The Pacific Island Health Officers Association (PIHOA) is a non-profit organization that is led by and represents the collective interests of the Ministers, Secretaries, and Directors of Health of the U.S.-Affiliated Pacific Islands (USAPI). The USAPI include the three U.S. Flag Territories of Guam, the Commonwealth of the Northern Mariana Islands, and American Samoa, and the three Freely Associated States (independent nations in a special compact relationship with the United States) of the Republic of the Marshall Islands, the Republic of Palau, and the Federated States of Micronesia (Pohnpei, Kosrae, Chuuk, and Yap). The USAPI are populated by more than 500,000 people who live on hundreds of islands and atolls spanning millions of square miles of ocean and crossing five Pacific time zones. PIHOA's mission is to improve the health and well-being of USAPI communities by providing, through consensus, a unified credible voice on health issues of regional significance.