Nā Hora Nicholas tēnei atikara.
Te Tauraki, Ngāi Tahu’s health agency supporting Māori wellbeing across Te Waipounamu, is warning Pharmac that their proposed changes to diabetes medicine funding will worsen conditions for Māori, stating that “Māori with type two diabetes will die earlier as a result of diabetes and more Māori will end up with heart failure and kidney failure”.
This week, Te Tauraki and Te Rūnanga o Ngāi Tahu have announced their formal submission opposing Pharmac’s proposal to remove Māori and Pacific ethnicity-based eligibility criteria for empagliflozin, liraglutide and dulaglutide, core medicines used in the treatment of type 2 diabetes.
Te Tauraki says the current ethnicity-based pathway was introduced in 2021 to address disparities in diabetes outcomes, shifting access toward a clinical need model and lowering cardiovascular risk thresholds.
“Quite literally, it is a matter of life and death. And I don't say that lightly,” Dr Maira Patu says.
The Te Tauraki Board Director and general practitioner says the newer medicines provide protections not offered by standard treatment.
“The newer diabetes medications protect our heart and our kidneys. The older medication just lowers their blood sugars.”
“We know that Māori who are diagnosed with type two diabetes are 10 years younger and are more likely to have bad effects on the heart and the kidneys.”
Dr. Patu emphasises that Māori with type 2 diabetes have 1.96 times higher all-cause mortality and are 3.5 times more likely to die from diabetes-related causes.
“Taking away this medication takes away their protection and shortens Māori lives and increases Māori hospitalisations. That's what it looks like very simply. It's a very dangerous call.”
Pharmac has said the changes are intended to improve access based on clinical need and reduce reliance on ethnicity as an eligibility factor.
"Every New Zealander deserves to know that when they or someone they love needs healthcare, it will be there for them," said Health Minister Simeon Brown in a Government Press Release.
“Ethnicity shouldn’t decide what funded options you can access to manage type 2 diabetes.” Associate Health Minister David Seymour added. He said the proposal is intended to improve access to medicines based on clinical need rather than ethnicity, as part of a broader shift toward a needs-based funding model, but Dr. Patu says that Māori are already facing systemic barriers in healthcare access.
“We wait longer times for our appointments, doctors spend less time with us, we get less investigations, we're less likely to be prescribed medications, and then we're less likely to be referred on to specialist care.”
Dr. Patu argues this decision will only worsen matters for Māori with diabetes stating that the ethnicity-based pathway was introduced because standard approaches were not working for everyone. She rejected claims that removing ethnicity criteria creates fairness.
“Fairness and equality and treating everybody the same sound good, don't they?” she said.
“But in medicine, treating everybody the same isn't best practice. And treating everyone the same can actually cause harm” she emphasised that clinicians are trained to adjust their practice to ensure that all patients get the correct investigations, medications and diagnosis.
Te Tauraki and Te Rūnanga o Ngāi Tahu are calling for Pharmac to retain the ethnicity pathway, introduce a lower cardiovascular risk threshold, undertake Treaty analysis of the proposal, and engage with Iwi Māori Partnership Boards.
“If Pharmac ignores the evidence, then Māori with type two diabetes will die earlier as a result of the diabetes” said Dr. Patu.
“The evidence is clear. There is no debate about what will happen.”
Te Tauraki is the Ngāi Tahu-mandated health and wellbeing advocate. It operates as the Whānau Ora commissioning agency across Te Waipounamu and is an Iwi Māori Partnership Board established under the Pae Ora (Healthy Futures) Act 2022. Their vision is whanau Māori living healthy lives.
|
|
|
Kei te whakatūpato te ratonga hauora o Ngāi Tahu, a Te Tauraki, i a Pharmac mō āna tapahitanga ki te pūtea rongoā mate huka. E ai ki a rātou, ka kino ake ngā hua mō te Māori. I kī rātou, “Māori with type two diabetes will die earlier as a result of diabetes and more Māori will end up with heart failure and kidney failure.”
Nō tēnei wiki, i tuku a Te Tauraki rāua ko Te Rūnanga o Ngāi Tahu i tā rāua tono e whakahē ana i te kaupapa a Pharmac ki te tango i ngā paearu ā-iwi Māori me Pasifika mō te āheitanga ki ngā rongoā empagliflozin, liraglutide, me te dulaglutide, he rongoā matua mō te mate huka momo 2.
E ai ki a Te Tauraki, i whakaurua te ara ā-iwi o nāianei i te tau 2021 hei whakatika i ngā rerekētanga o ngā putanga mate huka, ā, ka neke te urunga ki tētahi tauira urunga haumanu, ā, ka whakaheke hoki i ngā paepae mōrearea iaia manawa.
“Quite literally, it is a matter of life and death. And I don't say that lightly,” e ai ki a Tākuta Maira Patu.
Ko ia tētahi o ngā mema Poari o Te Tauraki ā he Tākuta hoki, ā, e kī ana ia he nui ake ngā painga tiaki o ngā rongoā hou.
“The newer diabetes medications protect our heart and our kidneys. The older medication just lowers their blood sugars.”
“We know that Māori who are diagnosed with type two diabetes are 10 years younger and are more likely to have bad effects on the heart and the kidneys.”
“Taking away this medication takes away their protection and shortens Māori lives and increases Māori hospitalisations. That's what it looks like very simply. It's a very dangerous call.”
E ai ki a Pharmac, ka whai ēnei huringa ki te whakapiki i te urunga i te hiahia haumanu, me te whakaiti i te whakawhirinaki ki te iwi hei paearu. I kī te Minita Hauora a Simeon Brown i tētahi putanga a te Kāwanatanga: “Every New Zealander deserves to know that when they or someone they love needs healthcare, it will be there for them,”
“Ethnicity shouldn’t decide what funded options you can access to manage type 2 diabetes.” Hei tā te Minita Tuarua mō te Hauora a David Seymour. I kī ia he kaupapa tēnei kia huri ki tētahi tauira pūtea e hāngai ana ki te hiahia haumanu, kaua ki te ā-iwi, engari e kī ana a Tākuta Patu kei te pā kē ngā aukatinga pūnaha ki te Māori i te urunga ki te hauora.
“We wait longer times for our appointments. Doctors spend less time with us. We get less investigations, we're less likely to be prescribed medications, and then we're less likely to be referred on to specialist care.”
E ai ki a Tākuta Patu, mā tēnei whakatau ka kino ake ngā āhuatanga mō te Māori e mate huka ana, ā, e kī ana ia i whakaurua te ara ā-iwi nā te korengā o ngā huarahi paerewa mō te katoa. I whakahē ia i te kōrero mā te tango i ngā paearu ā-iwi ka hua te ōritetanga.
“Fairness and equality and treating everybody the same sound good, don't they?” i kī ia.
“But in medicine, treating everybody the same isn't best practice. And treating everyone the same can actually cause harm”
Hei tā Tākuta Patu, he mea whakangungu ngā rata kia whakarerekē i ā rātou mahi kia tika ai te urunga o ngā tūroro katoa ki ngā tūhuratanga, ki ngā rongoā, me te whakatau māuiui.
Kei te karanga a Te Tauraki rāua ko Te Rūnanga o Ngāi Tahu kia pupuri tonu a Pharmac i te ara ā-iwi, kia whakaurua he paepae mate iaia-manawa iti ake, kia whakahaerehia he tātaritanga Tiriti o te tono, ā, kia mahi ngātahi ki ngā Iwi Māori Partnership Boards.
“If Pharmac ignores the evidence, then Māori with type two diabetes will die earlier as a result of the diabetes” i kī a Tākuta Patu.
“The evidence is clear. There is no debate about what will happen.”
Ko Te Tauraki te rōpū tautoko hauora me te oranga i raro i te mana o Ngāi Tahu. E mahi ana hei umanga Whānau Ora puta noa i Te Waipounamu, ā, he Iwi Māori Partnership Board i raro i te Pae Ora (Healthy Futures) Act 2022. Ko tā rātou tirohanga ko te whānau Māori e ora ana i ngā oranga hauora.