Tonga’s long-awaited dialysis centre project, which the nation was told would be launched last year, has effectively collapsed after the United States-based organisation behind it failed to secure the funding needed to deliver the promised service, Health Minister Dr Siale ʻAkauʻola has revealed.
The disclosure marks a dramatic setback for a project that was initially presented as a major philanthropic initiative backed by a Utah-based family with medical and business connections and an interest in addressing Tonga’s growing burden of diabetes and kidney disease.
In 2019, Utah news outlet KSL reported that Dr Mansoor Emam, a US-based doctor who had visited Tonga and treated patients suffering from diabetes and related illnesses, and his brother-in-law Khosrow B. Semnani, a prominent Salt Lake City industrialist and philanthropist, were behind plans to build the dialysis facility in Tonga.
The 2019 report did not indicate that the project was dependent on raising funds from donors or other outside sources. By 2024, however, fundraising and donor support had become an explicit part of efforts to establish the dialysis service, indicating that securing sufficient funding had become a significant issue for the project.
Dr Emam’s son, Rod Emam, had close ties to Tonga through his friendship with the late Tongan-American Siaosi Brown. Following Brown’s death while attempting to rescue a woman and child from dangerous waters in Utah, Emam proposed naming the dialysis facility the Siaosi Brown Dialysis Center in his friend’s memory. KSL reported that Dr Emam and Semnani agreed to the proposal.
The dialysis centre was to form part of a larger facility known as the Semnani Health Center and was promoted as providing desperately needed treatment in a country where patients with kidney failure have had to seek dialysis overseas.
Tonga has a high burden of non-communicable diseases, particularly diabetes and hypertension, which can lead to chronic kidney disease and kidney failure. With no established dialysis service in Tonga, patients requiring dialysis have had to seek treatment overseas, including in Fiji, New Zealand and the United States, often at considerable financial and personal cost.
Over the following years, the initiative developed into a broader network of charitable partnerships and fundraising and appeared to be making substantial progress.
A groundbreaking ceremony was held in Tonga in 2023, construction began and international organisations became involved in efforts to establish the service.
The project appeared to move even closer to becoming operational when 10 new dialysis machines arrived in Tonga in about April last year. Then-Health Minister Dr ʻAna ʻAkauʻola announced at a press conference that the centre was expected to open in November, an announcement that was widely celebrated on social media as Tonga appeared finally set to have its own dialysis service.
Funding Capacity Falls Short
However, Dr Siale, the newly appointed Minister of Health, has now said that after reviewing records of communications between the Ministry of Health and those behind the project, it became clear that the sponsor did not have the financial capacity to provide the service it had promised.
He said fundraising efforts had failed to generate sufficient money to implement the project, despite preparations having advanced to the point where the centre had been expected to begin operating.
The Ministry subsequently learned that the organisation behind the project was experiencing financial difficulties, he said.
The sponsor has indicated that it needs more time to consider the project, but the Minister’s assessment raises serious doubt over whether the original arrangement can proceed.
The failure of the original funding arrangement now leaves the Government facing a more fundamental question: how Tonga can establish and sustain its own dialysis service, and whether another funding arrangement or international partner will be required.
Dr Siale said the problem now was that the Ministry was not prepared to operate such an expensive and sophisticated service. While obtaining some of the necessary equipment was relatively straightforward, he said the greater challenge was the high cost of securing the specialised medical professionals required to provide dialysis treatment safely and sustainably.
He said there was a signed agreement between the Government and the US sponsors, under which the sponsors were responsible for providing the dialysis equipment and the specialist medical personnel required to operate the service, while Tonga’s contribution was limited to providing the land, buildings and nursing staff.
