Four cardiac and respiratory charities have merged into a single entity, the Cardiac and Respiratory Foundation, with lung cancer screening advocacy and public funding for RSV immunisation at the top of its agenda.

The Asthma and Respiratory Foundation, The Heart of Aotearoa, the Lung Foundation, and the Bronchiectasis Foundation have combined under the new banner. Letitia Harding, previously chief executive of the Asthma and Respiratory Foundation, leads the merged organisation. The Minister of Health is scheduled to officially open the foundation at a launch event in Auckland on a Thursday, according to RNZ.

The merger consolidates advocacy across what were previously four separate charity workstreams covering asthma, heart disease, lung conditions and bronchiectasis. Work the Lung Foundation had already been doing on lung cancer screening has been absorbed into the new entity.

Harding cited New Zealand's more than 29,000 registered charities as one of the highest charity-per-population rates in the world. The consolidation, in that context, reduces the number of organisations competing for the same donor base and government attention in the cardiac and respiratory space.

A nationally funded lung cancer screening programme is among the foundation's main priorities. Harding has advocated for targeted screening rather than blanket screening, pointing to cost concerns. That position aligns the new entity with the screening work the Lung Foundation had already progressed before the merger.

The foundation's other immediate focus is securing public funding for RSV (respiratory syncytial virus) immunisation. RSV is a leading cause of respiratory hospitalisation in infants and older adults, but Pharmac has not yet listed an RSV immunisation product on the public schedule. The foundation's advocacy on that front effectively extends the combined organisations' remit from chronic respiratory and cardiac conditions into infectious disease prevention.

For those working in health policy and the NGO sector, the merger follows a pattern of consolidation among condition-specific charities that have found themselves stretched thin across fundraising, clinical advisory work and government liaison. Four separate boards, four sets of overheads and four competing asks to the same ministers and officials have become one. Whether that produces a louder single voice in Budget bids and Pharmac processes, or simply a larger organisation with the same constrained resources, will depend on how the merged entity structures its advocacy operation.

The lung cancer screening push has a clear policy target. New Zealand has no national lung cancer screening programme. Targeted low-dose CT screening for high-risk populations, particularly current and former heavy smokers, is established in clinical guidelines internationally and has been implemented in varying forms in Australia, the United Kingdom and parts of Europe. Harding's emphasis on targeted rather than universal screening signals an awareness that Treasury and the Ministry of Health will weigh any screening proposal against cost-effectiveness thresholds.

The RSV funding ask is more narrowly directed at Pharmac's decision-making. An RSV product (nirsevimab) was approved by Medsafe in 2024, but public funding through Pharmac has not followed. The foundation stepping into this space means the immunisation access argument now has a combined cardiac-respiratory voice behind it, rather than a single-condition organisation making the case.

The choice to launch in Auckland with the Minister of Health signals the foundation's intent to engage directly with government from the outset. Auckland is also the catchment with the highest burden of respiratory disease, particularly among Māori and Pasifika populations, where hospitalisation rates for conditions like asthma and bronchiectasis are disproportionately high.

What remains to be seen is how the merged entity manages the distinct clinical communities it now represents. Cardiac and respiratory advocacy have different expert advisory networks, different relationships with specialist colleges and, at times, competing claims on the same health budget lines. The governance structure Harding and her board put in place will determine whether the consolidation delivers the efficiency and amplified voice its architects intend.

The broader context is a health system under sustained fiscal pressure, where NGO advocacy has become a significant lever in pushing new programmes through Cabinet and Pharmac processes. A merged foundation with combined reach across cardiac and respiratory conditions may carry more weight in those processes than any of its predecessor organisations did alone. The new entity's early priorities make clear where it intends to test that proposition.