Who is the leader of Peru?

President of the Republic: Martín Alberto Vizcarra Cornejo

President of Peru

The President of Peru () officially called the President of the Republic of Peru () is the head of state and head of government of Peru and represents the republic in official international matters. Presidents de facto who assumed power through political coups are also included in this list.

The last directly elected President of Peru was Pedro Pablo Kuczynski, from July 28, 2016 to March 21, 2018, when he resigned from office. Following the traditional constitutional succession, First Vice President Martín Vizcarra, former governor of Moquegua, Minister of Transportation, and Ambassador to Canada, succeeded him in office as the 67th President of Peru, on 23 March 2018.

The last coup d'état was performed by Alberto Fujimori in 1992, who is now imprisoned for human rights violations and corruption.

Ordinarily, presidents are elected for five-year terms, with no opportunity for immediate reelection. A former president can run again after being out of office for a full term. The change of government takes place on July 28, which is the date of independence from Spain and thus a national holiday.

The current Peruvian Constitution of 1993 establishes in its article 113 that the Presidency of the Republic is vacated by:
Four presidents of Peru have resigned: Guillermo Billinghurst (forced resignation), Andrés Avelino Cáceres, Alberto Fujimori, and Pedro Pablo Kuczynski.

During its more than 190 years of independence, Peru has been ruled by the military leaders who fought for independence, the leaders of the War of the Pacific, representatives of the aristocracy, and democratically elected leaders. Also, the history of the presidency has involved civil wars, coups and violence. More than once, several individuals claimed the right to be president at the same time.

Different titles have been used, such as "Protector of Peru" (used by José de San Martín), and "Supreme Protector" (by Andrés de Santa Cruz).

The following table contains a list of the individuals who have served as President of Peru.

The Protectorate of Peru existed from August 3, 1821 until September 20, 1822.

The Republic of Peru was declared on July 28, 1821 but it was constituted on September 20, 1822. It existed until August 11, 1836.

In 1836, the south of the country declared itself independent by creating the Republic of South Peru, while the north of the country became the Republic of North Peru. The two states confederated with the Republic of Bolivia to form the Peru–Bolivian Confederation on October 28, 1836. Marshal Andrés de Santa Cruz served as the Supreme Protector of the Confederation. Simultaneously, the actual control of each Republic remained in the hands of their respective presidents. The Peru-Bolivian Confederation dissolved on August 25, 1839.

The Republic of North Peru existed from August 11, 1836 until August 25, 1839.

The Republic of South Peru existed from March 17, 1836 until August 25, 1839.

The Republic of Peru was reestablished on August 25, 1839.

There are currently (since 2018) six living former presidents of Peru. In order of office they are:

The President of the Republic of Peru is the Head of the Peruvian State, Head of the Peruvian Government and the Supreme Commander of the Peruvian Armed Forces.

The official style is:

His/Her Excellency [name of the president]

Common usages include:

"El Presidente de la Republica" / The President of the Republic

Names of incumbents.

1- Vice President of the Republic: Mercedes Rosalba Aráoz Fernández

2- President of Congress: Daniel Enrique Salaverry Villa

3- First Vice President of Congress: Leyla Felícita Chihuán Ramos

4- Second Vice President of Congress: Segundo Leocadio Tapia Bernal

5- Third Vice President of Congress: Yeni Vilcatoma de la Cruz


What's the national dish of Honduras?

Carneada is considered one of Honduras' national dishes, known as "plato típico" when served in Honduran restaurants. While it is a type of dish, a "carneada" or "carne asada", like its Mexican counterpart, is usually more of a social event with drinks and music centered on a feast of barbecued meat. The cuts of beef are usually marinated in sour orange juice, salt, pepper and spices, and then grilled.

Honduran cuisine

Honduran cuisine is a fusion of indigenous (Lenca) cuisine, Spanish cuisine, Caribbean cuisine and African cuisine. There are also dishes from the Garifuna people. Coconut and coconut milk are featured in both sweet and savory dishes. Regional specialties include fried fish, tamales, carne asada and baleadas. Other popular dishes include meat roasted with chismol and carne asada, chicken with rice and corn, and fried fish with pickled onions and jalapeños. In the coastal areas and in the Bay Islands, seafood and some meats are prepared in many ways, some of which include coconut milk.

Among the soups the Hondurans enjoy are bean soup, mondongo soup (tripe soup), seafood soups and beef soups. Generally all of these soups are mixed with plantains, yuca, and cabbage, and served with corn tortillas.

Other typical dishes are the montucas or corn tamale, stuffed tortillas, and tamales wrapped in plantain leaves. Also part of Honduran typical dishes is an abundant selection of tropical fruits such as papaya, pineapple, plum, sapote, passion fruit and bananas which are prepared in many ways while they are still green.

Common beverages for dinner or lunch include soft drinks. One agua fresca that is very popular in Honduras is agua de ensalada. This freshly made drink consists of shopped fruit such as apples and varies seasonal fruit. Another papular drink is agua de nance. When it comes to bottle drinks among the most tasteful is called tropical and it is a banana flavor soft drink.

Hondurans usually have a large, hearty breakfast. It typically consists of fried eggs (whole or scrambled), refried beans, Honduran salty sour cream ("mantequilla"), hard olancho cheese, avocado, sweet fried plantains, and tortillas. It is common for most households to first prepare tortillas, a staple for nearly every dish, which are used throughout the rest of the day.

Other breakfast favorites include carne asada (roasted meat) and Honduran spicy sausages ("chorizo"). A good breakfast will be accompanied with hot, dark—in this case Honduran-grown—coffee. Honduran coffee is renowned for its delicate qualities, being grown on the slopes of the Honduran mountains over rich soils of volcanic origin. A specific brand famous for its flavour comes from the Honduran region of Marcala, others being the Copán coffee and the one grown in Ocotepeque.

Street vendors often sell breakfast baleadas made of flour tortillas, toppings such as eggs, meat, and even pickled onions, and small tamales made of sweet yellow corn dough, called "tamalitos de elote", eaten with sour cream; fresh horchata and posole is also common.
"I have also seen the street side vendors sell hot I mean very hot tomatoes with chili peppers in the middle; you should try one
of them someday."

Another great breakfast or it can be considered desert as well is rosquillas. Rosquillas can be considered like a Hondurian doughnut. Made from corn (masa, cheese and yeast).

"Sopa de caracol" (conch soup) is one of the most representative dishes of the Honduran cuisine. This soup was made famous throughout Latin America because of a catchy song from Banda Blanca called "Sopa de Caracol." The conch is cooked in coconut milk and the conch's broth, with spices, yuca (cassava), cilantro, and green bananas known as "guineo verde". Other varieties including crab, fish or shrimp are known as "sopa marinera".

This traditional soup is made by boiling black or red beans with garlic in water until soft. Once they are soft, the beans are blended, and added to a pot filled with water and with pork bones to serve as the base of the soup. Once the soup base has taken a chocolate color and has boiled enough, the bones are removed, and water is added to the pot, along with the rest of the ingredients, which may include yuca, green plantains, eggs, and many other ingredients. The soup is served with rice and tortillas, and may be accompanied with sour cream, smoked dry cheese, avocados and lemons.

The meat is usually accompanied by "chimol" salsa (made of chopped tomatoes, onion and cilantro with lemon and spices), roasted plátanos (sweet plantains), spicy chorizos, olanchano cheese, tortillas, and refried mashed beans.

Rice and beans is a popular side dish in the Honduran Caribbean coast. It is often called Casamiento. Every country that their own signature bean and in Honduras they are red beans ( frijoles cheles). Typically in Honduras the beans are refried and served with green fried bananas (tajadas).

Fried Yojoa fish is a famous Honduran dish that is served all over the country. The fish often has a more savory flavor compared to other types of fish served in the region. Yojoa fish is salted, spiced, and later deep fried. It is then oftentimes served with pickled red cabbage, pickled onions and deep fried sliced plantains called tajaditas.

The baleada is one of the most common street foods in Honduras. The basic style is made of a flour tortilla which is folded and filled with refried beans, quesillo or cheese and sour cream (mantequilla). Many people add roasted meat, avocado, plantains or scrambled eggs as well. There are Honduran Fast-food chains that serve different kinds of Baleadas.

Corn, or "maíz", is a staple in Honduran cuisine. Eating corn comes to Hondurans as an inheritance of their Maya-Lenca ancestors; the Maya believed corn to be sacred, and that the father gods created men from it.

Some tortilla based dishes include:
Tacos Fritos: Tortillas are filled in with ground meat or chicken and rolled into a flute. The rolled tacos are then deep fried and served with raw cabbage, hot tomato sauce, cheese and sour cream as toppings.

Catrachitas: A common simple snack, made of deep fried tortilla chips covered with mashed refried beans, cheese and hot sauce. A variant of this snack are de "Chilindrinas", deep fried tortilla strips with hot tomato sauce and cheese. It is common in Honduran restaurants to serve an "Anafre", a clay pot with melting cheese or sour cream, mashed beans and sometimes chopped chorizo (Honduran sausage) heated on top of a clay container with burning charcoal, and tortilla fried chips to dip in. Similar to Swiss fondue.

Enchiladas: The whole Tortilla is deep fried and served with a variety of toppings. First ground pork meat is placed, next raw chopped cabbage or lettuce, then hot tomato sauce, and a slice of boiled egg.

Chilaquiles: Tortillas are covered in egg and deep fried. Afterwards placed in a wide container to form a layer of tortilla as a base. Cheese, cooked chicken and hot tomato sauce with spices is then added. Again place another layer of tortillas and continue to do so to make something like a Tortilla Lasagna. Place in the oven and let cook until cheese melts and the tortillas are soft. Served with thick sour cream.

Tortilla con Quesillo: Two tortillas with quesillo, a melted cheese, in between and then pan fried; served with a tomato sauce. Mashed beans are sometimes also added as a filling with the cheese.


Is there a cure for sjögren syndrome?

Neither a cure for SS nor a specific treatment is known to permanently restore gland secretion. Instead, treatment is generally symptomatic and supportive.

Sjögren syndrome

Sjögren syndrome (SjS, SS) is a long-term autoimmune disease that affects the body's moisture-producing glands. Primary symptoms are a dry mouth and dry eyes. Other symptoms can include dry skin, vaginal dryness, a chronic cough, numbness in the arms and legs, feeling tired, muscle and joint pains, and thyroid problems. Those affected are at an increased risk (5%) of lymphoma.
While the exact cause is unclear, it is believed to involve a combination of genetics and an environmental trigger such as exposure to a virus or bacteria. It can occur independently of other health problems (primary Sjögren syndrome) or as a result of another connective tissue disorder (secondary Sjögren syndrome). The inflammation that results progressively damages the glands. Diagnosis is by biopsy of moisture-producing glands and blood tests looking for specific antibodies. On biopsy there are typically lymphocytes within the glands.
Treatment is directed at the person's symptoms. For dry eyes artificial tears, medications to reduce inflammation, punctal plugs, or surgery to shut the tear ducts, may be tried. For a dry mouth, chewing gum (preferably sugar free), sipping water, or a saliva substitute may be used. In those with joint or muscle pain, ibuprofen may be used. Medications that can cause dryness, such as antihistamines, may also be stopped.
The disease was described in 1933 by Henrik Sjögren, after whom it is named; however, a number of earlier descriptions of people with the symptoms exist. Between 0.2% and 1.2% of the population are affected, with half having the primary form and half the secondary form. Females are affected about ten times as often as males and it commonly begins in middle age; however, anyone can be affected. Among those without other autoimmune disorders, life expectancy is unchanged.

The hallmark symptom of SS is dry mouth and keratoconjunctivitis sicca (dry eyes). Vaginal dryness and dry skin and dry nose may also occur. Other organs of the body may also be affected including kidneys, blood vessels, lungs, liver, pancreas, and brain.

Skin dryness in some people with SS may be the result of lymphocytic infiltration into skin glands. The symptoms may develop insidiously, with the diagnosis often not considered for several years, because the complaints of sicca may be otherwise attributed to medications, a dry environment, aging, or may be regarded as not of severity warranting the level of investigation necessary to establish the presence of the specific underlying autoimmune disorder.

SS can damage vital organs of the body with symptoms that may plateau or worsen, or go into remission as with other autoimmune diseases. Some people may experience only the mild symptoms of dry eyes and mouth, while others have symptoms of severe disease. Many patients can treat problems symptomatically. Others are forced to cope with blurred vision, constant eye discomfort, recurrent mouth infections, swollen parotid glands, dysphonia (vocal disorders including hoarseness), and difficulty in swallowing and eating. Debilitating fatigue and joint pain can seriously impair quality of life. Some patients can develop renal (kidney) involvement (autoimmune tubulointerstitial nephritis) leading to proteinuria (excess protein in urine), urinary concentrating defect, and distal renal tubular acidosis.

SS is associated with a number of other medical conditions, many of which are autoimmune or rheumatic disorders, such as celiac disease, fibromyalgia, SLE (lupus), autoimmune thyroiditis, multiple sclerosis and spondyloarthropathy, and several malignancies, principally non-Hodgkin lymphoma.

The cause of SS is unknown, but it may be the influence of a combination of genetic, environmental, and other factors—as is the case with many other autoimmune disorders.

The observation of high rates of autoimmune disorders in families of SS is linked with a genetic predisposition to the syndrome. Studies on the polymorphisms of human leukocyte antigen (HLA)-DR and HLA-DQ gene regions in SS patients show differential susceptibility to the syndrome due to different types of the resulting autoantibody production.

Since SS is associated with a high prevalence in women, sex hormones, especially estrogen, are believed to affect humoral and cell-mediated immune responses affecting susceptibility to the syndrome. Androgens are generally considered to prevent autoimmunity. Studies on mice models suggest estrogen deficiency stimulates presentation of autoantigens, inducing SS-like symptoms.

Microchimerism of fetal cells (offspring lymphoid cells in maternal circulation) may generate autoimmunity in women who have been previously pregnant. Generation of an autoimmune potential via microchimerism may lead to a switch from a silent form of autoimmunity with age-dependent decrease in self-tolerance.

Viral proteins, engulfed molecules, or degraded self-structures may initiate autoimmunity by molecular mimicry and increase the chances of SS development. Epstein-Barr virus, hepatitis C, and human T-cell leukemia virus-1 are among the most studied infectious agents in SS. Damaged self-structures targeted for apoptosis may be mistakenly exposed to the immune system, triggering autoimmunity in exocrine glands, which are often prone to autoimmune responses.

The pathogenetic mechanisms of SS have not been fully elucidated, resulting in the lack of pathophysiology knowledge of the management of this autoimmune exocrinopathy. Although the numerous factors contributing to the progression of this disease have made it difficult to find out the exact origin and cause, major advances over the past decade have contributed to a proposed set of pathogenic events that occur prior to the diagnosis of SS.

SS was originally proposed as a specific, self-perpetuating immune system-mediated loss of exocrine glands, specifically acinar and ductal cells. Although this explains the more obvious symptoms (e.g., the lack of salivary and lacrimal fluid), it does not explain the more widespread systemic effects seen in the progression of the disease.

In the presence of a susceptible genetic background, both environmental and hormonal factors are thought capable of triggering the infiltration of lymphocytes, specifically CD4+ T cells, B cells, and plasma cells, causing glandular dysfunction in the salivary and lacrimal glands.

SS is associated with increased levels in cerebrospinal fluid (CSF) of IL-1RA, an interleukin 1 antagonist. This suggests that the disease begins with increased activity in the interleukin 1 system, followed by an autoregulatory up-regulation of IL-1RA to reduce the successful binding of interleukin 1 to its receptors. Interleukin 1 likely is the marker for fatigue, but increased IL-1RA is observed in the CSF and is associated with increased fatigue through cytokine-induced sickness behavior. SS, though, is characterized by decreased levels of IL-1ra in saliva, which could be responsible for mouth inflammation and dryness. Patients with secondary SS also often exhibit signs and symptoms of their primary rheumatic disorders, such as systemic lupus erythematosus, rheumatoid arthritis, or systemic sclerosis.

The genetic locus most significantly associated with primary SS is the major histocompatibility complex/human leukocyte antigen (MHC/HLA) region, as demonstrated by the preliminary results of the first genome-wide association study (GWAS). This GWAS included data from a discovery cohort of 395 patients of European ancestry with primary SS, and 1,975 healthy control individuals, and from a replication study that comprised 1,234 cases and 4,779 healthy controls. Associations with polymorphisms located at six independent loci were also detected; "IRF5, STAT4, BLK, IL12A, TNIP1," and "CXCR5". This also suggested the activation of the innate immune system, notably through the IFN system, B-cell activation through "CXCR5"-directed recruitment to lymphoid follicles and B-cell receptor (BCR) activation involving" BLK", and T-cell activation owing to HLA susceptibility and the IL-12-IFN-γ-axis.

Patients of different ethnic origin carry different HLA susceptibility alleles, of which, HLA-DR and HLA-DQ are involved in the pathogenesis of SS. For example, patients from Northern and Western Europe and from North America show a high prevalence of "B8, DRw52," and "DR3" genes. HLA class II alleles are associated with the presence of specific subsets of autoantibodies, rather than with the disease itself. Autoantibodies refer to the loss of B-cell tolerance leading to production of antibodies directed against diverse organ-specific and organ nonspecific antigens. Association between HLA and SS is restricted to patients with anti-SSA/Ro or anti-SSB/La antibodies. Seropositivity for anti-Ro and anti-La is associated with greater severity and longer duration of disease, and findings of their high abundance from the salivary glands of SS patients suggests their imperative role in the pathogenesis of SS.

Beyond genetics, epigenetic abnormality related to DNA methylation, histone acetylation, or microRNA expression probably have key roles in the pathogenesis of autoimmune diseases, including SS, though research in this area is very limited and minimal.

Environmental factors, such as glandular viral infection, could prompt epithelial cells to activate the HLA-independent innate immune system through toll-like receptors. Although a number of infectious, exogenous agents have been implicated in the pathogenesis of SS, such as Epstein-Barr virus (EBV), human T-lymphotropic virus 1, and hepatitis C virus, their association with SS appears weak. While EBV is present in the salivary glands of normal individuals, a high incidence of EBV reactivation in SS patients has been reported with increased levels of EBV DNA. This indicates viral reactivation and inability of lymphoid infiltrates to control EBV replication in SS, leading to the initiation or perpetuation of an immune response in target organs. Nonetheless, it remains to be clarified exactly how reactivation of EBV is induced in lesions of patients with SS, and which specific molecular mechanisms are involved in the process of viral reactivation.

Epithelial cells in SS lesions are active participants in the induction and perpetuation of the inflammatory process. Environmental and hormonal factors, in concert with an appropriate genetic background, are believed to trigger SS, which dysregulates epithelial cells and allows aberrant homing and activation of dendritic cells (DCs), T cells, and B cells. Dendritic cells are antigen-presenting cells which process antigen material and present it to other T cells. Following the migration of lymphocytes into the glands in response to chemokines and specific adhesion molecules, T cells interact with epithelial cells. Epithelial cells are further activated by proinflammatory cytokines (IL-1β, IFN-γ, and TNF), which are produced by adjacent T cells. The early accumulation of plasmacytoid dendritic cells in the target tissues, which produce high levels of type 1 IFNs, seems important, as these cells can further dysregulate the immune response through abnormal retention of lymphocytes in the tissues and their subsequent activation. IFN-α stimulates the production of B-cell activating factor (BAFF) by epithelial cells, DCs, and T cells. BAFF stimulates aberrant B-cell maturation, leading to the emergence of self-reactive B cells, which locally produce autoantibodies, in a germinal centre-like structure (GC-like), which is also the location of lymphomagenesis (origin of lymphoma).

Dysregulation of apoptosis (programmed cell death) is believed to play a role in the pathogenesis of a variety of autoimmune diseases, though its role in SS is controversial. Both the Fas and Fas ligand proteins are overexpressed in primary SS patients, while expression of BCL-1, which is known to downregulate apoptosis, was found significantly reduced in acinar and ductal epithelial cells of SS patients compared to healthy people. "In situ" studies did not show increased apoptosis among glandular epithelial cells, but did show reduced apoptosis among infiltrating mononuclear cells. Reduced apoptosis was also implicated in the accumulation of autoreactive B-cells found in the glands. The relationship of autoantibodies expressed in SS with apoptosis is still being researched.

Sex hormones seem to influence humoral and cell-mediated immune response, with estrogen being considered one of the biggest factors responsible for sex-immunologic dimorphism. Estrogen deficiency appears to play a role in development of SS. It has been hypothesized that androgen administration to the ocular surface may serve as an effective therapy for dry eyes.

Diagnosing SS is complicated by the range of symptoms a patient may manifest, and the similarity between symptoms of SS and those of other conditions. Also, patients with SS symptoms approach different specialities for treatment, which can make diagnosis difficult. Since dry eyes and dry mouth are very common symptoms, and frequently occur in people over 40, people often think the symptoms are age-related and ignore them. However, some medications can cause symptoms similar to those of SS. The combination of several tests, which can be done in a series, can eventually diagnose SS.

SS is usually classified as either 'primary' or'secondary'. Primary Sjögren syndrome occurs by itself and secondary Sjögren syndrome occurs when another connective tissue disease is present.

Blood tests can be done to determine if a patient has high levels of antibodies that are indicative of the condition, such as antinuclear antibody (ANA) and rheumatoid factor (because SS frequently occurs secondary to rheumatoid arthritis), which are associated with autoimmune diseases. Typical SS ANA patterns are SSA/Ro and SSB/La, of which Anti-SSB/La is far more specific; Anti-SSA/Ro is associated with numerous other autoimmune conditions, but are often present in SS. However, Anti-SSA and Anti-SSB tests are frequently not positive in SS.

The rose bengal test uses a stain that measures state and function of the lacrimal glands. This test involves placing the non-toxic dye rose bengal on the eyes. The dye’s distinctive colour helps in determining the state and functioning of tear film and the rate of tear evaporation. Any distinctive colour change can indicate SS, but confirming the condition requires many related diagnostic tools.

Schirmer's test measures the production of tears: a strip of filter paper is held inside the lower eyelid for five minutes, and its wetness is then measured with a ruler. Producing less than of liquid is usually indicative of SS. This measurement analysis varies among people depending on other eye-related conditions and medications in use when the test is taken. A slit-lamp examination can reveal dryness on the surface of the eye.

Symptoms of dry mouth and dryness in the oral cavity are caused by the reduced production of saliva from the salivary glands (parotid gland, submandibular gland, and sublingual gland). To check the status of salivary glands and the production of saliva, a salivary flow-rate test is performed, in which the person is asked to spit as much as they can into a cup, and the resulting saliva sample is collected and weighed. This test's results can determine whether the salivary glands are functioning adequately. Not enough saliva produced could mean the person has SS. An alternative test is non-stimulated whole saliva flow collection, in which the person spits into a test tube every minute for 15 minutes. A resultant collection of less than is considered a positive result.

A lip/salivary gland biopsy takes a tissue sample that can reveal lymphocytes clustered around salivary glands, and damage to these glands due to inflammation. This test involves removing a sample of tissue from a person’s inner lip/salivary gland and examining it under a microscope. In addition, a sialogram, a special X-ray test, is performed to see if any blockage is present in the salivary gland ducts (i.e. parotid duct) and the amount of saliva that flows into the mouth.

Also, a radiological procedure is available as a reliable and accurate test for SS. A contrast agent is injected into the parotid duct, which opens from the cheek into the vestibule of the mouth opposite the neck of the upper second molar tooth. Histopathology studies should show focal lymphocytic sialadenitis. Objective evidence of salivary gland involvement is tested through ultrasound examinations, the level of unstimulated whole salivary flow, a parotid sialography or salivary scintigraphy, and autoantibodies against Ro (SSA) and/or La (SSB) antigens.

SS can be excluded from people with past head and neck radiation therapy, acquired immunodeficiency syndrome (AIDS), pre-existing lymphoma, sarcoidosis, graft-versus-host disease, and use of anticholinergic drugs.

There is no prevention mechanism for SS due to its complexity as an autoimmune disorder. However, lifestyle changes can reduce the risk factors of getting SS or reduce the severity of the condition with patients who have already been diagnosed. Diet is strongly associated with inflammation that is mostly seen in many autoimmune related diseases including SS. An experimental study concludes that SS patients show high sensitivity to gluten that directly relates to inflammation. Moderate exercise is also helpful in SS patients, mainly reducing the effect of lung inflammation.

Moisture replacement therapies such as artificial tears may ease the symptoms of dry eyes. Some patients with more severe problems use goggles to increase local humidity or have punctal plugs inserted to help retain tears on the ocular surface for a longer time.

Additionally, cyclosporine (Restasis) is available by prescription to help treat chronic dry eye by suppressing the inflammation that disrupts tear secretion. Prescription drugs are also available that help to stimulate salivary flow, such as cevimeline (Evoxac) and pilocarpine. Salagen, a manufactured form of pilocarpine, can be used to help produce tears, as well as saliva in the mouth and intestines. It is derived from the jaborandi plant.

In women with SS, vaginal dryness, vulvodynia and dyspareunia (painful sexual intercourse) are often reported; personal lubricants are recommended to help lessen irritation or pain that may result from dryness in the vaginal and vulva areas.

Nonsteroidal anti-inflammatory drugs (NSAIDs) may be used to treat musculoskeletal symptoms. For individuals with severe complications, corticosteroids or immunosuppressive drugs may be prescribed, and sometimes IVIG (intravenous immunoglobulin). Also, disease-modifying antirheumatic drugs (DMARDs) such as methotrexate may be helpful. Hydroxychloroquine (Plaquenil) is another option and is generally considered safer than methotrexate. However, these prescribed drugs have a range of side effects such as nausea, loss of appetite, dizziness, hair loss, stomach aches/cramps, headache, liver toxicity, and increased risk of infections. Also, people who take drugs to suppress the immune system are more likely to develop cancer later.

For systemic symptoms, including fatigue, joint pain, myositis and neuropathy, biologic immunosuppressant drugs such as rituximab and belimumab that work via B-cell pathology are often used and have less toxic profiles than traditional immunosuppressive regimens.

Preventive dental treatment is also necessary (and often overlooked by the patient), as the lack of saliva associated with xerostomia creates an ideal environment for the proliferation of bacteria that cause cavities. Treatments include at-home topical fluoride application to strengthen tooth enamel and frequent teeth cleanings by a dental hygienist. Existing cavities must also be treated, as cavities that extend into the tooth can not be effectively treated through teeth cleaning alone, and are at a high risk of spreading into the pulp of the tooth, leading to the loss of vitality and need for extraction or root canal therapy. This treatment regimen is the same as for all xerostomia patients—such as those undergoing head and neck radiation therapy, which often damages the salivary glands, which are more susceptible to radiation than other body tissues.

Published studies on the survival of SS patients are limited in varied respects, perhaps owing to the relatively small sample sizes, and secondary SS is associated with other autoimmune diseases. However, results from a number of studies indicated, compared to other autoimmune diseases, SS is associated with a notably high incidence of malignant non-Hodgkin lymphoma (NHL). NHL is the cancer derived from white blood cells. About 5% of patients with SS develop some form of lymphoid malignancy. Patients with severe cases are much more likely to develop lymphomas than patients with mild or moderate cases. The most common lymphomas are salivary extranodal marginal zone B cell lymphomas (MALT lymphomas in the salivary glands) and diffuse large B-cell lymphoma.

Lymphomagenesis in primary SS patients is considered as a multistep process, with the first step being chronic stimulation of autoimmune B cells, especially B cells that produce rheumatoid factor at sites targeted by the disease. This increases the frequency of oncogenic mutation, leading to any dysfunction at checkpoints of autoimmune B-cell activation to transform into malignancy. A study's finding has concluded the continuous stimulation of autoimmune B cells, leading to subtle germinal abnormalities in genes having specific consequences in B cells, which underlies the susceptibility to lymphoma.

Apart from this notably higher incidence of malignant NHL, SS patients show only modest or clinically insignificant deterioration in specific organ-related function, which explains the only slight increases in mortality rates of SS patients in comparison with the remainder of the population.

Among the complications discussed above, women with anti-Ro/SS-A and anti-La/SS-B antibodies who become pregnant, have an increased rate of neonatal lupus erythematosus with congenital heart block requiring a pacemaker. Type I cryoglobulinemia is a known complication of SS.

SS is the second most common rheumatic autoimmune disorder, behind rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE). There are no geographical differences in the rates of SS. SS has been reported in all areas of the world, although regional rates have not been well studied. Depending on the criteria for determining prevalence, studies estimate the prevalence of SS at 500,000 to 2 million people in the United States. Moreover, other broader studies of prevalence of SS range widely with some reports of up to a prevalence of 3% of the population. A few studies that have been conducted on the incidence of SS report that the incidence of the syndrome varies between 3 and 6 per 100,000 per year.

Nine out of ten SS patients are women. In addition to prevalence in women, having a first-degree relative with an autoimmune disease and previous pregnancies have been identified as epidemiological risk factors. Differences in prevalence due to race and ethnicity are unknown.

Although SS occurs in all age groups, the average age of onset is between ages 40 and 60, although experts note that up to half of all cases may be left undiagnosed or unreported. The prevalence of SS generally increases with age.

SS is reported in 30-50% of people with rheumatoid arthritis and 10-25% with systemic lupus erythematosus.

Jan Mikulicz-Radecki (1850–1905) is generally credited with the first description of SS. In 1892, he described a 42-year-old man with enlargement of the parotid and lacrimal glands associated with a round-cell infiltrate and acinar atrophy. However, the criteria Mikulicz established for diagnosis, often led to misdiagnosis of Mikulicz’s syndrome. Many conditions, such as tuberculosis, infections, sarcoidosis, and lymphoma present with similar conditions to those listed under Mikulicz’s syndrome. Nevertheless, the term "Mikulicz’s syndrome" is still used occasionally to describe the appearance of lymphocytic infiltrates on salivary-gland biopsies.

In 1930, Henrik Sjögren (1899–1986), an ophthalmologist in Jönköping, Sweden, observed a patient with low secretions from the lacrimal and salivary glands. Sjögren introduced the term keratoconjunctivitis sicca for the symptom of dry eyes (keratoconjunctivitis). In 1933, he published his doctoral thesis, describing 19 females, most of whom were postmenopausal and had arthritis, showing clinical and pathological manifestations of the syndrome. Sjögren clarifies that keratoconjunctivitis sicca, resulting from water deficiency, had no relation to xerophthalmia, resulting from vitamin A deficiency. Sjögren's thesis was not well received as the Board of Examiners criticized some clinical aspects.

After extensive research and data collection, Sjögren published an essential paper in 1951, describing 80 patients with keratoconjunctivitis sicca, 50 of whom also had arthritis. His subsequent follow-up conference trips pertaining to his paper led to an international interest in SS. The term "keratoconjunctivitis sicca" was coined by Sjögren himself and began to be identified as SS in literature, although it can now have more general usage.

Research on multifactorial autoimmune diseases such as SS focuses on expanding the knowledge surrounding the disorder, improving diagnostic tools and finding ways to prevent, manage, and cure the disorder. The United Kingdom Primary Sjögren's Syndrome Registry, a tissue biobank of samples taken for research, supported by the Medical Research Council, UK was established in 2010.

As an autoimmune disease, susceptibility to SS is greatly influenced by the human leukocyte antigen. DQA1*05:01, DQB1*02:01, and DRB1*03:01 alleles were identified as risk factors, while DQA1*02:01, DQA1*03:01 and DQB1*05:01 alleles were found to be protective factors for the disease. The relationship between alleles and specific race was also established. HLA-DQ2 and HLA-B8 are generally found in Caucasian patients, while HLA-DR5 is related to Greek and Israeli patients. Multiple genome-wide association scans may be conducted in the future to identify key risk variants.

Viruses that can trigger the immune response of the syndrome include human T-lymphotropic virus type 1 (HTLV-1), Epstein-Barr virus (EBV), human immunodeficiency virus (HIV) and hepatitis C virus (HCV). The UK Primary Sjögren's Syndrome Registry supports clinical trials and genetic studies of SS and is open to people wishing to participate in research studies and researchers studying the disease.

Some research showed that the lack of vitamin A and vitamin D are associated with this disease. Vitamin D deficiency was found to be related to neurological manifestations and the presence of lymphoma among patients. On the other hand, vitamin A levels were inversely associated with extra-glandular manifestations of the disease.

Saliva is a potential diagnostic tool of SS because the salivary component is changed after onset of the disease. With the new miniaturization technology, called ‘lab on a chip’, the diagnosis can be more convenient.

With regard to therapeutics, multiple monoclonal antibodies were under investigation in 2007. The most promising seemed to be the anti-CD20 rituximab and the anti-CD22 epratuzumab, while the anti-TNF-α and IFN-α seemed less effective.

In 2014, the Sjögren's Syndrome Foundation announced a five-year goal to cut the time to diagnoses in half.


When was New Zealand colonized?

The history of New Zealand dates back at least 700 years to when it was discovered and settled by Polynesians, who developed a distinct Māori culture centred on kinship links and land. The first European explorer to sight New Zealand was Dutch navigator Abel Tasman on 13 December 1642. The Dutch were also the first non-natives to explore and chart New Zealand's coastline. Captain James Cook, who reached New Zealand in October 1769 on the first of his three voyages, was the first European explorer to circumnavigate and map New Zealand. From the late 18th century, the country was regularly visited by explorers and other sailors, missionaries, traders and adventurers. In 1840 the Treaty of Waitangi was signed between the British Crown and various Māori chiefs, bringing New Zealand into the British Empire and giving Māori the same rights as British subjects. There was extensive British settlement throughout the rest of the century and into the early part of the next century. War and the imposition of a European economic and legal system led to most of New Zealand's land passing from Māori to Pākehā (European) ownership, and most Māori subsequently became impoverished.

History of New Zealand

From the 1890s the New Zealand Parliament enacted a number of progressive initiatives, including women's suffrage and old age pensions. After becoming a self-governing dominion with the British Empire in 1907, the country remained an enthusiastic member of the empire, and over 100,000 New Zealanders fought in World War I as part of the New Zealand Expeditionary Force. After the war, New Zealand signed the Treaty of Versailles (1919), joined the League of Nations, and pursued an independent foreign policy, while its defence was still controlled by Britain.

When World War II broke out in 1939, New Zealanders contributed to the defence of the British Empire; the country contributed some 120,000 troops. From the 1930s the economy was highly regulated and an extensive welfare state was developed. Meanwhile, Māori culture underwent a renaissance, and from the 1950s Māori began moving to the cities in large numbers. This led to the development of a Māori protest movement which in turn led to greater recognition of the Treaty of Waitangi in the late 20th century.

The country's economy suffered in the aftermath of the 1973 global energy crisis, the loss of New Zealand's biggest export market upon Britain's entry to the European Economic Community, and rampant inflation. In 1984, the Fourth Labour Government was elected amid a constitutional and economic crisis. The interventionist policies of the Third National Government were replaced by "Rogernomics", a commitment to a free market economy. Foreign policy after 1980 became more independent especially in pushing for a nuclear-free zone. Subsequent governments have generally maintained these policies, although tempering the free market ethos somewhat.

New Zealand was originally settled by Polynesians from Eastern Polynesia. Genetic and archaeological evidence suggests that humans emigrated from Taiwan to Melanesia and then travelled east through to the Society Islands; after a pause of 70 to 265 years, a new wave of exploration led to the discovery and settlement of New Zealand. The most current reliable evidence strongly indicates that initial settlement of New Zealand occurred 1280 – 1320 CE. Previous dating of some Kiore (Polynesian rat) bones at 50 – 150 CE has now been shown to have been unreliable; new samples of bone (and now also of unequivocally rat-gnawed woody seed cases) match the 1280 CE date of the earliest archaeological sites and the beginning of sustained, anthropogenic deforestation.

The descendants of these settlers became known as the Māori, forming a distinct culture of their own. The latter settlement of the tiny Chatham Islands in the east of New Zealand about 1500 CE produced the Moriori; linguistic evidence indicates that the Moriori were mainland Māori who ventured eastward.

The original settlers quickly exploited the abundant large game in New Zealand, such as moa, which were large flightless ratites pushed to extinction by about 1500. As moa and other large game became scarce or extinct, Māori culture underwent major change, with regional differences. In areas where it was possible to grow taro and kūmara, horticulture became more important. This was not possible in the south of the South Island, but wild plants such as fernroot were often available and cabbage trees were harvested and cultivated for food. Warfare also increased in importance, reflecting increased competition for land and other resources. In this period, fortified pā became more common, although there is debate about the actual frequency of warfare. As elsewhere in the Pacific, cannibalism was part of warfare.
Leadership was based on a system of chieftainship, which was often but not always hereditary, although chiefs (male or female) needed to demonstrate leadership abilities to avoid being superseded by more dynamic individuals. The most important units of pre-European Māori society were the whānau or extended family, and the hapū or group of whānau. After these came the iwi or tribe, consisting of groups of hapū. Related hapū would often trade goods and co-operate on major projects, but conflict between hapū was also relatively common. Traditional Māori society preserved history orally through narratives, songs, and chants; skilled experts could recite the tribal genealogies ("whakapapa") back for hundreds of years. Arts included whaikōrero (oratory), song composition in multiple genres, dance forms including haka, as well as weaving, highly developed wood carving, and tā moko (tattoo).

New Zealand has no native land mammals (apart from some rare bats) so birds, fish and sea mammals were important sources of protein. Māori cultivated food plants which they had brought with them from Polynesia, including sweet potatoes (called kūmara), taro, gourds, and yams. They also cultivated the cabbage tree, a plant endemic to New Zealand, and exploited wild foods such as fern root, which provided a starchy paste.

The first Europeans known to reach New Zealand were the crew of Dutch explorer Abel Tasman who arrived in his ships "Heemskerck" and "Zeehaen". Tasman anchored at the northern end of the South Island in Golden Bay (he named it Murderers' Bay) in December 1642 and sailed northward to Tonga following an attack by local Māori. Tasman sketched sections of the two main islands' west coasts. Tasman called them "Staten Landt", after the "States General of the Netherlands", and that name appeared on his first maps of the country. In 1645 Dutch cartographers changed the name to "Nova Zeelandia" in Latin, from "Nieuw Zeeland", after the Dutch province of "Zeeland". It was subsequently anglicised as "New Zealand" by British naval captain James Cook of HM Bark "Endeavour" who visited the islands more than 100 years after Tasman during 1769–1770. Cook returned to New Zealand on both of his subsequent voyages.

Various claims have been made that New Zealand was reached by other non-Polynesian voyagers before Tasman, but these are not widely accepted. Peter Trickett, for example, argues in "Beyond Capricorn" that the Portuguese explorer Cristóvão de Mendonça reached New Zealand in the 1520s, and the Tamil bell discovered by missionary William Colenso has given rise to a number of theories, but historians generally believe the bell 'is not in itself proof of early Tamil contact with New Zealand'.

From the 1790s, the waters around New Zealand were visited by British, French and American whaling, sealing and trading ships. Their crews traded European goods, including guns and metal tools, for Māori food, water, wood, flax and sex. Māori were reputed to be enthusiastic and canny traders, even though the levels of technology, institutions and property rights differed greatly from the standards in European societies. Although there were some conflicts, such as the killing of French explorer Marc-Joseph Marion du Fresne in 1772 and the destruction of the "Boyd" in 1809, most contact between Māori and European was peaceful.

European (Pākehā) settlement increased through the early decades of the 19th century, with numerous trading stations established, especially in the North Island. Christianity was introduced to New Zealand in 1814 by Samuel Marsden, who travelled to the Bay of Islands where he founded a mission station on behalf of the Church of England's Church Missionary Society. By 1840 over 20 stations had been established. From missionaries, the Māori learnt not just about Christianity but also about European farming practices and trades, and how to read and write. Beginning in 1820, linguist Samuel Lee worked with Māori chief Hongi Hika to transcribe the Māori language into written form.

The first full-blooded European infant in the territory, Thomas Holloway King, was born on 21 Feb 1815 at the Oihi Mission Station near Hohi Bay in the Bay of Islands. Kerikeri, founded in 1822, and Bluff founded in 1823, both claim to be the oldest European settlements in New Zealand. Many European settlers bought land from Māori, but misunderstanding and different concepts of land ownership led to conflict and bitterness. In 1839, the New Zealand Company announced plans to buy large tracts of land and establish colonies in New Zealand. This alarmed the missionaries, who called for British control of European settlers in New Zealand.

The effect of contact on Māori varied. In some inland areas life went on more or less unchanged, although a European metal tool such as a fish-hook or hand axe might be acquired through trade with other tribes. At the other end of the scale, tribes that frequently encountered Europeans, such as Ngāpuhi in Northland, underwent major changes.

Pre-European Māori had no distance weapons except for tao (spears) and the introduction of the musket had an enormous impact on Māori warfare. Tribes with muskets would attack tribes without them, killing or enslaving many. As a result, guns became very valuable and Māori would trade huge quantities of goods for a single musket. From 1805 to 1843 the Musket Wars raged until a new balance of power was achieved after most tribes had acquired muskets. In 1835, the peaceful Moriori of the Chatham Islands were attacked, enslaved, and nearly exterminated by mainland Ngāti Mutunga and Ngāti Tama Māori. In the 1901 census, only 35 Moriori were recorded although the numbers subsequently increased.

Around this time, many Māori converted to Christianity. The reasons for this have been hotly debated, and may include social and cultural disruption caused by the Musket Wars and European contact. Other factors may have been the appeal of a religion that promotes peace and forgiveness, a desire to emulate the Europeans and to gain a similar abundance of material goods, and the Māori's polytheistic culture that easily accepted the new God.

In 1788 the Colony of New South Wales had been founded. According to the future Governor, Captain Arthur Phillip's amended Commission, dated 25 April 1787 the colony of New South Wales included "all the islands adjacent in the Pacific Ocean within the latitudes of 10°37'S and 43°39'S" which included most of New Zealand except for the southern half of the South Island. In 1825 with Van Diemen's Land becoming a separate colony, the southern boundary of New South Wales was altered to the islands adjacent in the Pacific Ocean with a southern boundary of 39°12'S which included only the northern half of the North Island. However, these boundaries had no real impact as the New South Wales administration had little interest in New Zealand.

New Zealand was first mentioned in British statute in the Murders Abroad Act 1817. It made it easier for a court to punish "murders or manslaughters committed in places not within His Majesty's dominions", and the Governor of New South Wales was given increased legal authority over New Zealand. The jurisdiction of the Supreme Court of New South Wales over New Zealand was initiated in the New South Wales Act 1823, and lesser offences were included at that time. In response to complaints from missionaries, about lawless sailors and adventurers in New Zealand, the British government appointed James Busby as Official Resident in 1832. In 1834 he encouraged Māori chiefs to assert their sovereignty with the signing of the "Declaration of Independence" in 1835. This was acknowledged by King William IV. Busby was provided with neither legal authority nor military support and was thus ineffective in controlling the European population.

In 1839, the New Zealand Company announced its plans to establish colonies in New Zealand. This and the increased commercial interests of merchants in Sydney and London spurred the British to take stronger action. Captain William Hobson was sent to New Zealand to persuade Māori to cede their sovereignty to the British Crown. In reaction to the New Zealand Company's moves, on 15 June 1839 new Letters Patent were issued to expand the territory of New South Wales to include all of New Zealand. Governor of New South Wales George Gipps was appointed Governor over New Zealand. This was the first clear expression of British intent to annex New Zealand.

On 6 February 1840, Hobson and about forty Māori chiefs signed the Treaty of Waitangi at Waitangi in the Bay of Islands. Copies of the Treaty were subsequently taken around the country to be signed by other chiefs. A significant number refused to sign or were not asked but, in total, more than five hundred Māori eventually signed.

The Treaty gave Māori sovereignty over their lands and possessions and all of the rights of British citizens. What it gave the British in return depends on the language-version of the Treaty that is referred to. The English version can be said to give the British Crown sovereignty over New Zealand but in the Māori version the Crown receives "kawanatanga", which, arguably, is a lesser power (see interpretations of the Treaty). Dispute over the true meaning and the intent of either party remains an issue.

Britain was motivated by the desire to forestall other European powers (France established a very small settlement at Akaroa in the South Island later in 1840), to facilitate settlement by British subjects and, possibly, to end the lawlessness of European (predominantly British and American) whalers, sealers and traders. Officials and missionaries had their own positions and reputations to protect.

Māori chiefs were motivated by a desire for protection from foreign powers, the establishment of governorship over European settlers and traders in New Zealand, and to allow for wider settlement that would increase trade and prosperity for Māori.

Hobson died on 10 September 1842. Robert FitzRoy, the new governor, took some legal steps to recognise Māori custom. However, his successor, George Grey, promoted rapid cultural assimilation and reduction of the land ownership, influence and rights of the Māori. The practical effect of the Treaty was, in the beginning, only gradually felt, especially in predominantly Māori regions.

At first New Zealand was administered from Australia as part of the colony of New South Wales. On 1 July 1841 New Zealand became a colony in its own right.
Settlement continued under British plans, inspired by a vision of New Zealand as a new land of opportunity. The Church of England sponsored the Canterbury Association colony with assisted passages from Great Britain in the early 1850s. As a result of the influx of settlers, the Pākehā population grew explosively from fewer than 1000 in 1831 to 500,000 by 1881. Some 400,000 settlers came from Britain, of whom 300,000 stayed permanently. Most were young people and 250,000 babies were born. The passage of 120,000 was paid by the colonial government. After 1880 immigration reduced, and growth was due chiefly to the excess of births over deaths.

In 1846, the British Parliament drafted elaborate plans for a form of self-government for the 13,000 settlers in New Zealand. The new Governor, George Grey, suspended the plans. He argued that the Pākehā could not be trusted to pass laws that would protect the interests of the Māori majority — already there had been Treaty violations — and persuaded his political superiors to postpone its introduction for five years.

British writer Edward Gibbon Wakefield (1796–1862) exerted a far-reaching influence. His plans for systematic British colonisation focused on a free labour system, in contrast to the slavery in the United States and the convict labour in Australia. Inspired by evangelical Christianity and abolitionism, Wakefield's essays (1829 to 1849), condemned both slavery and indentured and convict labour as immoral, unjust, and inefficient. Instead, he proposed a government sponsored system in which the price of farm land was set at a high enough level to prevent urban workers from easily purchasing it and thus leaving the labour market. His colonisation programmes were over-elaborate and operated on a much smaller scale than he hoped for, but his ideas influenced law and culture, especially his vision for the colony as the embodiment of post-Enlightenment ideals, the notion of New Zealand as a model society, and the sense of fairness in employer-employee relations.

In response to increased petitioning for self-governance from the growing number of British settlers, the British Parliament passed the New Zealand Constitution Act 1852, setting up a central government with an elected General Assembly (Parliament) and six provincial governments. The General Assembly did not meet until 24 May 1854, 16 months after the Constitution Act had come into force. Provinces were reorganised in 1846 and in 1853, when they acquired their own legislatures, and then abolished with effect in 1877. The settlers soon won the right to responsible government (with an executive supported by a majority in the elected assembly). But the governor, and through him the Colonial Office in London, retained control of native policy until the mid-1860s.

The Māori tribes at first sold the land to the settlers, but the government voided the sales in 1840. Now only the government was allowed to purchase land from Māori, who received cash. The government bought practically all the useful land, then resold it to the New Zealand Company, which promoted immigration, or leased it for sheep runs. The Company resold the best tracts to British settlers; its profits were used to pay the travel of the immigrants from Britain.

Because of the vast distances involved, the first settlers were self-sufficient farmers. By the 1840s, however, large scale sheep stations were exporting large quantities of wool to the textile mills of England. Most of the early settlers were brought over by a programme operated by the New Zealand Company and were located in the central region on either side of Cook Strait, and at Wellington, Wanganui, New Plymouth and Nelson. These settlements had access to some of the richest plains in the country and after refrigerated ships appeared in 1882, they developed into closely settled regions of small-scale farming. Outside these compact settlements were the sheep runs. Pioneer pastoralists, often men with experience as squatters in Australia, leased lands from the government at the annual rate of £5 plus £1 for each 1,000 sheep above the first 5,000. The leases were renewed automatically, which gave the wealthy pastoralists a strong landed interest and made them a powerful political force. In all between 1856 and 1876, 8.1 million acres were sold for £7.6 million, and 2.2 million acres were given free to soldiers, sailors and settlers. With an economy based on agriculture, the landscape was transformed from forest to farmland.

Gold discoveries in Otago (1861) and Westland (1865), caused a worldwide gold rush that more than doubled the population in a short period, from 71,000 in 1859 to 164,000 in 1863. The value of trade increased fivefold from £2 million to £10 million. As the gold boom ended Premier Julius Vogel borrowed money from British investors and launched in 1870 an ambitious programme of public works and infrastructure investment, together with a policy of assisted immigration. Successive governments expanded the program with offices across Britain that enticed settlers and gave them and their families one-way tickets.

From about 1865, the economy lapsed into a long depression as a result of the withdrawal of British troops, peaking of gold production in 1866 and Vogel's borrowing and the associated debt burden (especially on land). Despite a brief boom in wheat, prices for farm products sagged. The market for land seized up. Hard times led to urban unemployment and sweated labour (exploitative labour conditions) in industry. The country lost people through emigration, mostly to Australia.

In 1870 Julius Vogel introduced his "grand go-ahead policy" to dispel the slump with increased immigration and overseas borrowning to fund new railways, roads and telegraph lines. Local banks — notably the Bank of New Zealand and the Colonial Bank — were "reckless" and permitted "a frenzy of private borrowing".

Although norms of masculinity were dominant, strong minded women originated a feminist movement starting in the 1860s, well before women gained the right to vote in 1893. Middle class women employed the media (especially newspapers) to communicate with each other and define their priorities. Prominent feminist writers included Mary Taylor, Mary Colclough (pseud. Polly Plum), and Ellen Ellis. The first signs of a politicised collective female identity came in crusades to pass the Contagious Diseases Prevention Act.

Feminists by the 1880s were using the rhetoric of "white slavery" to reveal men's sexual and social oppression of women. By demanding that men take responsibility for the right of women to walk the streets in safety, New Zealand feminists deployed the rhetoric of white slavery to argue for women's sexual and social freedom. Middle class women successfully mobilised to stop prostitution, especially during the First World War.

Māori women developed their own form of feminism, derived from Māori nationalism rather than European sources.

In 1893 Elizabeth Yates was elected mayor of Onehunga, making her the first woman in the British Empire to hold the office. She was an able administrator: she cut the debt, reorganised the fire brigade, and improved the roads and sanitation. Many men were hostile however, and she was defeated for re-election. Hutching argues that after 1890 women were increasingly well organised through the National Council of Women, the Women's Christian Temperance Union, the Women's International League, and others. By 1910 they were campaigning for peace, and against compulsory military training, and conscription. They demanded arbitration and the peaceful resolution of international disputes. The women argued that womenhood (thanks to motherhood) was the repository of superior moral values and concerns and from their domestic experience they knew best how to resolve conflicts.

Prior to 1877 schools were operated by the provincial government, churches, or by private subscription. Education was not a requirement and many children did not attend any school, especially farm children whose labour was important to the family economy. The quality of education provided varied substantially depending on the school. The Education Act of 1877 created New Zealand's first free national system of primary education, establishing standards that educators should meet, and making education compulsory for children aged 5 to 15.

From 1840 there was considerable European settlement, primarily from England and Wales, Scotland and Ireland; and to a lesser extent the United States, India, China, and various parts of continental Europe, including the province of Dalmatia in what is now Croatia, and Bohemia in what is now the Czech Republic. Already a majority of the population by 1859, the number of Pākehā settlers increased rapidly to reach over one million by 1916.

In the 1870s and 1880s, several thousand Chinese men, mostly from Guangdong, migrated to New Zealand to work on the South Island goldfields. Although the first Chinese migrants had been invited by the Otago Provincial government they quickly became the target of hostility from white settlers and laws were enacted specifically to discourage them from coming to New Zealand.

Māori had welcomed Pākehā for the trading opportunities and guns they brought. However it soon became clear that they had underestimated the number of settlers that would arrive in their lands. "Iwi" (tribes) whose land was the base of the main settlements quickly lost much of their land and autonomy through government acts. Others prospered – until about 1860 the city of Auckland bought most of its food from Māori who grew and sold it themselves. Many "iwi" owned flour mills, ships and other items of European technology, some exported food to Australia for a brief period during the 1850s gold rush. Although race relations were generally peaceful in this period, there were conflicts over who had ultimate power in particular areas – the Governor or the Māori chiefs. One such conflict was the Northern or Flagstaff War of the 1840s, during which Kororareka was sacked.

As the Pākehā population grew, pressure grew on Māori to sell more land. Land is not only an economic resource, but also one basis of Māori identity and a connection with their ancestor's bones. Land was used communally, but under the mana of chiefs. In Māori culture there was no such idea as selling land until the arrival of Europeans. The means of acquiring land was to defeat another hapu or iwi in battle and seize their land. Te Rauparaha seized the land of many lower North Island and upper South Island iwi during the musket wars. Land was usually not given up without discussion and consultation. When an iwi was divided over the question of selling this could lead to great difficulties as at Waitara.

Pākehā had little understanding of all that and accused Māori of holding onto land they did not use efficiently. Competition for land was one important cause of the New Zealand Wars of the 1860s and 1870s, in which the Taranaki and Waikato regions were invaded by colonial troops and Māori of these regions had some of their land taken from them. The wars and confiscation left bitterness that remains to this day. After the conclusion of the Land Wars some iwi, especially in the Waikato, such as Ngati Haua sold land freely. However, only the chiefs and their whanau benefited from this income. The 2013 Ngati Haua treaty settlement recognised that many Ngati Haua had not received any benefit from the large payments in the 1870s hence the government was paying compensation.

Some iwi sided with the government and, later, fought with the government. They were motivated partly by the thought that an alliance with the government would benefit them, and partly by old feuds with the iwi they fought against. One result of their co-operation strategy was the establishment of the four Māori electorates in the House of Representatives, in 1867.

After the wars, some Māori began a strategy of passive resistance, most famously at Parihaka in Taranaki. Most, such as NgaPuhi and Arawa continued co-operating with Pākehā. For example, tourism ventures were established by Te Arawa around Rotorua. Resisting and co-operating iwi both found that Pākehā desire for land remained. In the last decades of the century, most iwi lost substantial amounts of land through the activities of the Native Land Court. This was set up to give Māori land European-style titles and to establish exactly who owned it. Due to its Eurocentric rules, the high fees, its location remote from the lands in question, and unfair practices by some Pākehā land agents, its main effect was to allow Māori to sell their land without restraint from other tribal members.

The combination of war, confiscations, disease, assimilation and intermarriage, land loss leading to poor housing and alcohol abuse, and general disillusionment, caused a fall in the Māori population from around 86,000 in 1769 to around 70,000 in 1840 and around 48,000 by 1874, hitting a low point of 42,000 in 1896. Subsequently, their numbers began to recover.

While the North Island was convulsed by the Land Wars, the South Island, with its smaller Māori population, was generally peaceful. In 1861 gold was discovered at Gabriel's Gully in Central Otago, sparking a gold rush. Dunedin became the wealthiest city in the country and many in the South Island resented financing the North Island's wars. In 1865 Parliament defeated a proposal to make the South Island independent by 17 to 31.

The South Island was home to most of the Pākehā population until around 1911 when the North Island again took the lead, and has supported an ever-greater majority of the country's total population through the 20th century and into the 21st.

Scottish immigrants dominated the South Island and evolved ways to bridge the old homeland and the new. Many local Caledonian societies were formed. They organised sports teams to entice the young and preserved an idealised Scottish national myth (based on Robert Burns) for the elderly. They gave Scots a path to assimilation and cultural integration as Scottish New Zealanders.

The pre-war era saw the advent of party politics, with the establishment of the Liberal Government. The landed gentry and aristocracy ruled Britain at this time. New Zealand never had an aristocracy but it did have wealthy landowners who largely controlled politics before 1891. The Liberal Party set out to change that by a policy it called "populism." Richard Seddon had proclaimed the goal as early as 1884: "It is the rich and the poor; it is the wealthy and the landowners against the middle and labouring classes. That, Sir, shows the real political position of New Zealand." The Liberal strategy was to create a large class of small land-owning farmers who supported Liberal ideals.

To obtain land for farmers the Liberal government from 1891 to 1911 purchased 3.1 million acres of Māori land. The government also purchased 1.3 million acres from large estate holders for subdivision and closer settlement by small farmers. The Advances to Settlers Act of 1894 provided low-interest mortgages, while the Agriculture Department disseminated information on the best farming methods.

The 1909 Native Land Act allowed the Māori to sell land to private buyers. Māori still owned five million acres by 1920; they leased three million acres and used one million acres for themselves. The Liberals proclaimed success in forging an egalitarian, antimonopoly land policy. The policy built up support for the Liberal party in rural North Island electorates. By 1903 the Liberals were so dominant that there was no longer an organised opposition in Parliament.

The Liberal government laid the foundations of the later comprehensive welfare state: introducing old age pensions; maximum hour regulations; pioneering minimum wage laws; and developing a system for settling industrial disputes, which was accepted by both employers and trade unions. In 1893 it extended voting rights to women, making New Zealand the first country in the world to enact universal female suffrage.

New Zealand gained international attention for its reforms, especially how the state regulated labour relations. The impact was especially strong on the reform movement in the United States.

Coleman argues that the Liberals in 1891 lacked a clear-cut ideology to guide them. Instead they approached the nation's problems pragmatically, keeping in mind the constraints imposed by democratic public opinion. To deal with the issue of land distribution, they worked out innovative solutions to access, tenure, and a graduated tax on unimproved values.

In the 1870s Julius Vogel's "grand go-ahead policy" of borrowing overseas had increased the public debt from £7.8 million in 1870 to £18.6 million in 1876, but had constructed many miles of railways, roads and telegraph lines and attracted many new migrants.

In the 1880s, New Zealand's economy grew from one based on wool and local trade to the export of wool, cheese, butter and frozen beef and mutton to Britain. The change was enabled by the invention of refrigerated steamships in 1882 and a result of the large market demands overseas. In order to increase production, alongside a more intensive use of factor inputs a transformation of production techniques was necessary. The required capital came mainly from outside of New Zealand. Refrigerated shipping remained the basis of New Zealand's economy until the 1970s. New Zealand's highly productive agriculture gave it probably the world's highest standard of living, with fewer at the rich and poor ends of the scale.

During this era () the banking system was weak and there was little foreign investment, so businessmen had to build up their own capital. Historians have debated whether the "long depression" of the late 19th century stifled investment, but the New Zealanders found a way around adverse conditions. Hunter has studied the experiences of 133 entrepreneurs who started commercial enterprises between 1880 and 1910. The successful strategy was to deploy capital economising techniques, and reinvesting profits rather than borrowing. The result was slow but stable growth that avoided bubbles and led to long-lived family owned firms.

New Zealand initially expressed interest in joining the proposed Federation of the Australian colonies, attending the 1891 National Australia Convention in Sydney. Interest in the proposed Australian Federation faded and New Zealand decided against joining the Commonwealth of Australia in 1901. New Zealand instead changed from being a colony to a separate "Dominion" in 1907, equal in status to Australia and Canada. Dominion status was a public mark of the self-governance that had evolved over half a century through responsible government. Just under one million people lived in New Zealand in 1907 and cities such as Auckland and Wellington were growing rapidly.

In New Zealand, prohibition was a moralistic reform movement begun in the mid-1880s by the Protestant evangelical and Nonconformist churches and the Woman's Christian Temperance Union and after 1890 by the Prohibition League. It never achieved its goal of national prohibition. It was a middle-class movement which accepted the existing economic and social order; the effort to legislate morality assumed that individual redemption was all that was needed to carry the colony forward from a pioneering society to a more mature one. However, both the Church of England and the largely Irish Catholic Church rejected prohibition as an intrusion of government into the church's domain, while the growing labour movement saw capitalism rather than alcohol as the enemy. Reformers hoped that the women's vote, in which New Zealand was a pioneer, would swing the balance, but the women were not as well organised as in other countries. Prohibition had a majority in a national referendum in 1911, but needed a 60% majority to pass. The movement kept trying in the 1920s, losing three more referenda by close votes; it managed to keep in place a 6 pm closing hour for pubs and Sunday closing (leading to the so-called six o'clock swill). The Depression and war years effectively ended the movement.

The country remained an enthusiastic member of the British Empire. 4 August is the date the outbreak of World War I is marked in New Zealand. During the war, more than 120,000 New Zealanders enlisted to the New Zealand Expeditionary Force, and around 100,000 served overseas; 18,000 died and about 41,000 men were listed as wounded. Conscription had been in force since 1909, and while it was opposed in peacetime there was less opposition during the war. The labour movement was pacifistic, opposed the war, and alleged that the rich were benefitting at the expense of the workers. It formed the New Zealand Labour Party in 1916. Māori tribes that had been close to the government sent their young men to volunteer. Unlike in Britain, relatively few women became involved. Women did serve as nurses; 640 joined the services and 500 went overseas.

New Zealand forces captured Western Samoa from Germany in the early stages of the war, and New Zealand administered the country until Samoan Independence in 1962. However Samoans greatly resented the imperialism, and blamed inflation and the catastrophic 1918 flu epidemic on New Zealand rule.

More than 2700 men died in the Gallipoli Campaign. The heroism of the soldiers in the failed campaign made their sacrifices iconic in New Zealand memory, and is often credited with securing the psychological independence of the nation.

After the war New Zealand signed the Treaty of Versailles (1919), joined the League of Nations and pursued an independent foreign policy, while its defence was still controlled by Britain. New Zealand depended on Britain's Royal Navy for its military security during the 1920s and 1930s. Officials in Wellington trusted Conservative Party governments in London, but not Labour. When the British Labour Party took power in 1924 and 1929, the New Zealand government felt threatened by Labour's foreign policy because of its reliance upon the League of Nations. The League was distrusted and Wellington did not expect to see the coming of a peaceful world order under League auspices. What had been the Empire's most loyal dominion became a dissenter as it opposed efforts the first and second British Labour governments to trust the League's framework of arbitration and collective security agreements.

The governments of the Reform and United parties between 1912 and 1935 followed a "realistic" foreign policy. They made national security a high priority, were sceptical of international institutions, and showed no interest on the questions of self-determination, democracy, and human rights. However the opposition Labour Party was more idealistic and proposed a liberal internationalist outlook on international affairs.

The Labour Party emerged as a force in 1919 with a socialist platform. It won about 25% of the vote. However its appeals to working class solidarity were not effective because a large fraction of the working class voted for conservative candidates of the Liberal and Reform parties. (They merged in 1936 to form the New Zealand National Party.) As a consequence the Labour party was able to jettison its support for socialism in 1927 (a policy made official in 1951), as it expanded its reach into middle class constituencies. The result was a jump in strength to 35% in 1931, 47% in 1935, and peaking at 56% in 1938. From 1935 the First Labour Government showed a limited degree of idealism in foreign policy, for example opposing the appeasement of Germany and Japan.

Like most other countries, New Zealand was hard hit by the Great Depression of the 1930s, which affected the country via its international trade, with farming export drops then going on to affect the money supply and in turn consumption, investment and imports. The country was most affected around 1930–1932, when average farm incomes for a short time dipped below zero, and the unemployment rates peaked. Though actual unemployment numbers were not officially counted, the country was affected especially strongly in the North Island.

Unlike later years, there were no public benefit ('dole') payments – the unemployed were given'relief work', much of which was however not very productive, partly because the size of the problem was unprecedented. Women also increasingly registered as unemployed, while Māori received government help through other channels such as the land development schemes organised by Āpirana Ngata. In 1933, 8.5% of the unemployed were organised in work camps, while the rest received work close to their homes. Typical occupations in relief work were road work (undertaken by 45% of all part-time and 19% of all full-time relief workers in 1934, with park improvement works (17%) and farm work (31%) being the other two most common types of work for part-time and full-time relief workers respectively).

Attempts by the United-Reform Coalition to deal with the situation with spending cuts and relief work were ineffective and unpopular. In 1935, the First Labour Government was elected, and the post-depression decade showed that average Labour support in New Zealand had roughly doubled comparable to pre-depression times. By 1935 economic conditions had improved somewhat, and the new government had more positive financial conditions. Prime Minister Michael Joseph Savage proclaimed that: "Social Justice must be the guiding principle and economic organization must adapt itself to social needs."

The new government quickly set about implementing a number of significant reforms, including a reorganisation of the social welfare system and the creation of the state housing scheme. Labour also gained Māori votes by working closely with the Rātana movement. Savage was idolised by the working classes, and his portrait hung on the walls of many houses around the country. The newly created welfare state promised government support to individuals "from the cradle to the grave", according to the Labour slogan. It included free health care and education, and state assistance for the elderly, infirm, and unemployed. The opposition attacked the Labour Party's more left-wing policies, and accused it of undermining free enterprise and hard work. The Reform Party and the United Party merged to become the National Party, and would be Labour's main rival in future years. However the welfare state system was retained and expanded by successive National and Labour governments until the 1980s.

In foreign policy, the Labour Party in power after 1935 disliked the Versailles Treaty of 1919 as too harsh on Germany, opposed militarism and arms buildups, distrusted the political conservatism of the National Government in Britain, sympathized with the Soviet Union, and increasingly worried about threats from Japan. It denounced Italy's role in Ethiopia and sympathized with the republican forces in the Spanish Civil War. Those policies favoured the left but it also was pro-German. It consistently advocated negotiations with Nazi Germany, signed a trade agreement with it, welcomed the Munich agreement of 1938 regarding the division of Czechoslovakia, discouraged public criticism of the Nazi regime, and pursued a slow rearmament programme. When World War II broke out in September 1939, it recommended to London a negotiated peace with Berlin; however after the fall of France in the spring of 1940, it did support the British war effort militarily and economically.

When war broke out in 1939, New Zealanders saw their proper role as defending their proud place in the British Empire. It contributed some 120,000 troops. They mostly fought in North Africa, Greece/Crete, and Italy, relying on the Royal Navy and later the United States to protect New Zealand from the Japanese forces. Japan had no interest in New Zealand in the first place; it had already over-reached when it invaded New Guinea in 1942. (There were a few highly publicised but ineffective Japanese scouting incursions.) The 3rd New Zealand Division fought in the Solomons in 1943–44, but New Zealand's limited manpower meant 2 Divisions could not be maintained, and it was disbanded and its men returned to civilian life or used to reinforce the 2nd Division in Italy. The armed forces peaked at 157,000 in September 1942; 135,000 served abroad, and 10,100 died.
New Zealand, with a population of 1.7 million, including 99,000 Māori, was highly mobilised during the war. The Labour party was in power and promoted unionisation and the welfare state. Agriculture expanded, sending record supplies of meat, butter and wool to Britain. When American forces arrived, they were fed as well.

The nation spent £574 million on the war, of which 43% came from taxes, 41% from loans and 16% from American Lend Lease. It was an era of prosperity as the national income soared from £158 million in 1937 to £292 million in 1944. Rationing and price controls kept inflation to only 14% during 1939–45.

Over £50 million was spent on defence works and military accommodation and hospitals, including of roads.

Montgomerie shows that the war dramatically increased the roles of women, especially married women, in the labour force. Most of them took traditional female jobs. Some replaced men but the changes here were temporary and reversed in 1945. After the war, women left traditional male occupations and many women gave up paid employment to return home. There was no radical change in gender roles but the war intensified occupational trends under way since the 1920s.

Labour remained in power after the Second World War and in 1945, Labour Prime Minister Peter Fraser played an important role in the establishment of the United Nations, of which New Zealand was a founding member. However, domestically Labour had lost the reforming zeal of the 1930s and its electoral support ebbed after the war. After Labour lost power in 1949, the conservative National Party began an almost continuous thirty-year stint in government, interrupted by single-term Labour governments in 1957 to 60 and 1972 to 75. National Prime Minister Sidney Holland called a snap election as a result of the 1951 waterfront dispute, an incident that reinforced National's dominance and severely weakened the union movement.

Cooperation with the United States set a direction of policy which resulted in the ANZUS Treaty between New Zealand, America and Australia in 1951, as well as participation in the Korean War.

Fedorowich and Bridge argue that the demands of the Second World War produced long-term consequences for New Zealand's relationship with the government in London. The key component was the office of the high commissioner. By 1950 it was the main line of communications between the British and New Zealand governments.

1950s New Zealand culture was deeply British and conservative, with the concept of "fairness" holding a central role. New immigrants, still mainly British, flooded in while New Zealand remained prosperous by exporting farm products to Britain. In 1953 New Zealanders took pride that a countryman, Edmund Hillary, gave Queen Elizabeth II a coronation gift by reaching the summit of Mount Everest.

From the 1890s, the economy had been based almost entirely on the export of frozen meat and dairy products to Britain, and in 1961, the share of New Zealand exports going to the United Kingdom was still at slightly over 51%, with approximately 15% going to other European countries. The 1960s was a decade of rising prosperity for most New Zealanders, but from 1965 there were also protests – in support of women's rights and the nascent ecological movement, and against the Vietnam War. Irrespective of political developments, many New Zealanders still perceived themselves as a distinctive outlying branch of the United Kingdom until at least the 1970s. In 1973 Britain joined the European Community and abrogated its preferential trade agreements with New Zealand (see below), forcing New Zealand to not only find new markets, but also re-examine its national identity and place in the world.

Māori always had a high birth rate; that was neutralised by a high death rate until modern public health measures became effective in the 20th century when tuberculosis deaths and infant mortality declined sharply. Life expectancy grew from 49 years in 1926 to 60 years in 1961 and the total numbers grew rapidly. Many Māori served in the Second World War and learned how to cope in the modern urban world; others moved from their rural homes to the cities to take up jobs vacated by Pākehā servicemen. The shift to the cities was also caused by their strong birth rates in the early 20th century, with the existing rural farms in Māori ownership having increasing difficulty in providing enough jobs. Māori culture had meanwhile undergone a renaissance thanks in part to politician Āpirana Ngata. By the 1980s 80% of the Māori population was urban, in contrast to only 20% before the Second World War. The migration led to better pay, higher standards of living and longer schooling, but also exposed problems of racism and discrimination. By the late 1960s a protest movement had emerged to combat racism, promote Māori culture and seek fulfilment of the Treaty of Waitangi.

Urbanisation proceeded rapidly across the land. In the late 1940s, town planners noted that the country was "possibly the third most urbanised country in the world", with two-thirds of the population living in cities or towns. There was also increasing concern that this trend was badly managed, with it being noted that there was an "ill-defined urban pattern that appears to have few of the truly desirable urban qualities and yet manifests no compensating rural characteristics."

The country's economy suffered in the aftermath of the 1973 global energy crisis, the loss of New Zealand's biggest export market upon Britain's entry to the European Economic Community, and rampant inflation. Robert Muldoon, Prime Minister from 1975 to 1984, and his Third National Government responded to the crises of the 1970s by attempting to preserve the New Zealand of the 1950s. He attempted to maintain New Zealand's "cradle to the grave" welfare state, which dated to 1935. His government sought to give retirees 80% of the current wage, which would require large-scale borrowing; critics said it would bankrupt the treasury. Muldoon's response to the crisis also involved imposing a total freeze on wages, prices, interest rates and dividends across the national economy.

Muldoon's conservatism and antagonistic style exacerbated an atmosphere of conflict in New Zealand, most violently expressed during the 1981 Springbok Tour. In the 1984 elections Labour promised to calm down the increasing tensions, while making no specific promises; it scored a landslide victory.

However, Muldoon's government was not entirely backward looking. Some innovations did take place, for example the Closer Economic Relations (CER) free-trade programme with Australia to liberalise trade, starting in 1982. The aim of total free trade between the two countries was achieved in 1990, five years ahead of schedule.

In 1984, the Fourth Labour Government, led by David Lange, was elected amid a constitutional and economic crisis. The crisis led the incoming government to review New Zealand's constitutional structures, which resulted in the Constitution Act 1986. In power from 1984 to 1990, the Labour government launched a major policy of restructuring the economy, radically reducing the role of government. A political scientist reports:
"Between 1984 and 1993, New Zealand underwent radical economic reform, moving from what had probably been the most protected, regulated and state-dominated system of any capitalist democracy to an extreme position at the open, competitive, free-market end of the spectrum."
The economic reforms were led by finance minister Roger Douglas (1984–1988). Dubbed Rogernomics, it was a rapid programme of deregulation and public-asset sales. Subsidies were phased out to farmers and consumers. High finance was partly deregulated. Restrictions on foreign exchange were relaxed and the dollar was allowed to float and seek its natural level on the world market. The tax on high incomes was cut in half from 65% to 33%. The shares exchange entered a bubble, which then burst. Shares had a total value of $50 billion in 1987 and only $15 billion in 1991; at one point the crash was "the worst in world." Overall the economic growth fell from 2% a year to 1%. Douglas's reforms resembled the contemporaneous policies of Margaret Thatcher in Britain and Ronald Reagan in the United States.

Strong criticism of Rogernomics came from the left, especially from Labour's traditional trade union support-base; Lange broke with Douglas's policies in 1987; both men were forced out and Labour was in confusion.

In keeping with the mood of the 1980s the government sponsored liberal policies and initiatives in a number of social areas; this included Homosexual Law Reform, the introduction of 'no-fault divorce', reduction in the gender pay gap and the drafting of a Bill of Rights. Immigration policy was liberalised, allowing an influx of immigrants from Asia; previously most immigrants to New Zealand had been European and especially British.

The Fourth Labour Government also revolutionised New Zealand's foreign policy, making the country a nuclear-free zone and effectively leaving the ANZUS alliance. The French intelligence service's sinking of the "Rainbow Warror", and the diplomatic ramifications following the incident, did much to promote the anti-nuclear stance as an important symbol of New Zealand's national identity.

Voters unhappy with the rapid speed and far-reaching extent of reforms elected a National government in 1990, led by Jim Bolger. However the new government continued the economic reforms of the previous Labour government, in what was known as Ruthanasia. Unhappy with what seemed to be a pattern of governments failing to reflect the mood of the electorate, New Zealanders in 1992 and 1993 voted to change the electoral system to mixed-member proportional (MMP), a form of proportional representation. New Zealand's first MMP election was held in 1996. Following the election National was returned to power in coalition with the New Zealand First Party.

With the end of the Cold War in 1991, the nation's foreign policy turned increasingly to issues of its nuclear-free status and other military issues; its adjustment to neoliberalism in international trade relations; and its involvement in humanitarian, environmental, and other matters of international diplomacy.

In the 21st century, international tourism is a major contributor to the New Zealand economy, and the service sector more generally has grown. Meanwhile, the traditional agricultural exports of meat, dairy and wool have been supplemented by other products such as fruit, wine and timber as the economy has diversified.

The Fifth Labour Government led by Helen Clark was elected in 1999. In power for nine years, it maintained most of the previous governments' economic reforms – restricting government intervention in the economy much more so than previous governments – while putting more of an emphasis on social policy and outcomes. For example, employment law was modified to give more protection to workers, and the student loan system was changed to eliminate interest payments for New Zealand resident students and graduates.

New Zealand retains strong but informal links to Britain, with many young New Zealanders travelling to Britain for their "OE" (overseas experience) due to favourable working visa arrangements with Britain. Despite New Zealand's immigration liberalisation in the 1980s, Britons are still the largest group of migrants to New Zealand, due in part to recent immigration law changes which privilege fluent speakers of English. One constitutional link to Britain remains – New Zealand's head of State, the Queen in Right of New Zealand, is a British resident. However, British imperial honours were discontinued in 1996, the Governor-General has taken a more active role in representing New Zealand overseas, and appeals from the Court of Appeal to the Judicial Committee of the Privy Council were replaced by a local Supreme Court of New Zealand in 2003. There is public debate about whether New Zealand should became a republic, and public sentiment is divided on the issue.

Foreign policy has been essentially independent since the mid-1980s. Under Prime Minister Clark, foreign policy reflected the priorities of liberal internationalism. She stressed the promotion of democracy and human rights; the strengthening of the role of the United Nations; the advancement of anti-militarism and disarmament; and the encouragement of free trade. She sent troops to the War in Afghanistan, but did not contribute combat troops to the Iraq War although some medical and engineering units were sent.

John Key led the National Party to victory in the November 2008. Key became Prime Minister of the Fifth National Government which entered government at the beginning of the late-2000s recession. In February 2011, a major earthquake in Christchurch, the nation's second largest city, significantly impacted the national economy and the government formed the Canterbury Earthquake Recovery Authority in response. In foreign policy, Key announced the withdrawal of New Zealand Defence Force personnel from their deployment in the war in Afghanistan, signed the Wellington Declaration with the United States and has pushed for more nations to join the Trans-Pacific Strategic Economic Partnership.

A Labour-led coalition Government was formed in October 2017. Among other issues, it plans to tackle a burgeoning housing shortage crisis in New Zealand.