This principle underpins the Global Call to Action on Fragility Fractures, which urges health systems everywhere to implement systematic approaches that deliver:

• Acute multidisciplinary care for those who suffer hip, clinical vertebral, and other major fragility fractures;

• Ongoing post-acute care to restore function and independence for those whose abilities have been impaired by hip and other major fragility fractures; and

• Rapid secondary prevention following the first occurrence of a fragility fracture – whether in younger or older people – to prevent future fractures

Together, these pillars define a continuum of care designed to restore function, reduce re-fracture risk, and improve quality of life for millions of people worldwide.

In that same spirit, Osteoporosis New Zealand (ONZ) has launched Stronger Together: A Collaborative Strategy for Bone Health in New Zealand, a national roadmap that brings the Call to Action to life at country level.

A national strategy built on FFN principles

Stronger Together was unveiled at the New Zealand Parliament on 5^th November 2025. The strategy sets out a comprehensive, evidence-based framework that aligns closely with the FFN’s priorities – starting with optimal hip-fracture management and secondary fracture prevention and extending through to primary fracture prevention and bone-health promotion across the life course.

At its heart lies the same multidisciplinary vision articulated by the FFN: that orthopaedic surgeons, geriatricians, osteoporosis specialists, nurses, rehabilitation doctors, and allied health professionals must work together seamlessly to restore function and prevent future fractures.

Professor Takeshi Sawaguchi, President of the FFN, welcomed the strategy’s publication:

“Stronger Together beautifully aligns, at the top of its pyramid, with the FFN’s Global Call to Action on Fragility Fractures. It provides a clear example of how national systems can embed those principles into everyday care. While the document also ventures into primary fracture prevention – beyond the immediate scope of FFN – we warmly applaud any initiative that strengthens prevention across the continuum of care. Ultimately, prevention and treatment are two sides of the same coin.”

Making the Global Call to Action a national reality

The Call to Action’s three imperatives – acute multidisciplinary care, comprehensive post-acute rehabilitation, and rapid secondary fracture prevention – are central to Stronger Together. In New Zealand, these principles have been translated into concrete objectives supported by national clinical standards, data registries, and system-wide quality improvement.

Fracture Liaison Services (FLS) are a cornerstone of this approach, with the Australian and New Zealand Fragility Fracture Registry (ANZFFR) providing the measurement infrastructure to benchmark outcomes. Together, these initiatives have created a health system increasingly capable of learning from its own data and driving continuous improvement in fracture care and prevention.

John Mulka, Executive Director of Osteoporosis New Zealand, reflected on the FFN’s influence:

“The FFN’s Global Call to Action was our starting point and our inspiration. In New Zealand, we have worked hard to turn that global vision into reality by ensuring that every person who sustains a fragility fracture receives coordinated care and timely secondary fracture prevention. Stronger Together builds on that foundation, demonstrating how international collaboration can lead to tangible progress at national level.”

Beyond secondary prevention: extending the vision

While the FFN’s focus rightly remains on improving the care of those who have already sustained fragility fractures, Stronger Together also acknowledges that prevention must start much earlier in life. The strategy therefore spans seven objectives, from hip-fracture care through to achieving peak bone mass in youth and promoting optimal maternal nutrition during pregnancy.

This life-course framing does not dilute the FFN’s message, rather it strengthens it. By addressing bone health at every age, the burden of fragility fractures in older populations can ultimately be reduced.

Professor Sawaguchi emphasised that link between early action and later resilience:

“When national systems invest in both secondary and primary fracture prevention, they create a virtuous cycle of fewer fractures, better recovery, and healthier ageing. FFN is proud to see partners such as Osteoporosis New Zealand demonstrating how this can be achieved.”

Collaboration as the catalyst for change

The Stronger Together initiative has been endorsed by a wide range of international organisations, including the FFN, International Osteoporosis Foundation, Healthy Bones Australia, Osteoporosis Canada, and the UK Royal Osteoporosis Society. Its release under a Creative Commons Attribution licence allows sister organisations – including National FFNs – to adapt its structure and tools to local contexts.

This open-access approach echoes the FFN’s own commitment to shared learning across its global regions and National FFNs. The document’s Stronger Together Pyramid mirrors the FFN’s integrated model of acute care, secondary prevention, and rehabilitation, while its Call to Action invites the same collaborative engagement that drives FFN’s global network.

Reflections on a shared journey

Adjunct Professor Paul Mitchell, Strategic Advisor to Osteoporosis New Zealand and long-serving past member of the FFN Board and Executive Committee, reflected on the convergence of these efforts:

“Having had the privilege of being part of both FFN and Osteoporosis New Zealand since 2012, it is deeply rewarding to see these bodies of work come together. Stronger Together represents the practical expression of the FFN’s Call to Action within a national context. My hope is that both the global and national FFNs will feel encouraged to adapt and adopt elements of the strategy to empower their own efforts toward transforming fracture care and prevention.”

Professor Mitchell served as Chair of the FFN Communications Committee and a member of the FFN Executive Committee from 2018 to 2022, having first joined the FFN Board in 2014. In recognition of his contribution, he received the FFN Lifetime Achievement Award in 2024.

A model for adaptation and implementation

As Professor Mitchell’s reflection suggests, the relationship between the FFN’s global leadership and New Zealand’s national strategy is not hierarchical but reciprocal. The FFN provides the global framework; Stronger Together demonstrates its local application.

This interplay illustrates what the FFN community has long advocated – that sustainable improvement depends on integrating global standards with local innovation. By adapting shared principles to national health-system realities, countries can build coherent models that improve outcomes for patients everywhere.

Looking ahead

With Stronger Together, New Zealand joins a growing movement of nations taking the FFN’s vision from principle to practice. The strategy exemplifies what can be achieved when governments, clinicians, researchers, and advocates unite behind a common goal: to ensure that no person who sustains a fragility fracture is left behind.

As Professor Takeshi Sawaguchi observed, this is the essence of the FFN ethos – “global collaboration for local impact.”