A more effective, efficient and equitable health system in Tonga


A strong partnership between Australia and Tonga to implement an integrated health program has contributed to a halt in the rise of obesity, a decrease in smoking rates, and a decrease in physical inactivity - all key risk factors of non-communicable diseases (NCDs).

Australia is focused on reducing the health and economic burden of NCDs and on strengthening the health system in Tonga. We are continuing our health sector support with the Tonga Health Systems Support Program. This program focuses on strengthening the management of preventative health services, NCD health promotion, and support for mental health and disability services. Australia’s aid supported the development of an innovative model of village-based nursing that is being looked at for replication across the region and providing an excellent platform for improving and potentially expanding NCD primary and secondary prevention services.

We are also improving environmental health through support for infrastructure investments such as the Nuku’alofa Urban Development Project. This project is increasing access to clean water supply, sanitation and solid waste services, particularly in low income residential areas. The upgrade of the Nuku’alofa waste facility will add an additional 8-10 years to the lifespan of the waste management site.

Related initiatives

Tonga Health System Support Program (Phase 1 & 2)

Phase 1 – Up to $10.2 million, October 2009–December 2015
Phase 2 – Up to $12.2 million, March 2015–June 2020

Since 2009, Australia has invested in Tonga’s Ministry of Health through the Tonga Health Systems Support Program. Phase 1 of the Program aimed to improve community health services and deliver preventative health measures, while focusing on halting the rise in prevalence of NCDs and its risk factors. The program also supported improvements in primary health care services to a common national standard, a highly cost-effective skills development twinning arrangement with Ballarat’s St John of God Hospital, provision of critical clinical positions, and mentoring and training to support the operation of Tonga’s major hospital. Australia also supported Tonga to build a cadre of specially-trained NCD nurses to improve the treatment of NCDs. The nurses are stationed at health and diabetes centres across Tonga, including all outer island groups.

Since March 2015, Australia has continued to support to Tonga’s health sector in order to improve health service delivery, in particular preventative health services. Phase 2 of the Tonga Health Systems Support Program continues its strong focus on halting a rise in the prevalence of NCDs and its risk factors. In seeking a consolidated approach, Australia is providing its funding and technical assistance through both the Ministry of Health and the Tonga Health Promotion Foundation. The program has increased focus on building stronger health systems, increasing gender equity, improving mental health and disability services and building greater access to health services through strengthening universal health coverage (UHC).

Related documents*

Name of document Year published Type
Tonga Health Sector Support Program Phase 2: Evaluation report and management response 2019 Evaluation and management response
National Non-Communicable Disease Strategy 2015-2020 2016 Strategy
Tonga Health Sector Support Program Phase 2: Design document 2015 Design
Tonga Health Sector Support Program Phase 1: Independent progress review and management response 2013 Evaluation and management response
Tonga Health Sector Support Program Phase 1: Independent Progress Review 2013 Evaluation

Nuku’alofa Urban Development Sector Project

Up to $6.1 million, 2011–2017

The Nuku’alofa Urban Development Sector Project (NUDSP), led by the Asian Development Bank, improves the policy environment for urban planning, improves availability of water supply and increases consumer access to waste management services in Nuku’alofa. NUDSP works with the Tongan state-owned enterprises that oversee these services to achieve these improvements. NUDSP ensures that Nuku’alofa’s water supply has significantly less impact on fragile groundwater resources while providing an emergency water supply in the event of a natural disaster. 

Related documents*

Name of document Year published Type
Tonga Nuku’alofa Urban Development Sector Project: Consolidated Annual Report 2015 2016 Progress report
Tonga Nuku’alofa Urban Development Sector Project: Consolidated Annual Report 2014 2015 Progress report
Nuku’alofa Urban Development Project – Project Document, Asian Development Bank 2011 Design


* The Department of Foreign Affairs and Trade (DFAT) is committed to high standards of transparency and accountability in the management of the Australian aid program through publishing information on our website, including policies, plans, results, evaluations and research. Our practice is to publish documents after the partner government and any other partners directly involved in the delivery of the initiative have been consulted. Not all material published on this site is created by the Australian aid program and therefore not all documents reflect our views. In limited circumstances some information may be withheld for reasons including privacy and commercial sensitivity.

Last Updated: 20 August 2019