Honourable Speaker Sir;
Honourable Prime Minister;
Honourable Leader of the Opposition;
Honourable Cabinet Ministers and Assistant Ministers;
Honourable Members of the House;
Distinguished Guests;
Ladies and Gentlemen;
Ni sa bula vina’a and good afternoon to you all!
Honourable Speaker Sir,
I rise to respond to His Excellency the President Ratu Wiliame Maivalili Katonivere’s address for opening of the 2024 Session of Parliament last Monday and to thank His Excellency for his most gracious speech.
At the outset, His Excellency the President made some profound announcement with regards to Government policies and plans for the development and advancement of our nation Fiji, which we all need to take heed of and work towards as honourable members of this august House.
Among the highest priorities of the Coalition Government is the formulation of a new National Development Plan for the nation, as announced by His Excellency the President. The new National Development Plan will capture our collective vision and aspirations for the future, and set key initiatives and strategies that will allow the nation to grow sustainably in the many years ahead of us.
As alluded to by His Excellency the President, the key fundamental of the Government’s development agenda is inclusive development to improve the well-being of all our citizens. The National Development Plan is anticipated to be finalized by June this year, before the budget announcement.
DISEASE BURDEN
Honourable Speaker Sir,
His Excellency the President highlighted the commitment of the Ministry of Health and Medical Services to address the significant challenges posed by the increasing burden of Communicable and Non-Communicable Diseases in our population.
NCD
Non-communicable diseases (NCD) continue to be the main disease burden for our people contributing to 80% of all deaths in the country and 40% of premature death. I am grateful to the Hon Prime Minister and Minister responsible for the Civil Service for launching earlier this year the Policy and Guideline on Healthy Catering at government agencies and institutions which should guide how the civil service can promote and implement healthy eating and meal preparation.
The healthy habits to reduce NCDs in Fiji do not start inside our hospitals and nursing stations. They start and are nurtured in our homes, schools, villages, work places, offices, and also in the deliberations of this august House. The NCD crisis we have will require all our collective effort and determination to control and stop. The Ministry of Health and Medical Services is finalizing its Wellness and NCD Strategy with the help of our partners, which will guide our effort in addressing NCD in Fiji.
HIV&AIDS
Honourable Speaker Sir,
At this juncture, the Ministry is fighting an uphill battle with the increasing number of cases of HIV and AIDS.
While this is still the tip of the iceberg, it is commendable for the Government of the day to recognise two significant issues that were pushed under the carpet:
Firstly, it recognises drugs as an issue and secondly it recognised HIV.
Our latest statistics on HIV cases are alarming and demands our attention and collective action. From January to December 2023, we recorded 415 new HIV cases in Fiji, compared to 245 cases for the same period in 2022.
Out of these cases, 404 are adults, while 11 cases are children. Three of the children got HIV through sexual transmission, while 8 children got HIV/AIDS through Mother-To-Child Transmission (MTCT).
Of the total number of patients being diagnosed, 298 are reported to be males, 122 females and 4 transgenders. In addition, thirty-one (31) of these cases were teenagers aged between 15 to 19 years.
The increase is attributed through increase in active case finding within the MHMS using Point of Care Testing.
Unfortunately, in 2023 alone, Fiji lost 82 lives to HIV. Which is one to many.
According to the Global AIDS Monitoring Report, Fiji is now one of the top two (2) countries in the Asia-Pacific region with rapidly rising new HIV infections.
The Ministry is aware of the linkage between the use of illicit drugs in the country and the rise of HIV cases. Activities such as Blue Toothing for IV drug users and Chem-Sex amongst the younger population are fuelling the rise in new HIV cases.
The Ministry is finalizing the HIV Surge Strategy which will facilitate our collaboration with health partners, across government ministries, and our communities to strengthen prevention, increase national HIV testing by 3% for key population groups, improve access to diagnosis and treatment, reduce stigma and discrimination relating to HIV and AIDS, and strengthen the governance of our HIV response program.
I take this opportunity to remind everyone in Fiji that unsafe sexual practices and the use of injectable drugs are contributing to the rise of HIV in Fiji. Avoiding these risky behaviours can prevent you from getting the HIV infection.
I also want to remind everyone in Fiji that having HIV is not a death sentence. With treatment, people living with HIV can lead a normal and productive life, and have children who are free of HIV infections.
Honourable Speaker Sir,
To address the disease burden in Fiji, His Excellency the President had highlighted a number of important steps that the Ministry will undertake in the next 12 months
POLICIES AND LEGISLATIONS
Honourable Speaker Sir,
The Ministry of Health and Medical Services is focus on reviewing and updating a number of critical health legislations such as the Public Health Act 1935, the Nursing Act 2010, the Radiation Health Act 2009, and the Mental Health Act 2010.
Other health related legislations are also being considered for review as they impact the collaboration and coordination of effort between the Ministry, other Govt agencies, and the community, in the efficient delivery of health services and the protection of public health in Fiji.
HEALTH WORKFORCE
Honourable Speaker Sir,
Fiji continues to lose health care workers from the Ministry into the private health sector in Fiji or abroad. Current global trends indicate that the movement of health care workers will continue for some time due to a global lack of health care workers.
WHO estimates that the world will face a shortage of 10 million health care workers in 2030, reducing from 15 million in 2020. These gaps are still significant and contributing to the movement and maldistribution of health care workers in small island development states such as Fiji.
Nonetheless, the Ministry has noted that in the case of our nursing workforce, the attrition rate has reduced in the months of November and December 2023 following the implementation of salary adjustments and incentives for nurses which Parliament approved in the 2023/2024 national budget.
This is an encouraging sign, and the Ministry will continue to work with our stakeholders to address health human resource need for the immediate and the long term.
INFRASTRUCTURE IMPROVEMENT
Honourable Speaker Sir,
Since January 2023, the Ministry has continued with its health infrastructure improvement program with the budgetary allocation from Govt, and together with the generous support of our partners, local businesses, civil society organisations, hospital board of visitors, and community members.
Through this collaborative effort, the Ministry has completed a number of significant infrastructure improvement projects that include, amongst others, the:
1. refurbishment of Nagado Nursing Station, Vatulele Health Centre, Nukuilau Nursing Station and Nailaga Health Centre, in the Western division;
2. refurbishment of Dreketi Health Centre, Naqumu Nursing Station, and Savusavu Hospital in the Northern division;
3. refurbishment of Galoa Nursing Station, the Korovou Health Centre, and the SOPD clinic at Wainibokasi Hospital;
4. refurbishment of wards and road works at St Giles Hospital;
5. refurbishment of the Rose Hall at Tamavua Hospital;
6. construction on the food and water laboratory at Fiji CDC centre in Namaka;
7. refurbishment of Cicia Health Centre on Cicia Island in the Lau group;
8. construction of mortuary ramp and admin walkway at Labasa Hospital;
9. and the internal renovations and exterior painting of the Mataika House in Tamavua.
A number of infrastructure works are currently progressing such as the refurbishment of the Nausori Health Centre, the interior painting for Labasa hospital, and the construction of the Northern Medical Warehouse facility, to name a few, and the Ministry will continue to address the infrastructure improvement needs for all its more than 200 health facilities across the country.
The Ministry is aware of the infrastructural issues relating to the 100-year-old CWM Hospital, which have also been highlighted a number of times in the media.
The Ministry is engaging with the Ministry of Public Works and Transport and our health partners to address the immediate and long-term infrastructure needs for the hospital. We hope to announce this week a health partner support that will go a long way in addressing the short and long-term actions to improve the hospital buildings.
DIGITAL HEALTH
Honourable Speaker Sir,
The COVID 19 pandemic showed us the value of digital health in augmenting and enhancing the delivery of health services in Fiji and globally.
In 2023, the Ministry launched its first ever Fiji’s Digital Health Strategy 2023-2027, which is aimed at enhancing the Ministry’s communication and digital platforms and facilitating better disease surveillance, patient referral, supply chain and inventory management, resource planning and mobilization, and governance of its daily operations. Our divisional and subdivisional command centres operations will function much more effectively with access to a better digital and communication platform.
The strategy will assist in the introduction of new digital health program such as the immunization information system and telehealth capabilities that will further enhance health services as well as the storage and security of confidential health information for patients.
This five-year Digital Health Strategy and Implementation Plan with the associated package of digital support will address governance, systems and human resources in line with the Government’s overall digital plan.
HEALTH PROGRAMS
Honourable Speaker Sir,
The Ministry has targeted the strengthening of a number of health programs that have been impacted by the COVID 19 pandemic and which now need strengthening and enhancement.
PHC
The Ministry is finalizing its Primary Health Care strategy with the support of our partners. The strategy will define the Primary Health Care package that will be delivered at all levels of health services from the nursing station right up to main referral hospitals.
A strengthened Primary Health Care program will ensure that our population receive the health care they need in a timely manner, fulfilling our Universal Health Coverage targets for Fiji.
Extended Program of Immunization
While Fiji’s Immunisation program has been exemplary and applauded globally, the Ministry wishes to maintain the high immunization coverage for the population in Fiji. The last coverage survey showed a 95% coverage overall for all vaccines. The COVID-19 vaccination coverage for the primary doses is also 95% for the adult population.
With a strong child health program under the Ministry, Fiji has maintained its neonatal mortality rate of less than 12 per 1,000 live births consecutively over the past five years, meeting the SDG target of less than 12 deaths per 1000 live births by 2030. The Ministry will also begin to address and measure our progress towards the SDG target of less than 25 per 1000 live births for under 5 mortality rate.
The Ministry is strengthening the immunisation information management system with development partner support in the development of a digital immunisation registration system that will be completed over the next two years. This will allow defaulters to be traced efficiently, and readily available updated coverage data across the nation.
With development partner support, the Ministry has updated its Immunisation Policy, and rolled out the digital Bluetooth monitoring of our Cold Chain process, which is the heartbeat of Vaccination, providing the opportunity for research into the use of vaccines in Fiji.
Early Childhood Development (ECD)
In 2023, the Early Childhood Development Policy and Implementation Plan was launched through the collaborative effort of our health partners and the government agencies including the Ministry of Education and the Ministry of Women, Children, and Social Protection.
The Policy will ensure that the National ECD Advisory Committee effectively guide the holistic development of the more than 88,000 children between the age of 0 to 8 years in Fiji, through access to healthy nutrition, early education, and support for the parents.
INCLUSIVE DEVELOPMENT – DONOR PARTNERSHIPS
Honourable Speaker Sir,
Inclusive development is an approach the Ministry of Health & Medical Services is taking in terms of meeting our strategic objectives and most importantly improving the quality of health care for Fijians. For our many health programs, the Ministry is engaging our community partners and civil society organizations to address the health concerns of our communities, and in particular, address the health needs of our vulnerable communities so that the elderly, babies and children, pregnant mothers, the disabled, and those with chronic diseases are adequately addressed.
The increased allocation for medical outreach to rural communities, which is decentralised to our divisions for the first time ever, will ensure that our rural, hard-to-reach communities, and maritime communities are visited by our health teams, and their health needs addressed close to their own homes. In fact, as I speak, a team of Medical specialists led by our Acting Sub-Divisional Medical Officer (SDMO) Eastern Dr Luke Ravula are touring the islands of the Lau group providing medical care and health promotion activities
Through the Ministry’s Donor Coordination Unit, we are gradually building up our capacity to be able to engage effectively with our various health partners, and gain maximum benefit from their support and generosity.
The Ministry is grateful to the support of local businesses, NGOs, Civil Society Organizations, Board of Visitors, and community groups, as well as partners in DFAT, MFAT, KOICA, JICA, USAID, China Aid, World Bank, ADB, the UN organizations – WHO, UNICEF, UNFPA, UNDP, and the Government of Australia, New Zealand, USA, China, as well as families and individuals who have supported the Ministry in its effort to improve health service provision for the people of Fiji.
Honourable Speaker Sir,
I wish to conclude with His Excellency the President’s statement when he said that we should not see challenges as mountains, but as common missions to ascend and resolve with open and constructive dialogue, with a view to build social cohesion.
With this in mind, I wish to mention and extend my sincere gratitude and appreciation for the incredible work of our healthcare workers throughout the country. One of them was highlighted in the media recently – the Medical Officer at Cicia Health Centre in the Lau group Dr Rusila Tikoitoga who courageously and successfully delivered twins last month with limited medical resources at her disposal.
Now, this is not our ideal delivery plan for a twin pregnancy knowing the many risks associated with multiple pregnancies. However, this was the reality at the frontline on that day, and not of her choosing. Dr Tikoitoga displayed calmness, quick thinking remembering her training as a medical intern, and her dedication and faith to see the young mother and the newborn babies through.
Dr Tikoitoga exemplified many more dedicated and hardworking healthcare workers in Fiji whose stories we may never hear, who give their best day in and day out, in spite of the many challenges they face each day.
As their Minister, I salute all of them today and I also thank our friends and partners who help to make their work easier each day with their support.
The Ministry of Health and Medical Services cannot do it alone, we need everyone’s contribution to create a healthy population in Fiji.
VINAKA VAKALEVU & THANK YOU!