The promises
- No sign yet
Free public hospital services for everyone
No fee change found; the measured hospital charge is unchanged at SAT$22.50 a night.
Good for aigaRead more
- Promised
- FAST's 2025 manifesto, launched in Savai'i in July 2025, promised free public hospital services. No start date or cost was given 1.
- What happened
- Health was funded at SAT$170.7 million in 2025/26 and at SAT$183.4 million in the 2026/27 budget tabled in May 2026 3; the 2026/27 budget address announces no fee waiver 2. The Ministry of Health Act 2006 lets the minister set fees and charges by notice 4; no 2025 or 2026 notice introducing free care was found. Fees were already waived for people aged 60 and over and children aged 12 and under before the election, under the Ministry's 2020 to 2026 workforce plan 5.
- Impact on families
- The Samoa Bureau of Statistics price series for September 2026 records a hospital charge of SAT$22.50 a night, unchanged from September 2025; the health group of the CPI was 4.2% higher than a year earlier 6. No count of newly exempt patients or household savings has been published. A ministerial fee notice, or a budget line replacing fee income, would show delivery.
- Cost
- Not costed by FAST. Fee income is not published; the surveyed charge is SAT$22.50 a night, so the revenue lost is small against a SAT$183.4 million health budget.
- Verdict for families
- Good for aiga
- Can it be done?
- A stretch
- Long term
- Mixed long term
- Who gains
- Families who now pay the SAT$22.50 nightly charge and outpatient fees, mostly working-age adults, since children and older people are already exempt 65.
- Who pays
- The health budget forgoes fee income while medicines and staff are already short, so patients pay in waiting time and private purchases if supply does not grow 92.
- Assessment
- The fee income lost would be small: the surveyed hospital charge is SAT$22.50 a night, and health is already budgeted at SAT$183.4 million for 2026/27 62. The limit is capacity, not fees: the Ministry's workforce plan found gaps of 100 doctors and 226 nurses and midwives 5, the ministry counted 143 doctors in 2023/24 8, and a Samoa Medical Association letter counted 101 serving in the Ministry in November 2025 9. The IMF told Samoa in July 2026 that support should be targeted and temporary 7; a fee waiver is permanent and universal, but its cost is small and it removes a charge on working families at the point they are sick. The risk is capacity: without more staff and stock, free care means longer waits and more private purchases rather than more care.
Sources (9)
- Samoa election: Political parties make big promises on health, welfare and economy
- Minister of Finance Hon Mulipola Anarosa Budget Address 2026/2027
- Public to have say on $1.5 billion budget
- Ministry of Health Act 2006
- Samoa Health Workforce Development Plan 2020-2026
- Consumer Price Index, September 2026: CPI tables (Table 3, average retail prices of selected commodities)
- 2026 Article IV Consultation for Samoa: IMF Staff Concluding Statement
- Annual Report of the Ministry of Health for the Financial Year ending June 2024
- Clarifying facts Samoa's doctor workforce
- No sign yet
Free visits and medicines for pregnant women, children, older people and people with disabilities
Children under 12 and people over 60 already had fee waivers; medicines were short in 2026.
Good for aigaRead more
- Promised
- Free medical visits and medication for pregnant women, children, older people and people with disabilities, as listed in the Samoa Observer's comparison of the 2025 manifestos. No cost or date was given 1.
- What happened
- Public hospital and outpatient fees were already waived for people aged 60 and over and children aged 12 and under before the 2025 election, with some older people's NCD medicines subsidised through the pension scheme 2. No new rule extending free visits or free medicines to pregnant women or people with disabilities was found. The 2026/27 budget raised the medicines and consumables line from SAT$14 million to SAT$21.5 million, which the finance minister said includes outstanding supplier obligations 3. On 30 September 2026 Cabinet approved 24-month contracts with six companies to supply medicines, a decision its release tied to shortages across the health system 8.
- Impact on families
- In May 2026 patients at the national hospital could not get metformin, amlodipine or children's paracetamol and bought them privately 4. In July 2026 the health minister told ABC that 104 medicines had become scarce in the government's first nine months and nine were still short; one father said his private prescriptions cost more than SAT$200 5. No count of people newly getting free visits or medicines has been published. A fee notice naming the new groups, and pharmacy stock-out data, would show delivery.
- Cost
- Not costed by FAST. The medicines and consumables line is SAT$21.5 million in 2026/27, about 1.7% of receipts of SAT$1,284.7 million; the extra cost of free medicines for the named groups is not published.
- Verdict for families
- Good for aiga
- Can it be done?
- A stretch
- Long term
- Good long term
- Who gains
- Pregnant women, children aged 13 to 17, people with disabilities and older people, who now buy private prescriptions during shortages at more than SAT$200 a time in one reported case 5.
- Who pays
- The medicines line, already SAT$21.5 million with arrears inside it, would carry the extra cost; patients lose if the money goes to debt rather than stock 3.
- Assessment
- The groups named are those most in need: 17.6% of children aged 0 to 14 were below the poverty line in 2023 6. Children aged 12 and under and people aged 60 and over are already exempt from fees, so the new cost falls on pregnant women, people with disabilities and children aged 13 to 17 2. The limit is supply: 104 medicines became scarce in nine months, the World Bank's rural stock-out indicator stood at 30 in November 2025 against a target below 20, and the 2026/27 medicines line of SAT$21.5 million includes unpaid supplier bills 573. Reasoning: a targeted waiver is affordable and sound over the long term, but free medicines mean nothing while shelves are empty, so stock-outs would have to be fixed first.
Sources (8)
- What the three major parties are promising Samoa
- Samoa Health Workforce Development Plan 2020-2026
- Minister of Finance Hon Mulipola Anarosa Budget Address 2026/2027
- Tuilaepa urges health boss to pay $12M debt
- Samoa health system grapples with medicine supply
- Samoa Monetary Poverty Assessment 2023
- Samoa Health System Strengthening Program (P164382): Implementation Status & Results Report, Seq No 11
- Cabinet holds circulation of $100 Tala Commemorative Note
- No sign yet
Health insurance for all
No scheme, bill or budget line found.
Cuts both waysRead more
- Promised
- Health insurance for every Samoan, as listed in the Samoa Observer's election comparison. No amount, model or date was given 1.
- What happened
- The 2026/27 budget address contains no insurance scheme, and no bill has been reported since September 2025 2. Medical insurance was already a FAST priority in 2021 4; in December 2024 the SNPF chairman said a health-care scheme law signed by the Head of State on 22 April 2022 had never been implemented 3.
- Impact on families
- No enrolment, premium or claims figures exist because no scheme exists. Delivery would show as a law or regulation, a budget line and a count of people covered.
- Cost
- Not costed. No model was given; a budget-funded scheme would be a new recurrent line against receipts of SAT$1,284.7 million, and a contributory one would charge households premiums.
- Verdict for families
- Cuts both ways
- Can it be done?
- Not realistic
- Long term
- Too early to tell
- Who gains
- Nobody yet; a scheme would help families facing overseas or private bills only if it were funded and the public system could deliver the care 2.
- Who pays
- Households, through premiums or taxes, or the budget through a new recurrent line on top of a stated SAT$215.9 million cash deficit 2.
- Assessment
- No scheme design, bill or budget line exists, and the same idea went undelivered through the 2021 to 2025 term, even after a law was signed in April 2022 234. A contributory scheme has a narrow base: labour-force participation was 43.8% in 2022 5, so premiums or a tax would fall on the same households, or on a budget with a stated cash deficit of SAT$215.9 million 2 that the IMF wants kept targeted and temporary 6. Reasoning: insurance pays for care that the public system must still deliver, so without more doctors and medicines it moves money around rather than adding care.
Sources (6)
- What the three major parties are promising Samoa
- Minister of Finance Hon Mulipola Anarosa Budget Address 2026/2027
- The SNPF Healthcare Scheme to Benefit All
- Government eyes Salelologa hospital proposal
- 2022 Samoa Labour Force and Child Labour Survey
- 2026 Article IV Consultation for Samoa: IMF Staff Concluding Statement
- No sign yet
New hospital at Salelologa
Government leased land to a private specialist hospital that broke ground on 14 September 2026 and paused a week later; no public hospital is funded.
Costs aigaRead more
- Promised
- A new hospital at Salelologa, Savai'i, listed in the Samoa Observer's comparison of the 2025 manifestos. No cost or completion date was given 1.
- What happened
- The promise predates 2025: in June 2023 the Fiamē government's health minister said 20 acres had been reserved at Salelologa and funds were being sought from development partners 2, and in August 2024 the site was moved to another 20 acres near the market after the first was found waterlogged 3. Cabinet approved a 20-year lease of 10 acres at Salelologa to a private company on 5 September 2026 4. A privately financed specialist hospital broke ground on 14 September 2026; the promoter said building would take 12 to 14 months 5. On 21 September 2026 the developer, PSH, announced a temporary pause to restructure local shareholding and governance, saying the project was not cancelled 6. The 2026/27 budget address lists a new Savai'i hospital and national laboratory in its project pipeline without a stated amount 7. The promise was a public hospital; the land lease and the private build are action for a different thing, and no public construction budget, operating plan or fee schedule has been published.
- Impact on families
- No beds are open and no patients have been treated. Company records examined by PMN show 40% held by the Fiji-based promoter and 20% each by three local shareholders; PMN found no evidence the health minister held a financial interest 4. What a Savai'i family would pay at a private specialist hospital is unknown. Delivery would show as a public construction budget, an opening date, a bed count and a published fee schedule.
- Cost
- Not costed. No public construction or running budget is published, and the private project's cost was not disclosed.
- Verdict for families
- Costs aiga
- Can it be done?
- A stretch
- Long term
- Mixed long term
- Who gains
- The private promoter, holding 40%, and three local shareholders with 20% each, gain 10 acres of public land on a 20-year lease; Savai'i families gain only if fees prove affordable, which is unpublished 45.
- Who pays
- Savai'i families who were promised a public hospital and would pay private fees instead, and the public, whose land is leased while the project is paused 46.
- Assessment
- A private hospital on leased government land would cost the budget little to build but would charge fees, so families' access depends on a price schedule nobody has published 54. A public hospital would add a recurrent bill for staff the system does not have: the Ministry's workforce plan found gaps of 100 doctors and 226 nurses and midwives 8, and the budget's pipeline entry carries no figure 7. Reasoning: a Savai'i hospital would spare serious cases the ferry trip to Apia, but what the government has done is hand public land to a private operator with no published fees, while the public route is unfunded; families gain nothing yet and lose the land's use for 20 years.
Sources (8)
- What the three major parties are promising Samoa
- Government eyes Salelologa hospital proposal
- New land for Salelologa hospital
- Sāmoa hospital land deal raises questions over family and government links
- New Specialist Hospital to Elevate Health Care in Savai‘i Island
- PSH pauses Savaii Hospital project for governance restructure
- Minister of Finance Hon Mulipola Anarosa Budget Address 2026/2027
- Samoa Health Workforce Development Plan 2020-2026
- No sign yet
New hospital at Tuana'imato
The prime minister restated the plan in November 2025; no site, budget line or tender.
Cuts both waysRead more
- Promised
- A hospital at Tuana'imato, which the Faleata 1 MP said was presented in FAST's manifesto on its 2025 roadshow. No cost or date was given 1.
- What happened
- In his maiden speech in October 2025 the Faleata 1 MP supported the government's stated intention to build the hospital 1. On 17 November 2025 the prime minister confirmed plans for new hospitals at Tuana'imato and in Savai'i 2. The 2026/27 budget address does not list a Tuana'imato hospital or an appropriation for one, and no site, tender or construction has been reported 3.
- Impact on families
- Nothing has been built, so no change in travel time or treatment access is measured. A site, a budget line and a design contract would show progress.
- Cost
- Not costed. No site, design or appropriation exists.
- Verdict for families
- Cuts both ways
- Can it be done?
- A stretch
- Long term
- Too early to tell
- Who gains
- Families in Faleata and west Apia would gain a closer hospital if it were built; nothing yet 1.
- Who pays
- The national hospital at Moto'otua, which would lose staff to it, given a gap of 100 doctors and 226 nurses and midwives 4.
- Assessment
- No site, design, budget line or funding partner has been named 123. A new hospital a few kilometres from the national hospital at Moto'otua would need staff from the same pool: a Samoa Medical Association letter counted 101 doctors serving in the Ministry in November 2025 5, against a plan gap of 100 doctors and 226 nurses and midwives 4. Reasoning: without a costing or a staffing plan the proposal cannot be judged sound or unsound; built without staff it would split a thin workforce rather than add care.
Sources (5)
- Faleata 1 MP supports plans for a new hospital at Tuanaimato
- Sāmoa Prime Minister bans nation’s only newspaper from government access
- Minister of Finance Hon Mulipola Anarosa Budget Address 2026/2027
- Samoa Health Workforce Development Plan 2020-2026
- Clarifying facts Samoa's doctor workforce
- No sign yet
Healthy living and eating to fight NCDs
Existing World Bank-backed NCD screening continued; no new programme tied to the promise.
Good for aigaRead more
- Promised
- Healthy-eating and healthy-living initiatives against non-communicable diseases, part of the family-centred manifesto launched 12 July 2025. No programme amount or date was given 1.
- What happened
- World Bank-backed village screening for hypertension and diabetes had reached its 70% coverage target in 12 of Samoa's 34 districts by May 2025, before the election 2. The 2026/27 budget address names no new healthy-living or nutrition programme 3.
- Impact on families
- The World Bank's 16 February 2026 implementation report records, at 10 November 2025, 12 districts meeting its adult screening threshold, 4 of 8 rural district hospitals with multidisciplinary teams, 33% of people found high-risk through PEN Fa'a Samoa screening diagnosed within 60 days against a 70% target, and 18% of managed hypertensive patients under control against a 60% target 4. These reflect work started before this government. A new programme, its budget and later screening and control rates would show whether the promise changed anything.
- Cost
- Not costed by FAST. Existing NCD screening is World Bank-financed; the 2026/27 grant to the Samoa National Kidney Foundation alone is SAT$11,704,897, about 0.9% of receipts.
- Verdict for families
- Good for aiga
- Can it be done?
- Doable
- Long term
- Good long term
- Who gains
- Adults at risk of diabetes and hypertension, screened at village level across 12 districts 4.
- Who pays
- Nobody directly; the SAT$11,704,897 a year grant to the Samoa National Kidney Foundation is the cost families and the budget carry when prevention fails 3.
- Assessment
- Prevention is the cheap end of health spending: the grant to the Samoa National Kidney Foundation alone is SAT$11,704,897 in 2026/27 3, while screening runs on World Bank finance and met its target in 12 districts by May 2025 24. Results so far are weak: 33% of high-risk people diagnosed within 60 days against a 70% target, and 18% of treated hypertensive patients under control against 60% 4. A 2025 WFP analysis found over 40% of households could not afford a nutritious diet, so healthy-eating advice without cheaper food has limits 5. Reasoning: a programme that lowers diabetes and kidney failure saves the budget money for years, so the promise is sound; so far it has added nothing to what was already running.
Sources (5)
- FAST Party Manifesto Centres on the Family Unit
- Transforming Health Care Access in the Pacific Islands with World Bank Support
- Minister of Finance Hon Mulipola Anarosa Budget Address 2026/2027
- Samoa Health System Strengthening Program (P164382): Implementation Status & Results Report, Seq No 11
- Cost of the Diet Analysis in Samoa, August 2025
Projects in this area
- No visible progress
Rural hospital extensions, generators and WASH upgrades
Read more
- What it is
- A series of small contracts from 2023 to 2025 extended rural hospitals, added doctors' residences and backup generators, and upgraded water and sanitation at nine facilities. 123
- Planning
- All Electrical won Lalomanu and Poutasi (2 November 2023), LTT Electrical the four generators (22 November 2024) and Pao Construction the Safotu design-build (26 June 2025); a UNICEF award of 11 July 2024 names Ah Liki Construction for competitively bid WASH works at nine facilities. 123
- Result
- Contracts were awarded under Fiamē's government; no handover, completion or performance for any site has been published. 13 The World Bank's 16 February 2026 progress report found four of eight rural district hospitals with fully recruited multidisciplinary teams, so buildings alone do not fix staffing. 4 Rural families gain only when extensions, generators and water work and staff are there to use them; the four Ministry of Finance awards total about SAT$1.74m, and the UNICEF award to Ah Liki Construction shows no value. 123
- Cost
- Awards of SAT$489,878 (Lalomanu), SAT$484,790 (Poutasi), SAT$378,120 (Safotu), SAT$384,800 (generators); WASH contract value not published
- Funded by
- Ministry of Health; UNICEF-managed WASH works
- Visibility
- Awards and bidders are visible. Consolidated outcomes and final costs are not. 123
Sources (4)
- Tender Awards | MOF Samoa
- Tender Awards | MOF Samoa
- Construction works, WASH infrastructure upgrades in 9 Health Care Facilities in Samoa (Re-advertised)
- Disclosable Version of the ISR - Samoa Health System Strengthening Program - P164382 - Sequence No : 11
- No visible progress
New Savai'i public hospital and national laboratory
Read more
- What it is
- A new Savai'i public hospital and national laboratory appear in the 2026/27 budget pipeline with no cost, contract or date. 1
- Planning
- No building contract or detailed price has been published. 1
- Result
- Nothing built. In June 2023, under Fiamē's government, the Health Minister said 20 acres at Salelologa had been reserved, clearing and levelling had begun and funding was being sought from development partners; in August 2024 the site was changed because the first was waterlogged and close to the sea. 23 A Salelologa hospital was among FAST's health priorities before the 2021 election and was not delivered in that term; the current government has put it in a pipeline with no money attached. 12 Savai'i patients with serious conditions are still transferred to Upolu. 3 The private specialist hospital on 10 acres of government land at Salelologa is a separate project. 4
- Cost
- not published
- Funded by
- Development-partner programme proposed
- Visibility
- The budget names the objective only. 1
Sources (4)
- Minister of Finance Hon Mulipola Anarosa Budget Address 2026/2027
- Government eyes Salelologa hospital proposal
- New land for Salelologa hospital
- New Specialist Hospital to Elevate Health Care in Savai‘i Island
- Delayed
Salelologa private specialist hospital and hotel
Read more
- What it is
- A privately funded specialist hospital and 100-room hotel broke ground at Salelologa on 14 September 2026 and was paused the following week over shareholding and governance. 12
- Planning
- The government offered 10 acres of land in the new Salelologa township rather than a building grant; the developer, Pasifika Specialist Healthcare, says it will fully fund construction. No government tender was reported. 1
- Result
- The developer forecast 12 to 14 months of construction, then announced a temporary pause, reported on 22 September 2026, to cancel the existing local shareholding and restructure governance; it says the project is not cancelled. 12 Cabinet approved a 20-year lease of 10 acres of government land on 5 September 2026; company records reported by PMN show 40% held by the Fiji-based promoter and 20% each by three local shareholders, one of whom publicly identifies the Health Minister as her father, and PMN found no evidence the minister held a financial interest. 3 This is the current government's decision. 1 Public land goes to a private operator whose fees are unpublished, so whether Savai'i families gain affordable care or only a hotel with a clinic cannot be judged yet. 13
- Cost
- not published; government contributed 10 acres of land
- Funded by
- Pasifika Specialist Healthcare (private)
- Visibility
- The land contribution and pause were reported. Lease terms, rent, fee schedules, the private investment and the hotel design have not been published; questions raised by PMN about the shareholders' links to the Health Minister and a state-owned authority remain allegations. 123
Sources (3)
- New Specialist Hospital to Elevate Health Care in Savai‘i Island
- PSH pauses Savaii Hospital project for governance restructure
- Sāmoa hospital land deal raises questions over family and government links
What FAST did in 2021 to 2025
- September 2021Unclear
FAST's 2021 manifesto promised SAT$20 million a year for five years for primary health care, specialist training, meals for inpatients, a new central hospital for Savai'i at Salelologa and a medical insurance scheme 1. The 2021/22 budget provided SAT$126,715,844 for health, including SAT$2 million for inpatient food, SAT$3 million for district hospital and doctors' residence refurbishment and SAT$6 million for pharmaceuticals 2. The same budget cut selected government fees, including consultation fees at the National Hospital, by 20% from 1 November 2021 2. A dedicated SAT$20 million a year primary care line was not identified.
Sources (2)
- FAST Party Pre-Election Manifesto (2021)
- Budget Address 2021/2022
- 2023 to 2024Unclear
A 2023 vaccination catch-up campaign lifted reported measles vaccine coverage to 87% for the first dose and 74% for the second 1. The 2024/25 budget put the health ministry at SAT$156,664,219 and said seven of nine district hospitals had multidisciplinary teams by 2023 2. The World Bank's February 2026 report counts four of eight rural district hospitals with full teams at November 2025; the definitions differ, so the two figures do not match 3.
Sources (3)
- Samoa strengthens its vaccination programme
- Budget Address 2024/2025
- Samoa Health System Strengthening Program (P164382): Implementation Status & Results Report, Seq No 11
- 2021 to 2025Not kept
FAST's 2021 manifesto promised a central hospital for Savai'i at Salelologa and a medical insurance scheme 1. In June 2023 the health minister said 20 acres had been reserved and funds were being sought from development partners 2; in August 2024 the site was moved after the first was found waterlogged 3; no hospital was built by the end of the term. A health-care scheme law was signed on 22 April 2022, but the SNPF chairman said in December 2024 it had never been implemented 4. The Ministry of Health's 2023/24 annual report counted 1,466 staff, including 143 doctors, 475 registered nurses and 94 midwives, with 130 recruits and 119 departures that year 5. Its workforce plan had identified gaps of 100 doctors and 226 registered nurses and midwives 6.
Sources (6)
- FAST Party Pre-Election Manifesto (2021)
- Government eyes Salelologa hospital proposal
- New land for Salelologa hospital
- The SNPF Healthcare Scheme to Benefit All
- Annual Report of the Ministry of Health for the Financial Year ending June 2024
- Samoa Health Workforce Development Plan 2020-2026