The 62-year-old nurse was named in the New York Times today with confirmation from the International Committee of the Red Cross.
It effectively ends a five-and-a-half year agreement by media around the world to not name her, or her nationality, because of concerns held by the New Zealand Government that she would be killed by her captors.
Now that Islamic State is crumbling, they believe it's the time for stronger action.
Akavi's fate and whereabouts are unknown. The Red Cross has reason to believe she is alive, because at least two people described seeing her in December at a clinic in Sousa, one of the final villages to be held by the Islamic State.
She was working for the Red Cross when taken hostage in Syria in October 2013 along with five other Red Cross workers and one Red Crescent.
Foreign Affairs Minister Winston Peters says the Government is working on the basis that Akavi is still alive.
He says they're working with the Red Cross to find and recover here, but it's been a uniquely complex and difficult case.
The Government's actions included basing a small, non-combat unit in Iraq.
Islamic State territory was wiped out with the fall of Baghouz last month, but security forces have not yet been able to find Akavi or get confirmation of whether she was still alive.
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For six years, a cone of silence has been used to try to protect her life, while held hostage.
Media across New Zealand held back - as did outlets around the world - after the family of Louisa Akavi received a chilling email from inside Islamic State.
Akavi's terrorist kidnappers told her Porirua family she would be killed if her 2013 capture was made public.
Her situation is all the worse because Akavi has dedicated her life to the needs of the world's most vulnerable. She set out as a young nurse in the mid-1980s, disenchanted with medical bureaucracy, wanting to ensure red tape didn't get in the way of helping people.
Over decades she has carried out humanitarian work in Malaysia, Somalia, Bosnia and Chechnya.
It was in Chechnya in December 1996 where Akavi survived a brush with death. Men armed with silenced weapons entered the hospital where she and other Red Cross health workers were sleeping.
It didn't stop her work, as she continued on to Ethiopia, Iraq, Afghanistan and many other refugee camps around the world.
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Family spokesman Tuaine Robati has filmed a one-time statement to the media.
He says they love Louisa, and want her home.
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Since her abduction, the Islamic State has asked for a ransom of up to $33 million.
The New York Times reports there were negotiations between the Red Cross and the terrorist group in the months after her capture, via text, phone calls and emails.
The Islamic State initially demanded a ransom of €1m (NZ$1.67m) and for the release of detained fighters. The ransom later rose to €20m euros (NZ$33m) before falling again to €5m (NZ$8.35m) - on par with other Western hostages.
The New Zealand Government has a policy of not paying for hostages.
The head of Red Cross' crisis management team for Avaki's case, John Dyer, says their organisation's policy was also not to pay any ransoms.
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Since then, keeping the secret of her capture has involved a lot of work from many people.
Some media found out Akavi's identity soon her capture in October 2013.
But by an extraordinary feat over the following years, the Government managed to ensure her name and nationality were kept out of the news.
Former Foreign Minister Murray McCully was personally involved in many of the dealings to keep Akavi's case out of the media over those years.
McCully met with the editors and senior managers of each outlet which had asked about Akavi. Several other hostages had been named, and McCully had to argue why Akavi should be different. If just one media outlet refused to abide by the request, the whole plan would collapse because others would then have to be told.
The silence was agreed to with an assurance that should Akavi be freed or it was found she had died, media would be told.
A reason for keeping her nationality a secret was because New Zealand is one of the Five Eyes partners so its citizens could be treated as targets.
It was explained to media outlets it was possible Akavi – who is a Cook Island New Zealander - had told her kidnappers she was from the Cook Islands rather than New Zealand and that revealing her nationality could put her in greater danger.
It was not only New Zealand media that officials had to deal with.
Australian media also got in touch early and, at various points, media in the US and the United Kingdom. They included the New York Times and the UK-based Sunday Times.
McCully says some of those international took a bit more convincing, because other hostages' names were in the media.
However, as time stretched on after the fall of Baghouz in March, with no information about whether Akavi was alive or dead, it got harder to persuade media to keep the secret.
Despite concern from New Zealand in case Akavi was still being held, the International Red Cross opted to go public.
The New York Times today ran a story on Akavi.
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That's the Front Page for today, Monday, April 15, making sure you're across the biggest news of the day. For more on these stories, check out the New Zealand Herald, or tune in to Newstalk ZB.
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