This month, Sir Collin Tukuitonga became one of two professors of Niuean descent in the world. Professor Sir Collin says it’s an honour to join the ranks of his University of Auckland colleague, Professor of Pacific Health Vili Nosa, also from Niue – one of the smallest countries on the globe, with a population of less than 1,700 people.
“I’m not a true-blue academic. I didn’t do a PhD and stay in the university forever. I gained a lot of practical experience elsewhere, so it’s nice to be accepted by my peers in academic medicine,” says Sir Collin.
A Career Rooted in Public Health
Sir Collin is the director of Poutoko Ora a Kiwa – Centre for Pacific and Global Health at the University of Auckland. He was knighted in 2022 and even has his own Wikipedia page. His ‘practical experience’ spans a broad range of leadership roles, including serving as chief executive of the New Zealand Ministry of Pacific Affairs from 2007 to 2012 and developing a global strategy to improve diet and physical activity, which was adopted by the World Health Organisation (WHO) in 2004.
Addressing health inequities faced by Pacific and Māori people has been the driving force behind Sir Collin’s career over the past 45 years.
“People with the means often get too much medicine, and those who need it the most get the least. Those inequities stick out to me – Māori and Pacific people have poorer health, and it’s entrenched. We have the resources, skills, equipment, and facilities to make a change, and yet we haven’t. It seems unfair, unacceptable to me – and that’s the key driver, why I’m involved in public health,” he says.
Early Life in Niue
Growing up in Niue, Sir Collin developed a strong sense of community and social justice.
“We didn’t have much, not many books. We first had the radio when I was 10, electricity wasn’t a regular thing, so it was a pretty basic existence. You didn’t expect much for yourself – you didn’t think about whether you had the latest flashy clothes or shoes. You helped in the plantation, went fishing – it was all centred around contributing to the family and helping in the village. I guess that’s where I got my sense of social justice – your talents are not just for yourself.”
At the age of 15, his future changed when he won a scholarship to study medicine.
“I was lucky I had a decent brain, and I got one of two New Zealand government scholarships to go to university in Fiji. I had always been interested in helping people, so medicine was a natural selection, but the availability of the scholarship was a big factor. My family would not have been able to send me to university – I would have been a fisherman,” he says.
Leaving behind his “charmed life” in Niue, where he had been pampered by three sisters and surrounded by cousins, was a huge step, but Fiji still offered the simple pleasures of island life.
A Life in Medicine and Public Health
Sir Collin graduated as a junior doctor in 1979 and worked as a “real doctor” in family medicine for about 15 years. He returned to Niue to serve his community before being appointed to teach public health at the Fiji School of Medicine in 1987. However, following a military coup that same year, concerns for his first wife and their young children led him to flee to New Zealand, where he has lived ever since.
In the late 1980s, he played a key role in establishing a Pacific healthcare clinic in West Auckland, now called The Fono. With mainly Pasifika staff and low fees, the clinic improved healthcare accessibility for Pacific people.
While working as a GP in West Auckland, he noticed recurring patterns of hardship and poor health, which inspired him to push for systemic changes.
“It was predominantly families with young children, and you saw the same things over and over again – chesty coughs, skin infections. If you’re a thinking person, you have to say, ‘there has to be a better way than waiting for them to come back to the clinic with the same thing’. Those things were due to cold, damp, overcrowded housing, poor nutrition, and delayed access to healthcare. I thought if I was involved in public health, you could theoretically prevent those problems.”
Leadership in Public Health
In 2001, Sir Collin became Director of Public Health at the New Zealand Ministry of Health. During this time, he helped implement programs to reduce smoking harm in Pacific communities. Over the past 30 years, smoking rates have halved, though Māori and Pacific people still smoke at twice the rate of Pākehā New Zealanders.
“Smoking in young people in New Zealand is now 4.2 percent, compared to 27 percent of adults smoking in 1993. That’s a significant achievement for New Zealand, and I helped contribute to that.”
He also played a key role in introducing a vaccine for meningitis B during an epidemic in the early 2000s.
“We had high mortality rates among young Māori and Pacific people in New Zealand, and the vaccine led to a significant drop in occurrences of the disease, so I was pleased to help that along.”
International Influence
Sir Collin has held influential positions abroad, including three years at the World Health Organisation in Geneva, Switzerland, and seven years in New Caledonia as director-general of the Pacific Community. More recently, he was a key advisor to the New Zealand government during the Covid pandemic.
However, in December 2023, he resigned as chairperson of Te Whatu Ora Pacific Senate, citing concerns about the government’s direction.
“I was really incensed when they repealed our smoke-free legislation. I know that by undoing that world-leading legislation, Māori and Pacific people are going to be the worst affected – all for the purpose of them meeting their commitment to their friends to make tax cuts. I couldn’t continue on the advisory committees when clearly they were not interested in anything apart from what was on their agenda.”
Addressing Systemic Inequities
Sir Collin believes the higher rates of health problems among Pacific people, from cancer to measles, stem from deeper socio-economic disparities.
“Health is a symptom of underlying social conditions. It’s an extension of disparities in education, income, housing, and diet. We can’t just deal with it in the health sector; we have to address those issues – and they’re difficult issues.”
Despite the challenges, he remains committed to advocating for Pacific communities.
Looking Ahead
Now 67, Sir Collin enjoys mentoring young people at the University of Auckland. In his spare time, he focuses on developing and planting native trees on his family’s lifestyle block near Pakiri.
“There’s no set retirement age these days, and I love working with my many clever colleagues at the university. My friends say that when you retire and you don’t use your brain, it rots. I’m terrified of that possibility,” he laughs.
