Pacific islands due to their geography and isolation, coupled with financial problems and lack of skilled staff, offer an ideal environment for development and implementation of telehealth applications. Currently there are three major telehealth projects running in Pacific. POLHN (Pacific Open Learning Health Network) is a successful tele-health initiative among 10 Pacific Island countries that has been supported by funding from Japanese government. Pacific Basin Telehealth Initiative is another major telehealth project running in US affiliated Pacific Islands funded by Office of Advancement of Telehealth (OAT) of US government. Pacific Public Health Surveillance Network (PPHSN) is the third major project which was created in 1996 under the joint auspices of South Pacific Council (SPC) and WHO. We have investigated the various activities of these projects and proposed Universal Service Fund coverage for these projects to reduce the running cost and self sustainability. Secondly to over human resource shortage, we have extended our cooperation in human resource development (HRD) in telehealth and have started training programs in telehealth through ITU, APT, NICT, Sasakawa Fund, and other private sectors in developed nations. We are inviting research teams in health care field, governments sectors in island, and other stakeholders in the region and providing them an opportunity to study more advanced telehealth at the ITU eHealth Expert Training Course in the Shonan Campus, Hiratsuka Japan. We have also reported the activities of WINDS satellite which is currently under joint development JAXA and NICT. In addition to establishing a domestic ultra high speed Internet network, the project also aims to construct ultra high speed international Internet access, especially with Asian Pacific countries and regions that are more closely related to Japan.