Student Voices
Jul. 25 2022

My Summer on the Frontlines of Remaking the New Zealand Health System

July 1 marked a huge milestone for the future of health care in New Zealand.

New Zealand’s health system was completely overhauled, and our 21-year-old health structure was disestablished with the functions of district health boards merging into a single national organization called Health New Zealand (Health NZ). This new entity will manage all health services, including hospital and specialist services, and primary and community care. Equity is another cornerstone of the new system with the New Zealand government establishing a Māori (the Indigenous people of New Zealand) Health Authority which will work alongside Health NZ to improve services and achieve equitable health outcomes for Māori.

I am a first-generation international student from New Zealand studying at Mailman on a Fulbright scholarship. I’ve returned to my home country 9,000 miles away from Columbia to be on the front lines of this historic transition as part of my summer practicum.

For my practicum, which began in May, I have been working in two newly established national entities, the Public Health Agency, and the National Public Health Service. The Public Health Agency leads and coordinates population and public health policy, strategy, and regulation. In my work at the Agency, some of the things I’ve done include designing a public health communications campaign to build internal capability, drafting a policy memo on how we can incorporate a determinants-of-heath-based approach into the Public Health Agency, and workshopping with different teams on how we can recognize Indigenous knowledge alongside Western data as equally valid sources of data.

Last week I started the second part of my practicum in the National Public Health Service, which does the work on the ground, coordinating public health services, responding to threats like infectious disease outbreaks, and addressing issues like smoking, obesity, and an aging population. So far, I’ve been involved in writing a policy memo on a COVID-19 vaccination update (New Zealand has a 95 percent double dose uptake rate), and now I’m focusing on the monkeypox outbreak and looking at how New Zealand can procure the vaccine.

New Zealand is building off our world-leading response to COVID-19, which I was fortunate to be involved in for a year before I came to Mailman. We learned through the pandemic that a successful public health response requires collaboration across Government departments and communities to weave together relationships and plans. So, in the future, our health and disability system will be more focused on promoting good health and wellbeing, early prevention of disease and delivering care to people in communities.

While this is an incredible opportunity for New Zealand there are a number of challenges that we face going forward. These include sustaining the renewed focus on public health, ensuring sufficient funding of public health continues and strengthening public health capability at all levels of the health system. Strong public health leadership will need to be bold to overcome historical systemic barriers.

My Mailman education will continue to guide all aspects of my work. Mailman has given me a world-class foundation in public health concepts and frameworks. I’ve been applying things I learned in the Core, especially systems thinking in this setting. I’m looking forward to returning to New York in August to complete the final year of my MPH.


Tom Devine is a 2023 MPH candidate in the Sociomedical Sciences department. He is a Fulbright Scholar, William Georgetti Scholar & Gordon Watson Scholar from Whanganui, New Zealand and received a Bachelor of Science with Honors from the University of Otago.