Submission to Pharmac | Te Pātaka Whaioranga on proposed changes to diabetes medicines’ access criteria

Submission to Pharmac | Te Pātaka Whaioranga on proposed changes to diabetes medicines’ access criteria

11 June 2026

OraTaiao: Aotearoa New Zealand Climate and Health Council is responding to Pharmac | Te Pātaka Whaioranga’s call for submissions on proposed changes to diabetes medicines’ access criteria that remove ethnicity criteria.

Equity in health and climate policy is essential to improve and protect public health. For this reason, OraTaiao strongly opposes the proposed removal of the ethnicity-based access pathway for Māori and Pacific peoples. Removal of this pathway constitutes the reversal of a clinically-designed equity safeguard in a system with known entrenched inequities.

We are concerned that the proposal risks worsening existing inequities in diabetes outcomes, cardiovascular disease, chronic kidney disease, and premature mortality - as well as increasing health sector costs from treating worsening health with denial of these preventative medicines.

OraTaiao is also concerned that:

• the proposal ignores te Tiriti obligations and ignores the principles of current legislation - in particular, sections 6 and 7 of the Pae Ora Act 2022. OraTaiao notes that the Pae Ora Act 2022 continues in force as legislation ruling Pharmac | Te Pātaka Whaioranga’s work. This Act takes precedence over any Ministerial letters of expectation and other directions, and any other Pharmac | Te Pātaka Whaioranga policy including the recent Access Criteria Policy
• the proposal is founded on a Pharmac | Te Pātaka Whaioranga policy which we find problematic because it ignores current legislation which binds the Board and all Pharmac staff, is not congruent with te Tiriti, is internally inconsistent, lacks public consultation, and contradicts the Cabinet Circular on needs-based services
• Pharmac | Te Pātaka Whaioranga never developed or considered any options to retain the ethnicity criteria – despite these ethnicity criteria meeting the Cabinet Circular’s analytic requirements
• the proposal fails to fully reflect expert advice – which was even initially withheld from this consultation, despite Pharmac’s stated commitment to greater transparency
• details of how key evidence has been interpreted (contributing to Pharmac’s stance) have been withheld – despite Pharmac’s stated transparency commitments.

OraTaiao recommends that Pharmac | Te Pātaka Whaioranga:

• defer the removal of ethnicity criteria, pending further work and more robust public consultation
• amend the proposed special authority criteria by moving the ethnicity criteria’s position and by clarifying cardio-renal risk and early-onset T2DM
• publicly provide economic information for this proposal on QALY health gains, underlying assumptions, and PICOs used – particularly the counterfactuals undertake and publish a comprehensive equity impact assessment of this proposed change
• undertake analysis on whether, under the Cabinet Circular, retaining the ethnicity criteria for diabetes medicines would be allowable
• develop and consider an explicit option to retain the ethnicity criteria for diabetes medicines, if the Cabinet Circular’s requirements are met
• provide the Board with alternative interpretation of the evidence the Diabetes Advisory Committee assessed, that ethnicity criteria have improved, not lessened, access in Māori and Pacific peoples with known CVRD
• urgently revise the Pharmac | Te Pātaka Whaioranga Access Criteria Policy in line with the Cabinet Circular, that ethnicity and age are independent clinical/epidemiologic factors and discriminants, and release the revised Access Criteria for public consultation
• suspend the current Access Criteria Policy and not use it in proposal development until revised and consultation concluded 
• for any consultation on proposals, provide full clinical advice readily, economic information that includes health benefit assumptions, and sufficient time (at least six weeks) to assess all consultation material , for any proposals.

Thank you for the opportunity to provide feedback, and we welcome further contact.

Read our full submission here.

Role of lobbyists in climate law change just one example of unhealthy influences in politics

OraTaiao Convenor Summer Wright and Executive Board Member George Laking

9 June 2026

Mar - Apr 2026 Pānui

MEDIA RELEASE: Govt’s track record on climate change rings ‘major alarm bells’ for ministries merger

Tuesday 17 February 2026

Climate and Health experts say they have major concerns about plans to merge several ministries that are crucial to the country’s climate change response, given the Government’s track record of weakening or removing climate-critical policies and its chaotic upheaval of institutions like local government

Yesterday, as many communities around the country were busy responding to the recent extreme weather events, the Government released the draft bill to disestablish the Ministry for the Environment. 

Dr Summer Wright, OraTaiao convenor, says the Government pushing forward with plans to merge the Ministry for the Environment with the Ministries of Transport, Housing and Urban Development, after spending their years in power weakening or removing policies designed to respond to climate change, is a serious cause for concern.

“Environment, transport, housing and urban development are critical in our national response to climate change, both mitigation and adaptation. The Government has shown in its actions over the last two years that it either does not understand, or is choosing to deny, the seriousness of climate change”. 

With the ACT leader demanding smaller government over the weekend while celebrating more fossil fuel and agricultural emissions, it is clear a merger of this nature under this Government is a danger to our communities.”

“Climate change and the health, well-being and stability of our communities are clearly linked. Anyone witnessing the flooding and storm damage, including the loss of lives, can see this.”

Submission to Pharmac | Te Pātaka Whaioranga on proposed changes to diabetes medicines’ access criteria

Submission to Pharmac | Te Pātaka Whaioranga on proposed changes to diabetes medicines’ access criteria

11 June 2026

OraTaiao: Aotearoa New Zealand Climate and Health Council is responding to Pharmac | Te Pātaka Whaioranga’s call for submissions on proposed changes to diabetes medicines’ access criteria that remove ethnicity criteria.

Equity in health and climate policy is essential to improve and protect public health. For this reason, OraTaiao strongly opposes the proposed removal of the ethnicity-based access pathway for Māori and Pacific peoples. Removal of this pathway constitutes the reversal of a clinically-designed equity safeguard in a system with known entrenched inequities.

We are concerned that the proposal risks worsening existing inequities in diabetes outcomes, cardiovascular disease, chronic kidney disease, and premature mortality - as well as increasing health sector costs from treating worsening health with denial of these preventative medicines.

OraTaiao is also concerned that:

• the proposal ignores te Tiriti obligations and ignores the principles of current legislation - in particular, sections 6 and 7 of the Pae Ora Act 2022. OraTaiao notes that the Pae Ora Act 2022 continues in force as legislation ruling Pharmac | Te Pātaka Whaioranga’s work. This Act takes precedence over any Ministerial letters of expectation and other directions, and any other Pharmac | Te Pātaka Whaioranga policy including the recent Access Criteria Policy
• the proposal is founded on a Pharmac | Te Pātaka Whaioranga policy which we find problematic because it ignores current legislation which binds the Board and all Pharmac staff, is not congruent with te Tiriti, is internally inconsistent, lacks public consultation, and contradicts the Cabinet Circular on needs-based services
• Pharmac | Te Pātaka Whaioranga never developed or considered any options to retain the ethnicity criteria – despite these ethnicity criteria meeting the Cabinet Circular’s analytic requirements
• the proposal fails to fully reflect expert advice – which was even initially withheld from this consultation, despite Pharmac’s stated commitment to greater transparency
• details of how key evidence has been interpreted (contributing to Pharmac’s stance) have been withheld – despite Pharmac’s stated transparency commitments.

OraTaiao recommends that Pharmac | Te Pātaka Whaioranga:

• defer the removal of ethnicity criteria, pending further work and more robust public consultation
• amend the proposed special authority criteria by moving the ethnicity criteria’s position and by clarifying cardio-renal risk and early-onset T2DM
• publicly provide economic information for this proposal on QALY health gains, underlying assumptions, and PICOs used – particularly the counterfactuals undertake and publish a comprehensive equity impact assessment of this proposed change
• undertake analysis on whether, under the Cabinet Circular, retaining the ethnicity criteria for diabetes medicines would be allowable
• develop and consider an explicit option to retain the ethnicity criteria for diabetes medicines, if the Cabinet Circular’s requirements are met
• provide the Board with alternative interpretation of the evidence the Diabetes Advisory Committee assessed, that ethnicity criteria have improved, not lessened, access in Māori and Pacific peoples with known CVRD
• urgently revise the Pharmac | Te Pātaka Whaioranga Access Criteria Policy in line with the Cabinet Circular, that ethnicity and age are independent clinical/epidemiologic factors and discriminants, and release the revised Access Criteria for public consultation
• suspend the current Access Criteria Policy and not use it in proposal development until revised and consultation concluded 
• for any consultation on proposals, provide full clinical advice readily, economic information that includes health benefit assumptions, and sufficient time (at least six weeks) to assess all consultation material , for any proposals.

Thank you for the opportunity to provide feedback, and we welcome further contact.

Read our full submission here.

Submission on Building Resilience to Hazards Long-term Insights Briefing | Te Whakatipu i te Tū Pakari Tauroa o Aotearoa ki ngā Pūmate

27 August 2025

OraTaiao supports the intent of this long-term insights briefing (‘the briefing’). However, we believe it can be meaningfully improved and wish to make the following recommendations:

1. Addition of Te Tiriti as a foundation of resilience building.
2. Greater emphasis on the intersection between health and hazards throughout. 
3. Improved articulation of equity and greater emphasis on the necessity of equity in resilience building. 
4. Improved articulation of ‘Climate change and environmental stress’ in Section 2: Forces that shape risk and resilience.
5. Additions to Section 2: Forces that shape risk and resilience.
6. Accuracy on the current status of the Resource Management Act and its relationship to hazards planning.

Submission on Local Government (System Improvements) Amendment Bill

27 August 2025

OraTaiao is very concerned with the direction this Bill is taking the local government. Local government plays critical roles in human health, and in climate change adaptation, mitigation, and resilience building. This Bill fails to recognise these roles and, with little analysis, restricts local governments’ ability to deliver on communities’ climate and health needs.

We oppose the drastic narrowing of local government functions as it will put human health, climate resilience, and community wellbeing at serious risk. The Bill undermines councils’ ability to act preventatively, instead seeming to relegate them to crisis response once harms have already occurred. It is fiscally short-sighted and will compound inequities in health and wellbeing.

We are deeply concerned about the ad hoc nature of this and other legislative changes. The Government’s piecemeal approach is creating contradictory requirements and responsibilities for local government, with little or no consideration of human health, climate change, or the immense social and economic costs of climate impacts.

We also note the ongoing and deplorable removal of Te Tiriti provisions from public policy by the current Coalition Government. In this Bill, the removal of the requirement for councils to consider tikanga Māori knowledge when appointing council-controlled organisation directors erodes cultural competence and undermines equity. This will weaken the ability of communities to build enduring resilience and health, and reverses progress towards honouring Te Tiriti o Waitangi in local decision-making.

This submission covers:

1. The role of local government in health and climate change, and the need for decisions that recognise these intersections.
2. The failure of the proposed “core functions” and their long-term costs.
3. The value of the four wellbeings, and the wasted resources caused by repeated policy reversals.
4. The importance of Te Tiriti in legislation including for local government.

OraTaiao oppose the review of health workforce regulation

OraTaiao is opposed to the possible changes to health workforce regulation outlined in the Ministry of Health's Discussion document. Our submission focuses on the ignorance of the role of cultural safety and Te Tiriti o Waitangi in clinical safety, co-option of health language to justify inappropriate overstep into health professional regulation, and clear contradictions in stated goals versus what the actual outcomes would be. We suggest that this review be revoked and reattempted in good faith. Read our submission here.