respiratory diseases and diabetes contributed ten per cent, six per cent and five per cent to total mortality, respectively (2008). Communicable diseases along with maternal, perinatal and nutritional conditions in Tuvalu accounted for an estimated 21 per cent of all mortality in 2008. A government paper on HIV/AIDS reported that in 2010 there were ten people living with HIV in Tuvalu. Tuvalu is a non-endemic country for malaria. The estimated incidence of tuberculosis (TB) decreased by more than half overall in the period 1990–2013, although the period 2011–12 saw an increase in incidence from 152 per 100,000 people to 241; this then dropped to 228 cases in 2013. Estimated mortality (when mortality data excludes cases comorbid with HIV) from the disease has dropped slightly overall in the period 2007–13, although there was great fluctuation over this time. There is a lack of data to indicate the most commonly diagnosed psychiatric disorder. Health systems: In 2012 government expenditure on health was 15.4 per cent of GDP, equivalent to US$577 per capita. In the most recent survey, conducted between 1997 and 2010, there were 109 doctors, and 582 nurses and midwives per 100,000 people. Additionally, in the period 2007–12, 98 per cent of births were attended by qualified health staff and in 2013, 96 per cent of oneyear olds were immunised with one dose of measles. In 2012, 98 per cent of people were using an improved drinking water source Tu v a l u and 83 per cent had access to adequate sanitation facilities. The most recent survey, conducted in the period 2000–12, reports that Tuvalu has 18 pharmaceutical personnel per 100,000 people. Legislation in Tuvalu prevents the operation of private medical practices and pharmacies, so all facilities available on the islands are public. The country’s only hospital, Princess Margaret Hospital, is located in Funafuti and is capable of providing basic primary health care, and dental and pharmaceutical services. There are also eight medical centres, located on the outer islands, which are staffed by nurses. Serious cases are sent to Fiji or New Zealand under a medical referral scheme, the Tuvalu Medical Treatment Scheme. For diagnosis of some diseases, specimens need to be sent to laboratories overseas. Tuvalu’s main pharmacy is located in the Princess Margaret Hospital, and is responsible for the procurement of drugs and reproductive health commodities from suppliers. The Department of Pharmacy, which is a branch of the Ministry of Health, is responsible for organising training for nurses working in Tuvalu’s medical centres to ensure that they are proficient in the ordering and management of medicines and drugs. There are no licensed pharmaceutical manufacturers in Tuvalu. The National Drug and Therapeutic Committee, part of the Ministry of Health, functions as a regulation authority for pharmaceuticals. Australia and New Zealand are the main bilateral donors for development assistance in the health sector. The most recent act of parliament relating to mental health in Tuvalu is the Mental Treatment Ordinance 1973. There are no psychiatric hospitals in Tuvalu and mental health services are provided through outpatient facilities, with a heavy reliance on psychiatric nurses and psychiatric beds in general hospitals. Health MDGs: The Millennium Development Goals (MDGs) mature in 2015, but monitoring of progress is ongoing due to the time it takes to collect and analyse data from each country. For Tuvalu to achieve its targets for the reduction of child mortality, which forms MDG 4, it should have reduced under-five deaths per Commonwealth Health Partnerships 2015 283 Under-five mortality 60 50 40 30 20 1990 1995 2000 2005 2010 2015 Under-five mortality per 1,000 live births 2015 MDG 4 target 10 Mortality by cause of death (% of all deaths), 2008 Other NCDs Communicable, maternal, perinatal and nutritional Injuries Cardiovascular diseases Diabetes Respiratory diseases Cancer Tuberculosis: Incidence and mortality 1990 2000 2010 Mortality excluding cases comorbid with HIV (per100,000 people) Incidence of tuberculosis (per 100,000 people) – including cases comorbid with HIV 600 500 400 300 200 100 0
Commonwealth Health Partnerships 2015
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