Skin diseases are recognised as the cause of significant non-fatal disability, especially in resource-poor countries. The 2018 Global Burden of Disease study found skin diseases was the fourth leading cause of non-fatal disease burden worldwide. Fiji established a leprosy ward after 1969 following the closure of the leprosy island, Makogai. A skin clinic was later established at Twomey Hospital, Tamavua, Suva in 1977.
There are high rates of illness and death associated with skin disease in Fiji and across the Pacific islands but very few dermatologists live and work in the region. Specialist medical care and training was recognised as a health priority by Fiji and other Pacific Ministries of Health at the Eleventh Pacific Health Ministers Meeting on Yanuca Island, Fiji in 2015.
The need for medical specialist training has also been highlighted as a priority by an aid evaluation report, “Strengthening specialised clinical services in the Pacific” published by the Australian Department of Foreign Affairs and Trade. To date, Dermatology training is yet to be included in an Australian Aid programme.
To bridge the medical service gap, Pacific Dermatology has supported the development of post-graduate qualifications in Dermatology and local training of specialist dermatologists in the South Pacific for general practitioners as well as for nurses.
Since the commencement of specialist dermatologist training, the skin clinic at Twomey Hospital has grown from 800 patients per month in 2018 to almost 2,000 patients monthly. Clinic population health data has identified high rates of illness in vulnerable populations such as children, the elderly and people with non-communicable diseases such as diabetes.
Delivering post-graduate training in Dermatology meets two objectives of the 2015 Yanuca Island Declaration which details decisions and agreements made by Pacific Ministers of Health:
Post-graduate Dermatology training also addresses the United Nation’s Sustainable Development Goal 3: good health and wellbeing, and the World Health Organisation’s plans for addressing neglected tropical diseases including leprosy, filariasis and scabies.
In February 2019, the Pacific Dermatology Training Centre was formally opened, beginning the journey towards the vision imagined by Australian dermatologist, Dr Margot Whitfeld – access to specialised skin health care for all Pacific people wherever they live. The first four Diploma students graduated in 2019.
Read about Dr Va‘a-Fuimaono returning to Samoa to commission their first skin clinic.
The first three Masters of Medicine in Dermatology students graduated in 2024.
On 24th May 2025, the seventy-eighth World Health Assembly has unanimously adopted a resolution recognising “Skin diseases as a global public health priority”, emphasising their widespread impact, visibility and potential for early disease detection. Despite their prevalence, skin conditions often go under-recognised due to low awareness and weak surveillance, contributing to stigma and emotional distress.
The resolution calls for coordinated national action, including improved financing, training, diagnostics, and access to medicines, while urging WHO to lead efforts in scaling up integrated approaches and strengthening primary care to advance universal health coverage. This WHO resolution signed by all member nations, is an opportunity to take action. The Pacific Dermatology Training Centre established with support from Pacific Dermatology Ltd stands ready help.
Our key goal is to train and graduate more doctors who are skin specialists, ultimately extending to health services supported by trained allied health specialists and nurses.
We also aim to develop a more sustainable infrastructure for skin health in the Pacific.
Examples of three additional goals are:
Building a larger, well-equipped Pacific Dermatology Training Centre in Fiji and more extensive patient facilities at Twomey Hospital to expand the education program and provide higher quality medical care for patients with skin disease, and facilities for improved pathology services, specimen evaluation, and laboratory services.
Development of a Master of Medicine in Pathology including a dermatopathology education program, incorporating scholarships for Pacific doctors. Dermatopathologists examine skin tissue samples and can then diagnose, for example, disorders of the immune system, infectious disease, degenerative disease and cancers.
