Keep the pathway keeping our whānau alive
Te Tauraki is calling on Pharmac retain the Māori and Pacific ethnicity pathway for three diabetes medicines.
Alongside Te Rūnanga o Ngāi Tahu, Te Tauraki has responded to the proposal with a public submission voicing its opposition to the removal of Special Authority access criteria for the medicines.
The medicines in questions are SGLT2 inhibitors and GLP-1 receptor agonists, which are used to treat type 2 diabetes. They protect the heart and kidneys in ways that metformin, the standard first-line treatment, does not.
Te Tauraki Board Director Dr Maira Patu says the medicines prevent deaths, dialysis, and heart attacks.
Te Tauraki Board Director Dr Maira Patu
“Being prescribed metformin instead means we go back to receiving weaker protection while everyone else eventually gets the better drugs. The government calls that equal treatment. We call it locking in worse outcomes,” Dr Patu says.
“For Māori and Pasifika, who already experience drastically higher rates of heart failure and kidney disease than other ethnic groups, this distinction is a matter of life and death.”
Dr Patu says Māori experience 1.96 times higher all-cause mortality from type 2 diabetes and are 3.5 times more likely to die from diabetes-related causes. These disparities have persisted for more than 20 years under standard care.
“The ethnicity pathway was introduced in 2021 because standard care was not working for our people. It began to close the gap. Pharmac now proposes to remove it,” says Dr Patu.
“The government has framed this proposal as a move toward fairness. Treating everyone the same is not fairness. The health system treats Māori and Pasifika worse at every step. We experience longer wait times, shorter appointments, fewer prescriptions, fewer referrals. Removing the ethnicity criteria is colonisation wearing a new uniform."
Dr Patu says this proposal is part of a pattern. Over the past two years, the structural foundations of health equity have been progressively dismantled. Te Aka Whai Ora was disestablished, the smokefree generation policy was repealed, and mandatory cultural safety training for health professionals looks set to be dropped.
And now, the proposed removal of the only ethnicity-based equity criterion Pharmac has ever introduced.
Te Tauraki Chair Rakihia Tau agrees.
“Our whanau across Te Waipounamu are watching. They understand what it means when you remove the policy mechanisms that were put in place to keep them alive. These are not abstract decisions. They are about whether a grandmother avoids dialysis. Whether a father survives his 40s. Whether mokopuna have their tīpuna around.”
Te Tauraki Board Chair Rakihia Tau
In their formal response, Te Tauraki and Te Rūnanga o Ngāi Tahu are calling for Pharmac to:
• Retain the Māori and Pacific ethnicity access pathway tin full
• Proceed with the lower cardiovascular risk threshold as an additional pathway
• Publish a formal Treaty analysis of the proposed changes before any final decision
• Undertake genuine engagement with Iwi Māori Partnership Boards
• Model and consult on universal access based on HbA1c thresholds — a genuinely needs-based pathway that would make this debate unnecessary
Read the full public response here: Public response - Ngāi Tahu and Te Rūnanga o Ngāi Tahu