Patients and a regional health group have sued the Fiji-registered Oceanic Medical Reserve, seeking emergency dialysis supplies and a change to the board that decides how they are distributed. The case, filed in Suva on Thursday, escalates a shortage that officials say now threatens continuity of treatment in Samoa, Tonga and Kiribati.
The claim says 34 of the 91 people in those countries who rely on the reserve’s supplies have 11 days or less of peritoneal dialysis fluid left. No clinic has cancelled a treatment session, but the next shipment is not due until 14 October. The High Court in Suva has scheduled an emergency hearing for Monday.
Clinics reach the edge
The reserve’s stock has been under strain since two scheduled deliveries failed to arrive in July and August. Its annual purchasing fund is F$18 million (about €7.6 million), but the latest allocation gave priority to larger orders, leaving smaller island programmes waiting for replenishment. The reserve says a supplier’s production delay caused the missed deliveries.
Warsa Santoso, director of the Pacific Kidney Access Cooperative, said clinic staff had begun calling patients to check household stocks and plan around delivery dates. “People should not have to count treatment in bags left on a shelf,” Santoso said. The cooperative says it assembled its figures from clinic inventories checked this week.
People should not have to count treatment in bags left on a shelf.
Warsa Santoso, director of the Pacific Kidney Access Cooperative
The claim also challenges how the reserve is governed. Its 12-member board has eight seats held by the largest contributing states, while four smaller island members have no permanent voting place. The patients’ group wants an interim shipment within 72 hours and four reserved board seats for smaller members, arguing that the current system rewards bulk orders over medical need.
The reserve is registered in Fiji, allowing the High Court to hear the claim against its trustees. Lawyer Gisele Azevedo, representing the patients, said the group was not asking judges to choose each country’s supplies. It wants the court to require a published allocation method and a formal review of decisions affecting essential treatment.
Board rejects a carve-out
Margie Stiedemann-Mann, the reserve’s chief executive, said the board had acted under its existing rules and would not give one region priority simply because it had sued. “We are checking whether emergency stock can be moved without leaving another clinic short,” she said. She said a revised delivery schedule would be presented to member governments on Friday.
The reserve has 9,200 two-litre bags in its Lautoka depot, according to figures supplied to the court, but says most are committed to orders already approved. The claimants argue that the stock can cover the three affected programmes while a replacement shipment is arranged. The Monday hearing could decide whether any of it moves before the scheduled delivery.
The lawsuit has also sharpened a demand island governments have made for months: a permanent say in the regional body’s decisions, rather than occasional consultation after allocations are set. A ruling could affect how the reserve handles future shortages, including for insulin and emergency antibiotics. For the patients waiting on dialysis fluid, however, the immediate measure is simpler: whether supplies arrive before clinic cupboards run bare.
