PIHOA’s mission is to improve the health and well being of the USAPI by providing, through consensus, a unified credible voice on health issues of regional significance.


The idea of forming PIHOA first emerged in the mid-1980s as the region’s principal health officials gathered at conferences sponsored by the U.S. Department of Health and Human Services Region IX office, the World Health Organization, the Secretariat of the Pacific Community, and others. These Pacific Executive Health Officers recognized that while they shared common health interests, problems, concerns, and history, they had no formal mechanism to come together to discuss their commonalities. Working with the above groups gave them the opportunity to come together and work on finding appropriate regional solutions.

PIHOA was established in 1986 by the health officials of the six US-Affiliated Pacific Islands (USAPIs) of the US territories of American Samoa and Guam, US Commonwealth of the Northern Mariana Islands (CNMI), and the three US Compact Treaty Nations of the Federated States of Micronesia (FSM), Republic of the Marshall Islands (RMI), and the Republic of Palau. Reflecting on shared experiences and health challenges, the USAPI health officials originally established PIHOA as a regional, collective voice for advocacy and policymaking to address common health concerns. PIHOA was incorporated in the CNMI and Hawai’i in 1987 and gained 501(c)3 status in 2012.

PIHOA’s overarching goal is to strengthen local and regional health system capabilities, capacities and community resilience against local and external health threats in line with the Pacific regional health priorities (Health Islands Vision) and U.S. national priorities.

Today, PIHOA continues to provide a collective voice for Pacific health advocacy and regional policymaking but also supports partnership engagement and provision of technical assistance to USAPI health departments and ministries. PIHOA membership is currently comprised of the six USAPI chief health officials, their deputies, FSM state directors, chief executive officers of USAPI public hospitals, and 13 Pacific regional professional associations, USAPI academic institutions, and development partners.

Strategic Plan

PIHOA’s recently endorsed Strategic Framework for Action 2018-2022 will guide PIHOA’s strategic direction for the next five years. PIHOA’s mandates and regional priorities continue to align with and affirm the core principles of the 1995 Yanuca Declaration, and which were again endorsed under the Pacific Healthy Islands Vision 2015, whereby “children are nurtured in body and mind; environments invite learning and leisure; people work and age with dignity; ecological balance is a source of pride; and the ocean which sustains us is protected.”

At the March 2017 PIHOA Board Meeting in Saipan, CNMI, PIHOA members endorsed the following Key Focus Areas (KFAs) for the next 5 years:

  1. KFA 1.0 – Serve as the collective voice and “go-to” resource for health in the USAPIs
  2. KFA 2.0 – Strengthen the capacity of USAPI health agencies
  3. KFA 3.0 – Support PIHOA Board members as health leaders
  4. KFA 4.0 – Promote a culture of health and safety across the USAPI region
  5. KFA 5.0 – Increase PIHOA organizational effectiveness and sustainability
  6. KFA 6.0 – Strengthen partnerships across the Pacific health enterprise
  7. KFA 7.0 – Maintain and improve communications across all sectors
  8. KFA 8.0 – Cultivate continuous quality improvement