On Wednesday, 5 November 2025, the Osteoporosis New Zealand Charitable Trust (ONZ) publicly unveiled Stronger Together: A Collaborative Strategy for Bone Health in New Zealand at a reception held at the New Zealand Parliament and hosted by the Hon Casey Costello, Minister for Seniors and Associate Minister of Health.

The Issue
Healthy bones are at the core of our wellbeing, mobility and independence. People of all ages should protect their bone health by taking early action for osteoporosis prevention through bone-healthy nutrition, regular weight-bearing physical activity, the avoidance of negative lifestyle factors like smoking.

Osteoporosis matters as it is a serious health threat with potentially devastating consequences. One in three women and one in five men over the age of 50 will suffer an osteoporotic fracture in their lifetimes.  It is a disease of bone that progresses silently and can cause bones to become so brittle and break easily, even after a minor fall or bump. 

The Current Reality 
The following staggering figures underscore the heavy toll osteoporosis places on individuals, families, health care system and New Zealand¹:

• Every year in New Zealand more than 22,000 fragility fractures occur among people aged 50 years and older.
• Preventing fragility fractures delivers wide-ranging economic, health-system, societal and personal healthcare benefit.
• Neglect is a key reason for why osteoporosis, despite its serious repercussions, goes undiagnosed and untreated.
• Falls and fractures suffered by older people currently cost the Accident Compensation Corporation (ACC) NZ$360 million per year. Without effective 
  intervention this cost will double to more that NZ$720 million by 2035.
• ACC estimate that, by doing nothing to prevent these injuries, the cost of falls and fractures would reach $400 million by 2025.
• The number of fragility fractures is predicted to rise – 75% in the next 10 years.
• Best practice prevention reduces fractures by 30 to 40% and falls by up to 30% in patients suitable for intervention, potentially saving tens of thousands of hospital bed days.
• People who are over 50 years of age admitted to hospital with a hip fracture, fragility fracture at other skeletal sites, and other injurious falls not involving a fracture required over 300,000 hospital bed days in 2022. To put these numbers into perspective, imagine a hypothetical “Falls and Fragility Fractures Hospital” where all such patients in New Zealand are treated. This hospital would require 843 beds, ranking as the third-largest hospital in the nation.
• The high bed occupancy related to fragility fractures impedes Health NZ’s ability to meet Kiwis’ other pressing healthcare needs, such as care for cancer and kidney disease.
• An analysis commissioned by ACC in early 2024 sought to estimate the number of hospital bed days that could be saved over a five-year period through universal access to world-class Fracture Liaison Services (FLS) across New Zealand.
• FLS in New Zealand ensure that patients who present with a fragility fracture receive the best clinical practice to prevent subsequent fractures through standardised management of osteoporosis and falls prevention.
• Based on conservative assumptions, the analysis suggested that FLS would save 57,764 bed days over five years.  The subsequent conservative estimated savings to the New Zealand health care system is forecasted to be $86.6 million NZD.

Looking Ahead – Being Prepared and Ready
New Zealand is entering a new demographic era. By 2050, more than 40 percent of the population will be aged 50 years or over, the life stage when osteoporosis and fragility fractures are most prevalent. A ‘fragility fracture’ can result from low to no trauma. It is a sign of underlying bone weakness and the need for osteoporosis management.  Fragility fractures, most often affecting the hip, spine, wrist, humerus, and pelvis, are life-altering injuries. They cause pain, disability, and loss of independence, with many patients never regaining their pre-fracture mobility. For families, the impact is profound, as caring responsibilities and financial pressures often follow. For the health system, the costs already number in the hundreds of millions of dollars each year and are projected to escalate further.

Without systematic action, the personal and societal consequences of these fractures will grow substantially, placing strain on individuals and whānau, increasing demand on health and aged care services, and burdening the wider economy.

Our Collaborative Response
Stronger Together sets out a national strategy to meet this challenge, building on the foundations of BoneCare 2020 and aligning with international best practice. It takes a life-course approach, recognising that bone health is shaped from infancy to old age. The strategy is organised around seven objectives, beginning with the delivery of best clinical practice for people who sustain hip fractures, and extending through secondary and primary fracture prevention, the maintenance of bone health in older and younger adults, the achievement of peak bone mass in youth, and optimal maternal nutrition during pregnancy. Each objective is accompanied by evidence-based actions that, taken together, provide a coherent roadmap to improve outcomes across generations.

New Zealand Regarded as Leading the Way 
Significant progress has already been made in New Zealand, with international recognition for the progress in Aotearoa. Clinical standards and registries for hip fracture care and secondary fracture prevention now provide the infrastructure to measure and improve quality. These efforts must continue, with Fracture Liaison Services recognised and funded as core health services, and with secure resourcing of the registries that underpin them. New opportunities are emerging, such as the use of intravenous bisphosphonates delivered in hospitals to improve adherence, and the application of digital health and artificial intelligence to enhance case finding and streamline care. Beyond the clinic, innovative public awareness campaigns are needed to promote prevention and encourage New Zealanders to take ownership of their bone health throughout life.

More Work to Be Done
Implementing Stronger Together will require collaboration across government, health services, professional bodies, advocacy groups, and communities. It demands investment in workforce capability, mentorship, and continuous professional development. It also requires inclusive engagement, ensuring that New Zealand’s diverse communities are central to the design and delivery of solutions.

The Call to Action is clear. Bone health is not the responsibility of any one sector or discipline. It is an “all of society” issue, and addressing it will deliver benefits well beyond reducing fractures. By preventing avoidable harm, relieving pressure on hospitals and the aged care sector, and extending healthy life expectancy, Stronger Together offers a pathway to a stronger, healthier future for New Zealand.

John Mulka, ONZ Executive Director says: "Now is the time to continue our efforts to take decisive action to counteract the rising burden of osteoporosis-related fractures in New Zealand.  By prioritising bone health through preventive measures and early intervention, we can significantly reduce the burden of new fractures, and ultimately improve the quality of life for hundreds of thousands of New Zealanders, and most importantly, alleviate the strain on our health care system.  Stronger Together provides the framework and road map to achieving the standard of excellence we aspire towards”.

> Download the report Stronger Together: A Collaborative Strategy for Bone Health in New Zealand

Reference:
1. https://www.fragilityfracture.co.nz 

About ONZ
Osteoporosis New Zealand is the only national organisation in the country specifically committed to improving the lives of people who are at high risk of developing or living with osteoporosis.  We are driven to ensure that osteoporosis care in New Zealand is world leading. We engage with individuals and families, health professionals, policy makers, and the private sector through programmes of awareness, advocacy, and education to improve bone health and prevent fractures caused by osteoporosis. 
Visit Osteoporosis New Zealand to take the Know Your Bones test and for additional tips on bone health.