The government had not convened Parliament since the death of Finance Minister Lotoala Metia in December 2012; with Pitoi absent, it had only six active MPs to the Opposition's seven.
[6][7] He remained out of the country, reportedly recovering, in July 2013, when the government was ordered by Governor-General Sir Iakoba Italeli to reconvene Parliament and allow a motion of no confidence to be tabled.
[8] Following Prime Minister Telavi's removal by the Governor General on 1 August in the context of a political crisis (Telavi had sought to govern without the support of Parliament), Pitoi (still outside the country) and the rest of Cabinet were voted out of office a day later by Parliament, where the opposition now had a clear majority.
[9] Foreign Affairs Minister Taukelina Finikaso said in September 2013 that the Tuvaluan Parliament was looking at a possible by-election for Pitoi's seat following his long absence.
[10] In December 2013, Governor-General Iakoba Italeli declared a by-election for the Nanumaga constituency seat following a medical report on Dr Pitoi's health.