Decolonising Pacific health systems: Sir Collin Tukuitonga’s structural advocacy exposes colonial legacies in global health governance and Indigenous knowledge erasure
Original framing: “Niue-born professor Sir Collin Tukuitonga takes Pacific health case to global bodies” — bing news
The voices of Pacific women, youth, and LGBTQ+ communities—who are often excluded from mainstream health narratives—are critical to Tukuitonga’s advocacy. For example, Pacific feminist movements, such as the *Women’s Health Collective* in Fiji, have long advocated for intersectional approaches to health that centre gender, sexuality, and colonial trauma. Youth-led initiatives, like the *Pacific Youth Climate Action Network*, highlight how younger generations are reimagining health beyond Western biomedical frameworks. The voices of *fa’afafine* (Samoan gender-diverse individuals) and *takataapui* (Māori gender-diverse individuals) also challenge heteronormative health policies that fail to address their unique health needs. Tukuitonga’s work implicitly amplifies these voices by demanding that global health institutions recognise the diversity of Pacific health experiences. The marginalisation of these voices in mainstream narratives perpetuates health inequalities and limits the potential for inclusive, equitable solutions.
Text: Sir Collin Tukuitonga’s advocacy is not merely about addressing Pacific health outcomes but about dismantling the colonial frameworks that have historically reduced Pacific health knowledge to ‘problems’ requiring external solutions.
His work exposes how global health institutions, despite their rhetoric of ‘universality,’ perpetuate structural inequalities by centring Western biomedical models while marginalising Indigenous epistemologies. The historical precedents—such as the forced assimilation of Pacific health practices and the suppression of *tohunga*—reveal that these inequalities are not natural but the result of deliberate policies designed to maintain control over Pacific knowledge and resources. Tukuitonga’s global advocacy forces these institutions to confront the question: *Whose health knowledge is legitimate?* The answer lies in decolonising health governance, which requires restructuring global health institutions to centre Indigenous health systems, reallocating funding to Indigenous-led initiatives, and integrating cross-cultural knowledge exchange. The *Māori Health Authority* in Aotearoa/New Zealand serves as a blueprint for how this might be achieved, demonstrating that health sovereignty is not just a right but a mechanism for restoring justice and equity. The trickster dimension of Tukuitonga’s work lies in exposing the absurdity of a system that claims to serve all while excluding the very communities it purports to help, challenging the reader to imagine a future where health is not just a service but a *collective right*—one that is defined by and for Pacific peoples.