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Freshwater physical habitat: Data to 2024 – Stats NZ indicator

Source: Statistics New Zealand

Freshwater physical habitat: Data to 2024 – indicator

22 June 2026

Freshwater physical habitat is a fundamental indicator of the condition of Aotearoa New Zealand’s river ecosystems, underpinning the structure and function of aquatic communities by influencing where aquatic organisms can live. Understanding changes in habitat condition is critical to assessing the extent and impact of human activities on freshwater ecosystems.

We report on the current state of New Zealand’s freshwater physical habitat condition using the median habitat quality score calculated from data recorded at monitored river sites between 2020 and 2024. We also report on the relationship between upstream human modified land cover and physical habitat condition at monitored river sites.

Habitat quality scores are made up of 10 habitat parameters at each assessed site:

deposited sediment
invertebrate habitat diversity
invertebrate habitat abundance
fish cover abundance
fish cover diversity
hydraulic heterogeneity
bank erosion
bank vegetation
riparian width
riparian shade.

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Meat leads rise in exports in May – Overseas merchandise trade: May 2026 – Stats NZ news story and information release

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Defence News – RNZAF Poseidon crew spots fisherman missing for a week in Cook Islands

Source: New Zealand Defence Force

A Royal New Zealand Air Force (RNZAF) P-8A Poseidon crew has found a solo fisherman missing for a week in the northern Cook Islands.

 

The man, in his four-metre aluminium skiff, was spotted by the crew this morning (NZT) and he was able to wave to them.

 

Nearby fishing vessels had indicated they were able to pick the man up.

 

The fisherman had set off from Pukapuka Island, about 1140km northwest of Rarotonga, for a day’s fishing on Thursday last week (local time) but failed to return.

 

He was reported overdue to local police the following day and New Zealand’s Maritime Rescue Coordination Centre requested RNZAF help in the search earlier this week.

 

It was believed he had minimal safety or survival equipment.

 

The P-8A and crew started the search on Thursday (NZT).

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World Refugee Day: Almost 2 million children estimated to have returned to "unliveable conditions" in Syria in 18 months

Source: Save the Children
Almost 2 million children have returned to their hometowns in Syria in the past 18 months – the largest voluntary movement of returnees globally – but many find their homes damaged, basic services collapsed and the land contaminated by explosive devices, Save the Children said [1].
Ahead of World Refugee Day tomorrow, the child rights organisation fears the large scale of returns creates the illusion that conditions are safe after the end of 14 years of conflict in December 2024, putting pressure on Syrians to return [2].
An estimated 953,000 children are among more than 1.6 million refugees who have returned since Syria’s political transition on 8 December 2024, according to latest UNHCR figures. Save the Children estimates that about 1.02 million children [3] internally displaced within Syria have also returned to their areas of origin. 
As people return, 15.6 million people – nearly 70% of the population – remain in need of humanitarian assistance, including 7.5 million children [4]. Families are going back to communities where basic services, infrastructure and protection systems remain severely weakened due to conflict, economic collapse, and mass destruction. 
A survey by Save the Children at the end of last year in 90 households found that children are returning to conditions that are unsafe and unliveable. Nearly two-thirds of families said they arrived back to find their homes damaged or destroyed. Almost the same number said their level of access to both water and electricity was low. [5]
Save the Children said returning families are living one shock away from being forced to move again. In the survey, three in four said a further deterioration in the economy would push them to leave and nearly two thirds said the same of a deterioration in security. 
Adolescent girls face particular risks, including unsafe routes to school, dropout, and early marriage. Children with disabilities are also often excluded from the services their families seek for them. 
Children also face the risk of unexploded remnants of war. Between December 2024 and December 2025, children accounted for 37% of all reported civilian casualties from explosive ordnance in Syria, and 28% of those killed, according to NGO safety advisory body INSO . Much of the contamination is in agricultural land and the routes families walk every day. 
Only 57% of hospitals and 37% of primary health centres remain fully functional.
Lina-, 12, tried to go home with her family but found her home and school reduced to rubble. They ended up returning to their camp where they had been living for five years. 
She said: ” When we reached our village, our house and our school were both in rubble, and we could not stay, so we returned to the camp. We are not numbers. We are faces, dreams, and small but strong hearts.”
Jeremy Stoner, Save the Children Syria Acting Country Director, said: 
“Fourteen years of war in Syria displaced half the country’s 25 million people and shaped an entire generation of children born into rubble and ruin, who have never known life before the war. Now, families are coming back home, hoping their children can finally grow up in safety and peace.” 
“But no child can make a new beginning when there is no electricity or water supply; not enough food; no school or healthcare. When they are too scared to take a step outside due to the ground being littered with explosives. 
“International law dictates that any return of refugees must be voluntary, safe, dignified and informed. This is not safe. Already, an entire generation had their childhoods stolen during the war in Syria. We now need to see mass investment in reconstruction so that this generation of children does not continue to pay the price.”
Save the Children is calling on the Government of Syria, host governments, the United Nations, and donors to place children's safety, rights, and recovery at the heart of decisions about return. The organisation is also calling for investment in the conditions children need to return safely and to stay, such as large-scale clearance of explosive ordnance, restoration of healthcare, water and education, and guaranteed civil documentation for returnee children.
Save the Children has been working in Syria since 2012, reaching over five million people, including more than three million children, with child protection, education, food security and livelihoods, water, sanitation and hygiene, health and nutrition.
About Save the Children NZ:
Save the Children works in 120 countries across the world. The organisation responds to emergencies and works with children and their communities to ensure they survive, learn and are protected.
Save the Children NZ currently supports international programmes in Fiji, Cambodia, Bangladesh, Laos, Nepal, Vanuatu, Solomon Islands and Papua New Guinea. Areas of work include child protection, education and literacy, disaster risk reduction and climate adaptation, and alleviating child poverty.
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New Emergency Mobile Alert map "another step forward" – NEMA

Source: National Emergency Management Agency

A new map will allow anyone in New Zealand to see any live Emergency Mobile Alerts, the National Emergency Management Agency (NEMA) says.
Hosted on GetReady.govt.nz, the map will show all current active Alerts issued by authorised agencies such as NEMA, CDEM Groups, Fire and Emergency New Zealand and Police. The web page will show a web-accessible map of the area the alert was sent to, and the content of the message.
“This new map is another step forward for our emergency management capability that will help to keep people safe and informed.” NEMA’s Acting Director of Civil Defence Emergency Management Stef Michie says.
“Emergency Mobile Alerts are an important channel to notify people in New Zealand about emergencies in their area that are a serious threat to life, health or property. This map means anyone can look up a live alert on the map, see where it was sent, and what it said.
“Being able to look up live Alerts across the country will be particularly useful for people who are travelling, and for the media who can verify emergency information to understand where the Alert was sent and where it wasn’t.”
The Emergency Mobile Alert system currently sends alerts to all mobile devices connected to cell phone towers within a highlighted area. This new map will allow people outside the targeted area to stay informed about life safety actions that friends and whānau need to take.
The map will only show Alerts, and won’t include other information like evacuation areas or weather warnings, and it’s important that people read the content of the Alert that should describe the area affected and what actions people need to take to stay safe
Stef Michie says it’s important that people don’t rely solely on Emergency Mobile Alerts, because they are just one way of finding out important information in an emergency.
“We want people in New Zealand to understand that Emergency Mobile Alerts are just one channel we have. In an emergency, we need people to listen to the radio and follow advice from local Civil Defence Emergency Management groups.
“We also want people to trust their ‘danger sense’ – look out for natural warnings like suddenly rising water or strange noises from unstable slopes, and remember Long or Strong, Get Gone.
Emergency Mobile Alerts are now viewable from anywhere in New Zealand by going to  GetReady.govt.nz/ema-map
NOTES
Emergency Mobile Alerts are sent to you by cell towers in the targeted area. You may not receive an Alert if you are not connected to a cell tower in the targeted area. Or, if you phone is connected to a cell tower in the targeted area, you may get an Alert even if you're not physically in the area. Because of the way cell phone towers connect this can mean that some people outside the affected area will receive an Alert, so it is important to read the Alert message which should describe the area at risk or where the public need to be ready.
It does not store individual phone numbers or handset details, and does not offer an opt-out service. More information can be found here: Emergency Mobile Alert
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Health – Historic vote backs historic change for general practice funding

Source: General Practice Owners Association (GenPro)

The General Practice Owners Association (GenPro) says today's overwhelming vote by contracted primary care providers in favour of a new Government funding package marks a historic moment for general practice.

Contracted providers representing general practices across New Zealand voted by an 85 percent majority to accept the package, which includes the first significant reweighting of capitation funding since the system was introduced more than two decades ago.

GenPro Chair Dr Angus Chambers said the result demonstrated clear support for reform across the sector.

“This is a historic vote for historic change,” Dr Chambers said. “For the first time ever, general practice has had a direct say on a major funding reform that will shape its future. That is a significant milestone for the profession and for primary care in New Zealand.”

The vote followed a ratification process secured by GenPro, enabling all contracted providers to participate in the decision.

“I have been involved in general practice for 36 years and I cannot recall another occasion where general practices have been given the opportunity to vote on a change of this significance,” Dr Chambers said.

“It is important that general practice has a voice in decisions that affect its future, and this process has shown that the sector is ready and willing to take that responsibility.”

Dr Chambers said the package represented the most substantial review of general practice funding in more than 20 years and reflected the Government's willingness to address longstanding flaws in the funding system.

“We congratulate Health Minister Simeon Brown and Health New Zealand for recognising that the funding model needed updating and for engaging seriously with the sector.”
Dr Chambers said the sector would continue to push for further improvements when the funding model is reviewed again in 2028.

“We are pleased to see capitation reweighting introduced. While ethnicity has not been included in the new formula, that discussion is not over and will be part of future reviews.”

The revised funding formula will direct more funding towards patients with greater health needs and, together with annual funding uplifts, will result in most practices receiving increased funding.

“It is a solid package overall. Around half of practices will be clear beneficiaries, another sizeable group will be reasonably well supported, and transitional arrangements mean no practice should be significantly worse off in the short term.”

Dr Chambers acknowledged that not every practice would benefit equally from the reforms.
“There will be some practices that face challenges as transition funding reduces over time.

Around 20 percent of practices may come under greater pressure than usual to increase fees in future years as the transition arrangements wind down.

“What's particularly encouraging is that some practice owners who might not have personally benefited from the changes, still voted in favour because they recognised the wider benefits for patients and the sector. That reflects a genuine commitment to the greater good.”
Dr Chambers said the reforms would not solve all primary care's challenges.

“We still face workforce shortages and growing demand for services. This package helps improve financial sustainability, but it is not a complete solution to access issues.”

GenPro also welcomed changes to rural funding arrangements and the additional investment being directed towards rural practices, while noting that further work remains necessary.

“The Government has taken positive steps to strengthen rural funding, but rural communities continue to face significant healthcare challenges. We expect that to remain an important area for future negotiations and there remains a need for significant further investment.”

“By and large, this is a positive step forward. It demonstrates that government and the sector can work together to tackle longstanding issues and build a more sustainable future for general practice.”
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Northland News – Total Mobility Scheme changes – Supporting our communities through change

Source: Northland Regional Council

Residents in Whangārei and the Far North who use the Total Mobility (TM) scheme need to be aware that there are changes coming to the service.
The government has introduced updates to how the Total Mobility scheme is funded and delivered across the country. The changes are being implemented nationwide to support the long-term sustainability of the programme.
These changes will result in some adjustments to fares and subsidies and will apply from Wednesday 01 July 2026.
The subsidy available to service users is changing nationally, from 75% to 65%, and there are some changes to capped fares. This will mean a small increased cost for most journeys, though longer trips may cost more.
There are no changes to day-to-day use of the service. The booking process, use of Total Mobility cards and taxi operators all remain the same.
All registered Total Mobility clients in Whangārei and the Far North will have received, or will receive, a letter or email informing them of the changes. This communication will clearly outline what is changing and how individual journeys will be impacted.
Northland Regional Council (NRC) member Joe Carr, Chair of the Regional Transport Committee, encourages clients, whānau and caregivers to take the time to read this information carefully.
“We understand that changes can be unsettling, especially for those who depend on the scheme for everyday activities such as medical appointments, shopping, and social connections and that any additional financial burden may be difficult.”
Councillor Carr says if clients have any questions, concerns, or need help understanding how these changes affect them, they should contact the NRC Transport team directly on 0800 002 004.
“Staff are available to provide guidance and answer any queries, ensuring people feel supported throughout the transition and can continue to access essential services and stay connected to their communities.”
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Awards – Two wins at Taituarā Local Government Excellence Awards

Source: Northland Regional Council

A project to relocate the heart of flood-prone Whirinaki and a manager acknowledged for outstanding leadership and commitment to strengthening iwi and hapū partnerships in local government have been recognised at the Taituarā Local Government Excellence Awards
Northland Regional Council and Te Hikutū hapū won the Eagle Technology Award for Excellence in Community Engagement for their Whirinaki Managed Retreat project.
Using mātauranga Māori and the PARA (prevent, avoid, retreat, accommodate) framework, the Whirinaki community determined relocation was the safest long-term option for around 80 homes in the flood-prone South Hokianga valley.
The multimillion-dollar Whirinaki masterplan would enable whānau to move to elevated papakāinga, restoring the floodplain and creating new opportunities, while demonstrating shared leadership and Te Tiriti partnership.
Judges said the powerful partnership put community leadership at the heart of climate adaptation planning, creating a model that empowers people to shape decisions about their future while strengthening connections to whenua and culture.
The judges described the project as one of the exemplars from this year's field of entries, recognising its community-led approach and strong partnership model.
Meanwhile, Auriole Ruka, the council’s Pou Manawhakahaere – Group Manager, Strategic Partnerships and Engagement, was also recognised at the awards, receiving the inaugural Hononga Indigenous Overseas Manager Exchange to Victoria, Australia.
Offered for the first time this year with support from Hononga Consulting, this new exchange has been created to support and celebrate tangata whenua Māori working in local government.
It provides a unique opportunity for Indigenous local government leaders to connect, learn and share experiences with First Nations local government leaders in Victoria, Australia.
Auriole was recognised for her outstanding leadership and commitment to strengthening iwi and hapū partnerships in local government, as well as her wider contributions to her community and the sector.
The judges were particularly impressed by Auriole's vision for the exchange, noting her focus on building enduring relationships between Māori and Indigenous Australian leaders while strengthening collective responsibility for change and Indigenous leadership.
The Taituarā awards event was held in Wellington yesterday. (subs: Thursday 18 June)
Northland Regional Council Chair Pita Tipene today acknowledged both the Whirinaki project and Auriole Ruka for their respective wins.
“These recognitions reflect the strength of the relationships behind the mahi.”
“The Whirinaki project shows what can be achieved when communities, hapū and local government work together with a shared commitment to future generations.”
“Auriole's award acknowledges her dedication to strengthening partnerships with iwi and hapū and helping create genuine opportunities for Māori participation and leadership.”
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Ministerial Overreach – Minister guts Nursing Council board with no focus on patient safety – NZNO

Source: New Zealand Nurses Organisation

Minister of Health Simeon Brown has gutted the Nursing Council in a ministerial overreach which fails to focus on patient safety and gets ahead of his own deregulation process, NZNO says.
The Nursing Council board consists of up to 14 members and is a mixture of Ministerial appointees and members elected by nurses.
Tōpūtanga Tapuhi Kaitiaki o Aotearoa NZNO Kaiwhakahaere Kerri Nuku says Simeon Brown has replaced eight existing members, four last September and four in February.
“The chair and three board members who wanted to stay on have been replaced by the Minister. Two members did not seek reappointment. NZNO is also aware that two internationally qualified nurses have resigned in protest.
“Simeon Brown’s appointments have taken the number of nurses on the board from seven down to four.
“When almost half our nursing workforce – 43% – are internationally qualified, it is vital they are represented on the board.
“Nurses are the greatest advocates patients have. They understand their patients’ needs more than any other workforce as they work most often and most closely with them.
“Despite his constant rhetoric that he is putting patients first, Simeon Brown has made no attempt to ensure patient needs are the focus of a nurse-strong Council board,” Kerri Nuku says.
The changes at the Council come as the Government is preparing to give greater ministerial powers to direct responsible regulators through changes to the Health Practitioners Competence Assurance Act.
“Simeon Brown is getting ahead of his own process by choosing to put fewer nurses on the board.
“The Minister has form here after he admitted making unprecedented and sweeping changes to the Medical Council because he believed members were ‘pursuing an ideological agenda and becoming distracted from its core responsibilities’,” Kerri Nuku says. 
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Research – Global clinical trial reveals safest, most effective antibiotics for Staphylococcus aureus bloodstream infections

Source: Aotearoa Clinical Trials

Aotearoa New Zealand researchers and clinicians have contributed to a major international clinical trial that is set to change how Staphylococcus aureus bloodstream infections are treated worldwide. Teams across nine New Zealand sites, including Aotearoa Clinical Trials (ACTT) site at Middlemore Hospital, were part of the global SNAP Trial, which has identified safer and equally effective antibiotic options for this life-threatening condition.
This landmark clinical trial has identified the optimal antibiotics for Staphylococcus aureus (S. aureus or ‘golden staph’) bloodstream infections, a breakthrough that is set to reshape treatment for the life-threatening condition. The SNAP Trial found that the standard antibiotic, flucloxacillin, should no longer be the drug of choice to treat the infection, revealing that cefazolin and benzylpenicillin offer safer and equally effective alternatives to patients.
S. aureus is a leading cause of deadly bloodstream infections, responsible for an estimated 300,000 fatalities worldwide each year. Rates of S. aureus bloodstream infections in Aotearoa New Zealand (NZ) are amongst the highest in the world, particularly amongst Māori and Pacific people. While effective antibiotic treatments exist, there has been no clear consensus about which antibiotic is associated with the best outcomes for patients.
The Staphylococcus aureus Network Adaptive Platform Trial (SNAP Trial), led by researchers at the Peter Doherty Institute for Infection and Immunity (Doherty Institute) and the University of Newcastle, is the largest international clinical trial ever conducted for S. aureus infections involving more than 150 hospitals across more than 14 countries, including nine adult and paediatric sites in Aotearoa New Zealand. The multi-centre trial rapidly evaluates different antibiotics and treatment strategies to reduce mortality and improve patient outcomes.
S. aureus infections cause over one million deaths per year. The most serious form of S. aureus infections is when it enters the bloodstream, with a mortality rate of 15 to 25 per cent. While there are effective antibiotics to treat the bloodstream infections, uncertainty has remained over which treatments lead to the best patient outcomes. Findings from the SNAP Trial, published today in the New England Journal of Medicine (NEJM) and The Lancet, challenge the long-held assumption that flucloxacillin should remain the default treatment and provide important new evidence to guide treatment strategy.
The NEJM study – Comparing cefazolin and flucloxacillin In the study published in the NEJM, researchers compared antibiotics used to treat methicillin-susceptible Staphylococcus aureus (MSSA) infections. They found that cefazolin is at least as effective as flucloxacillin, but associated with fewer side effects and a lower risk of kidney injury.
The Royal Melbourne Hospital’s Professor Steven Tong, an Infectious Diseases Physician at the Doherty Institute in Australia and global co-lead investigator of the SNAP Trial, said the results provide clear evidence that cefazolin should be considered the first-line option to treat MSSA bloodstream infections.
“In the treatment of MSSA infections, there is an 89 per cent probability that cefazolin is associated with lower mortality,” said Professor Tong.
“Patients treated with cefazolin fare better, with fewer deaths within 90 days (15 per cent compared to 17 per cent for those who received flucloxacillin). Cefazolin was also associated with fewer cases of acute kidney injury, at 14 per cent, compared to 20 per cent with flucloxacillin.
“The results are sufficiently compelling that I immediately made the switch in my own clinical practice.”
The Lancet study – Comparing benzylpenicillin and flucloxacillin
In the paper published in The Lancet, the study evaluated whether benzylpenicillin could be used to treat penicillin-susceptible Staphylococcus aureus (PSSA) infections where laboratory testing confirmed the susceptibility to penicillin.
Professor Todd Lee, a Scientist at the Research Institute of the McGill University Health Centre and Infectious Diseases and Internal Medicine Physician at the McGill University Health Centre in Canada and co-lead investigator of both studies, said benzylpenicillin was as effective as flucloxacillin and likely safer.
“Patients treated with benzylpenicillin experienced less kidney damage, with mortality also lower at 14 per cent compared with 22 per cent in the flucloxacillin group,” said Dr Lee.
A shift away from flucloxacillin
Researchers said these results mark a turning point in the treatment of MSSA and PSSA bloodstream infections, signalling a shift in clinical practice.
Penicillin was once widely used to treat Staphylococcus aureus, but antibiotic resistance of S. aureus led clinicians to adopt flucloxacillin as the standard treatment for MSSA and PSSA infections.
The findings support moving away from flucloxacillin as the default treatment for MSSA and PSSA infections, given safer and equally effective alternatives are available.
Professor Joshua Davis, an Infectious Diseases Physician at the University of Newcastle and the Hunter Medical Research Institute in Australia, and global co-lead investigator of the SNAP Trial, said some strains are once again susceptible to penicillin, renewing interest in carefully reintroducing older antibiotics.
“These findings show clinicians can confidently use penicillin susceptibility results to guide treatment where laboratory testing is available,” said Professor Davis.
Lyn Whiteway, a sepsis survivor and consumer representative on both trials, welcomed the findings.
“The SNAP Trial shows what is possible when patients are truly at the centre of research. These findings will save lives and spare people from unnecessary harm,” said Ms Whiteway.
Translating the findings Researchers say the next challenge will be translating the findings into routine clinical practice.
While cefazolin availability may need to increase in some countries, researchers say implementation will ultimately depend on hospitals, laboratories and guideline groups incorporating the findings into clinical care.
“This is the largest trial ever conducted on staphylococcal bloodstream infections. It brought together countries from all over the world to answer important questions and improve care for millions of people,” added Professor Lee.
“Trials generate the evidence, but the next step is making sure that evidence changes practice.”
Dr Genevieve Walls, an Infectious Diseases physician at Middlemore Hospital, Aotearoa New Zealand lead for SNAP, and investigator working with Aotearoa Clinical Trials “These results are particularly important for Aotearoa New Zealand because of our extremely high rates of S. aureus bloodstream infection. It would not have been possible without the generosity of the patients who agreed to participate, and the hard work of clinical and research teams around the country. These results illustrate the power of collaborative research in answering clinical questions that are important for New Zealanders.”
Notes
§ The SNAP Trial is a major Australia-led global clinical study investigating the most effective treatments for Staphylococcus aureus bloodstream infections across all age groups.
§ This trial is the world’s largest study ever undertaken to improve treatment for Staphylococcus aureus infections.
§ So far in the over-arching SNAP Trial, participants have been enrolled in Australia, Canada, Germany, Israel, Japan, Malaysia, the Netherlands, New Zealand, Singapore, South Africa, Sweden, the United Kingdom and the United States. The trial will continue testing new approaches to improve outcomes for patients facing this serious infection.Peer-reviewed paper: The Staphylococcus aureus Network Adaptive Platform (SNAP) Trial Group. Cefazolin for Methicillin-Susceptible Staphylococcus aureus bacteremia. The New England Journal of Medicine (NEJM) (2026). DOI: http://doi.org/10.1056/NEJMoa2506905
Peer-reviewed paper: The Staphylococcus aureus Network Adaptive Platform (SNAP) Trial Group. Benzylpenicillin versus flucloxacillin or cloxacillin for the treatment of penicillin-susceptible Staphylococcus aureus bacteraemia (SNAP): an international, multicentre, open-label, non-inferiority randomised controlled trial. The Lancet 2026; published online June 17. https://doi.org/S0140-6736(26)00761-0
Funding: This study was supported by the National Health and Medical Research Council (NHMRC) and Medical Research Future Fund (MRFF) in Australia; the Canadian Institutes of Health Research (CIHR) and the Accelerating Clinical Trials Consortium Canada (ACTAEC); the University Medical Center (UMC) Utrecht and ZonMW in the Netherlands; the Health Research Council of New Zealand (HRC) and the Starship Foundation in New Zealand; the National Healthcare Group Fund and National Medical Research Council (NMRC) in Singapore; the National Institute for Health and Care Research (NIHR) in the UK; and the Paterson Family Foundation supported activities in South Africa.
Collaboration: This study was led by researchers at the Doherty Institute (a joint venture between the University of Melbourne and the Royal Melbourne Hospital) and the University of Newcastle through the SNAP Trial. It is the result of an international consortium with the Doherty Institute (Australia), Aotearoa Clinical Trials (New Zealand), the European Clinical Research Alliance on Infectious Diseases (ECRAID Netherlands), the Research Institute of the McGill University Health Centre (The Institute, Canada), University College London Innovative Clinical Trials Unit (UK), The University Medical Center Utrecht (Netherlands), the Clinical HIV Research Unit (CHRU, South Africa), Tan Tock Seng Hospital (TTSH, Singapore), and Rambam Health Corporation, The Sheba Fund for Health Services and Research and Beilinson Hospital (Israel).