Lancet Countdown
New findings in the inaugural indicator report of the Lancet Countdown Small Island Developing States (SIDS) reveal the distinct and growing risks and impacts of climate change on the health of these communities. Small Island Developing States are bearing the brunt of climate impacts from rising emissions, with their survival at stake.
A collaborative effort involving 35 authors from the Pacific, Caribbean, Indian Ocean, Europe, the Americas, Oceania, and Asia, the report draws on data from the indicators of the 2023 and 2024 global Lancet Countdown reports to offer deeper insight into climate change-related impacts, mitigation, adaptation, economic capacity, and engagement specific to the 59 countries, states, and territories classified as UN member and associate-member SIDS.
Key Messages
Small island developing states bear the brunt of climate impacts
SIDS are disproportionately affected by the adverse health impacts of climate change, despite collectively low emissions. SIDS are experiencing rapidly growing risks and health impacts from heat stress, drought, vector-borne diseases, and food insecurity.
Small island developing state health systems are not climate-ready
This report reveals that health systems are not climate-ready, exacerbating the risk of climate change overwhelming health-care systems, especially given the increased risk for non-communicable diseases, infectious diseases, and mental health disorders associated with climate change.
Small islands continue to spearhead international policy engagement on climate change and health
Small island developing states, standing on the frontlines of the climate crisis, are championing action to protect health and humanity. Small island leaders are sounding the alarm, standing at the forefront in catalysing action, while the nations most responsible for this crisis linger and delay.
Explore key findings of this year’s report
On the frontline of health impacts, spearheading the call for action
HEALTH HAZARDS, EXPOSURES, AND IMPACTS
A changing climate has profound implications for human health, with more frequent heat waves and extreme weather events, changing patterns of infectious disease transmission, deterioration of food and water resources, impacts on socioeconomic conditions, and the exacerbation of existing health challenges around the world. Indicators in this section track the multiple ways in which climate change threatens human health and wellbeing.
Indicator 1.1.2: Exposure of Vulnerable Populations to Heatwaves
In 2023, a record average of 41 and 43 heatwave days were experienced by each infant and older adult, respectively, across SIDS. This exposure was 48 and 36 times as many heatwave days, as during 2000-2004.
Indicator 1.1.4: Change in Labour Capacity
4.4 billion work hours were lost across labour sectors from SIDS in 2023 due to heat exposure; 71% more potential labour hours (1.8 billion additional hours) than the annual average in 1991-2000.
Indicator 1.4.1: Food Insecurity
The higher frequency of heatwave days and drought months in 2022 compared to 1981–2010, was associated with 2·6 million additional people experiencing moderate or severe food insecurity.
ADAPTATION, PLANNING, AND RESILIENCE FOR HEALTH
With climate change increasingly threatening the health and wellbeing of populations in every country, actions to build resilience and adapt to climate change are urgently needed. This section tracks how communities, health systems, and governments are understanding the health risks of climate change, the strategies and resources they are deploying, and how adaptation and resilience measures are being implemented globally.
Indicator 2.2.1: Climate Information for Health
Only 45% of 42 SIDS reporting to the World Meteorological Organization (WMO) provide climate analysis and diagnostics for the health sector, and only 32% provide climate change projections.
Indicator 2.2.3: Health Adaptation-Related Funding
From June 2015 to 2023, around US$3 billion was committed to adaptation projects that included SIDS. However, none of this funding was allocated for projects that explicitly address health.
Indicator 2.3.1: Lethality of Extreme Weather Events
Extreme weather events were increasingly lethal for SIDS with medium (56% increase) and very high (400% increase) HDI for 2014-2023 compared to 1990-1999.
MITIGATION ACTIONS AND HEALTH CO-BENEFITS
Reducing greenhouse gas emissions is essential to limit the health threats of climate change. Simultaneously, many of the interventions required to mitigate and adapt bring enormous benefits for human health and wellbeing in the form of cleaner air, healthier diets, and more liveable cities. Tackling climate change could be the greatest global health opportunity of the 21st century. Indicators in this section track the world’s efforts to mitigate climate change, and the effective and the health benefits of this response.
Indicator 3.1 Energy Use, Energy Generation, and Health
Only 8% of electricity in SIDS countries came from renewables in 2022, up from 4% in 2000, despite plentiful potential resources.
ECONOMICS AND FINANCE
The health impacts of climate change have profound economic implications. This section tracks the economic costs of the health impacts of climate change and its drivers, as well as the extent to which the world’s economy and financial systems are enabling the transition to a health-promoting, zero-carbon economy.
4.1.1 Economic losses due to weather-related extreme events
From 2000 to 2023, extreme weather events have caused monetary losses of over US$120 billion in SIDS.
Indicator 4.1.3: Loss of Earnings from Heat-Related Labour Capacity Loss
Between 1990 and 2023, SIDS lost around US$273 billion in potential earnings due to heat-related labour capacity loss, mainly from labour potential loss in the agriculture and construction sectors, which collectively accounted for 70% of total losses.
PUBLIC AND POLITICAL ENGAGEMENT
Public and political engagement underpins the foundations of the world’s collective response to climate change, with reductions in global emissions at the speed required by the Paris Agreement depending on engagement from all sectors of society. This working group tracks key actors’ engagement with the links between health and climate change, including in the media, national governments, the corporate sector, and the broader public.The indicators in this section track the links between health and climate change in the media, national governments, the corporate sector, and the broader public.
Indicator 5.1: Scientific Engagement in Health and Climate Change
Despite the increase in the number of scientific articles being produced from SIDS countries on health and climate change when comparing 2023 (N=75) and 2014 (N=35), SIDS are still underrepresented in the production of scientific publications on health and climate change.
Indicator 5.2: Government Engagement in Health and Climate Change
SIDS continued to spearhead international policy engagement on the links between health and climate change at the United Nations General Assembly (UNGA) with 64% of all climate and health statements at UNGA coming from SIDS leaders in 2022.
Dr Georgiana Gordon-Strachan, Director of the Lancet Countdown SIDS Centre
“Small island developing states are experiencing the sharp end of the climate crisis, with peoples’ health and wellbeing compromised as the planet warms, the oceans rise, and extreme weather becomes more frequent”
Dr Roannie Ng Shiu, Working Group 1 Lead on Health Hazards, Exposures and Impacts
“The concerning trajectory of these findings warns us that the loss and damage already felt as a result of climate change will worsen to the point of catastrophe, without concerted and ambitious action”
Michelle Mycoo, Working Group 2 Contributor on Adaptation, Planning, and Resilience for Health
“Small island leaders are sounding the alarm, standing at the forefront in catalysing action, while the nations most responsible for this crisis linger and delay”
Meet the SIDS report author team
Hailing from the Pacific, Caribbean, Indian Ocean, Europe, the Americas, Oceania, and Asia.
Country data sheets
Our country data sheets highlight the latest SIDS report findings at a country level.