other disasters. In assisting member states with relocations, we are advising them to take the opportunity to ensure that communities have improved access to clean water, better sanitation and improved access to land for community gardens (and become less reliant on imported flour, rice, etc.).

Q: What are the most important lessons emerging from your current experiences?

A: The main lesson is that climate change makes existing issues worse. Many member states do not have adequate access to clean water, and climate change makes access worse. Similarly, dengue is now constant in many islands, and climate change will compound the spread of dengue through global warming and expanding mosquito habitats. Controlling mosquito breeding sites is critical. Our advice to member states is to address these concerns ahead of time. Preparedness is critical.

Q: In a recent World Health Organization action plan on climate change and health for the Pacific Islands1, a goal is that, by 2030, all health systems in small island developing states will be resilient to climate variability and change. What do you think are the more immediate priority actions so these health systems can achieve this goal?

A: The immediate issue for many small island health systems is to ‘climate-proof’ existing healthcare facilities. Most healthcare facilities are located along the coast and many are vulnerable to the adverse effects of climate change – either destruction by cyclones or rising sea levels. Many facilities do not meet adequate building codes. Many of the smaller island states do not have the resources to climate-proof their facilities, but they need to act now. Island states can also take advantage of the opportunity to install renewable energy sources for their healthcare facilities.

Q: What actions are taking place in the Pacific to respond to the adverse health impacts of climate change, and who is playing an important role?

A: National governments, regional organisations and international agencies are all involved in the fight against climate change. Pacific nations made a huge impact on the Paris Agreement2, which is the main global instrument guiding work on climate change. Pacific nations continue to advocate strongly for action on climate change, especially after the withdrawal of the US from the Paris Agreement. At the local level, communities are taking action to protect their villages and homes from rising sea levels. Academic institutions are providing the evidence needed for advocacy and action. The media also plays an important role in information sharing and advocacy. The negative consequences of climate change are felt most acutely in the small island states of the Pacific. It is a crisis for many communities.

Q: What needs to be done going forward, and what role should wealthier and influential neighbours, like Australia and New Zealand, play?

A: Australia has been criticised for not being decisive enough about climate change. Pacific people have repeatedly called for stronger leadership by Australia and New Zealand in encouraging global players to reduce their emission levels of harmful greenhouse gases. Many in the region expect stronger action given the change of position by the US. Pacific nations have also requested financial assistance from Australia and New Zealand to support adaptation and mitigation strategies at the local level.

Q: How important is financial assistance to support adaptation and mitigation strategies at this stage?

A: Financial assistance is critical. None of the island states are in a position to be more resilient without external assistance. This is why island leaders have pushed hard to streamline access to global financing facilities and to reduce the associated bureaucracy. If governments do not access adequate external financial assistance, most communities will remain vulnerable to the adverse effects of climate change. Food and water security will be compromised and communities less able to manage. Vulnerable communities become less able to cope with the spread of waterborne and arthropod-borne diseases. Vulnerable communities become susceptible to mental disorders and post-traumatic stress disorder. Their lives and livelihoods will suffer.

Q: In recent years, the voices of Pacific leaders have been described as becoming “even more ardent with increasing force and urgency”.1 Are you optimistic that these voices will be heard?

A: Yes I am. We did not have much confidence in the lead-up to the Paris Agreement, but island leaders made a big impact there. They have continued to lead in many areas. For example, Fiji was chair of the United Nations climate change conference COP23. Island leaders also played a big part in the United Nations Oceans Conference in 2017, setting increased demands for urgent and better actions by developed nations. They continue to push for more decisive action.


The interview was conducted by the Editor-in-Chief of Public Health Research & Practice, Don Nutbeam.

Peer review and provenance

Internally peer reviewed, commissioned.


Creative Commons License

© 2018 Tukuitonga. This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International Licence, which allows others to redistribute, adapt and share this work non-commercially provided they attribute the work and any adapted version of it is distributed under the same Creative Commons licence terms.