Gout—a chronic condition that disproportionately affects Pacific populations – was the subject of an educational research project led by two Tongan academics, who partnered closely with Pacific groups in New Zealand.
Both Associate Professor Malakai ‘Ofanoa from the University of Auckland and Research Fellow Dr Samuela ‘Ofano, hail from Ha'apai in Tonga.
Over the past three years, under a Health Research Council project grant, they worked with a research team and communities, to ensure the educational resources produced were reflecting Pacific values, languages and lived experiences.
The study aimed to explore the views of Pacific people on how to improve the management of urate-lowering therapy among Pacific gout patients in South Auckland.
“...Our Pacific communities initiated, designed, implemented and evaluated gout resources that aim to improve the health of our peoples. Who owns these resources? The community themselves,” said Associate Professor ‘Ofanoa. “As researchers, our role is to enable and empower our communities to lead initiatives.”
Chronic arthritis
Gout is a chronic arthritis caused by high serum uric acid levels in the body that crystalise and deposit in the joints over time, resulting in painful gout flares. If untreated, gout can impact on quality of life through recurrent gout flares, joint damage and other health conditions such as cardiovascular disease with concomitant disability and loss of dependence
He said Pacific peoples experience some of the highest rates of gout in Aotearoa compared with non Māori, and non Pacific populations. This disproportionate burden is driven by a combination of genetic predisposition, Pacific bodies having evolved under wayfinding, oceanic survival conditions, influencing uric acid processing.
Stigma remains a major barrier to care, amplified by widespread misinformation on social media, where most gout related content overemphasises diet and minimises the roles of genetics and kidney function—framing gout as a personal failing rather than a chronic metabolic condition.
“This shame discourages Pacific families from seeking preventive treatment, even though long term urate lowering medication is the only proven method to dissolve urate crystals and stop recurrent flares.”
NIU ”Nesians Improving the Uptake of Urate lowering therapy”
One of the key outcomes of the project was the development of a Pacific health framework to drive a Pacific gout intervention. The framework is named NIU - Nesians Improving the Uptake of Urate lowering therapy.
“The community decided on the term Nesian as it encompasses the diversity of Pacific communities and many Islands across our region,” said Associate Professor ‘Ofanoa.
“Education is key. When communities understand the causes, treatments and lifestyle changes that can prevent gout, they are better equipped to take control of their health.”
A celebration honouring Pacific leadership and community partnership to co design new health resources for Pacific peoples, held last month at the Fale o Sāmoa in Māngere, marked the conclusion of the project funding and the launch of the initiatives.
Community leader Rose Lamont (Sāmoa), head of the Pacific People’s Health Advisory Group, emphasised the strength of Pacific collective values:
“We are strengthened by our shared Pacific values, and as a community we feel listened to as we work together for better health outcomes,” she said.
Aotearoa, New Zealand has the highest incidence rates of gout in the world, with 190 per 100,000 in 2017. In 2016, Pacific people in New Zealand, experience the highest burden of gout at a rate of 14%, compared to 9% in Māori and 4% for non-Māori non-Pacific. Pacific people are more likely to experience earlier onset, higher recurrence rate, and to be hospitalised for gout flares.
