Find Health and Medical expertise in Tonga

The Ministry of Health controls Tonga’s national health care system, which provides health care and medication free of charge. Tonga has 12 health centres and seven health clinics, which are staffed by a health officer and nurses. The centres are supported by five hospitals – one on each of the main islands. There are also a small number of private health care providers – these tend to be either traditional healers or private clinics run after hours by government doctors. Tongan hospitals usually have limited outpatient and emergency facilities. There are no pharmaceutical manufacturers or wholesalers in Tonga – the country imports all of its pharmaceutical requirements. The pharmaceutical sector in Tonga is not extensively regulated and there are no legal restrictions on pharmaceutical sales to licensed outlets. This is set to be overhauled under the WHO Country Co-operation Strategic Agenda (2013–17), one of the strategic priorities of which is to establish a national regulatory framework.

A WHO report in 2012 found that access to health care is good for the majority of people in Tonga, with the exception of communities on the most remote islands. The Ministry of Health’s mission statement is: ‘To respond effectively to the health needs of the Tongan people by providing the appropriate range and level of high quality health services and being accountable for the outcomes of these services.’ In the longer term, it aspires for Tonga to become ‘the healthiest nation in the Pacific Rim’ by 2020. In particular, Tonga is working on building its capacity to prevent and control NCDs, particularly obesity and hypercholesterolaemia.

Over time, the Tongan diet has moved away from traditional root crops, coconuts and fish to imported foods, with disastrous results – more than half of the adult population is obese and a third of people have type II diabetes.

Non-communicable diseases (NCDs) in Tonga accounted for an estimated 74% of all mortality in 2008. The most prevalent NCDs in Tonga are cardiovascular diseases, which accounted for 38% of total deaths across all age groups in 2008. Cancer, non-communicable variants of respiratory diseases and diabetes contributed 9%, 7% and 5% to total mortality, respectively (2008). Communicable diseases along with maternal, perinatal and nutritional conditions accounted for an estimated 22% of all mortality in 2008. In 2013 it was reported that there were two people in Tonga living with HIV. Tonga is a non-endemic country for malaria. There was a significant overall reduction in both estimated incidence of and estimated mortality (when mortality data excludes cases comorbid with HIV) from tuberculosis (TB) in the period 1990–2013.

Government expenditure

In 2013 government expenditure on health was 3.8% of GDP. In the most recent survey, conducted in the period 1997–2010, there were 56 doctors, and 388 nurses and midwives per 100,000 people. Additionally, in the period 2007–12, 98% of births were attended by qualified health staff and in 2013, 99% of one-year-olds were immunised with a dose of measles. In 2014, 100% of people were using an improved drinking water source and 91% had access to adequate sanitation facilities. The most recent survey, conducted in the period 2000–11, reports that Tonga has 15 pharmaceutical personnel per 100,000 people.

Less than a fifth of health care in Tonga (16%) was paid for by patients or funded by other non-governmental entities – such as private insurers, charities or employers – in 2012. Total health expenditure constituted 5.4% of GDP in 2012, of which 84% (US$200 per capita) was covered by the government.

Tonga is not a signatory to the International Covenant on Economic, Social and Cultural Rights, the covenant that commits signees to ensuring ‘the right of everyone to the enjoyment of the highest attainable standard of physical and mental health’.