A new report published on Thursday in The Lancet Global Health warns that residents of Small Island Developing States (SIDS) continue to carry a disproportionate and increasing health burden resulting from climate change, despite being responsible for less than 1% of global greenhouse gas emissions collectively.
Small Island Developing States (SIDS) are a distinct group of 58 sovereign states and dependent territories, called associate members, officially recognized by the United Nations for their unique social, economic, and environmental vulnerabilities. SIDS is categorized across three geographic regions: the Caribbean; the Pacific; and the AIS (Atlantic, Indian Ocean, and South China Sea).
The report comes at an important moment, as governments get ready for meetings on climate ambition and finance in the run-up to the next UN Climate Conference, COP31, to be held in Türkiye this winter.
The report, Small Island Developing States (SIDS) Report of the Lancet Countdown on Health and Climate Change, presents evidence based on 28 indicators across a range, including climate-related health impacts, adaptation, mitigation, finance, and political engagement and has been authored by 30 experts from 25 academic institutions. The report talks about risks, stressing the immediate need for greater international support for the climate-vulnerable SIDS group of nations.
High air pollution and heatwave
“…Infants in SIDS now experience seven times more heatwave days than in the early 2000s, while older adults experience five times more. In 2024, ambient heat posed a record average of 3000 hours of moderate risk of heat stress during light outdoor exercise compared, and an estimated 4.4 billion work hours were lost to extreme heat in the same year — the highest single-year potential loss since tracking began in 1990,” says the Lancet statement.
Heat is the health challenge
“Heat is becoming one of the defining health challenges for Small Island Developing States,” said Georgiana Gordon Strachan, Lancet Countdown SIDS regional director. “This report shows that protecting people from rising temperatures must now be a core priority for climate and health policy. We know what works—the challenge is ensuring that SIDS have the resources to implement solutions at the scale and speed that this crisis demands.”
The risk of dengue, chikungunya and other mosquito-borne climate-sensitive diseases is increasing, while extended drought has subjected to moderate to severe food insecurity an additional 2.7 million people.
Warming of the oceans continues to threaten fisheries, livelihoods, and marine food security across island nations. “Coastal regions of SIDS recorded a 0.61°C rise in sea surface temperatures across the 2022-2024 average compared with the baseline period of 1981– 2010, reflective of the El Niño–Southern Oscillation (ENSO),” says the statement.
Air pollution piggybacks
Severe air pollution piggybacks on climate risks.
“On average, more than 40 million people in SIDS were exposed to daily concentrations of particulate matter with a diameter of less than 10 μm (PM10) higher than the WHO guideline …” says the report.
“The exposure was driven by sand and dust storms, such as the Saharan dust events over the Caribbean. Poor air quality is associated with a cascade of health conditions, including asthma, chronic obstructive pulmonary disease, stroke, and cardiovascular disease,” it adds.
Report documents progress
The report, however, also documents important progress.
Solar photovoltaic capacity has more than doubled since 2020, early warning systems are improving, and deaths from extreme weather events have declined, indicating stronger preparedness, says the report.
“ …But limited institutional capacity, fragmented climate finance, and insufficient health adaptation investment are constraining adaptation. Only 10 of 58 SIDS have dedicated national health and climate adaptation plans and less than half of health systems are engaged in climate monitoring, a major factor enabling surveillance of climate-related health outcomes,” reminds the report.
Fund crunch
The report underlines that funding available to SIDS remains far below what is required to protect health and build resilience. “Many countries are dependent on loans, increasing debt burdens, while nearly half of identified climate financing needs remain uncosted, suggesting that current estimates substantially underestimate the true scale of investment required,” says the statement.
“The Pacific pre-COP meetings are an opportunity to put health at the centre of climate negotiations,” said Dr Roannie Ng Shiu, Lancet Countdown SIDS Working Group 1 lead. “SIDS have long led on climate action and justice; now the international community must respond with the finance and partnerships needed to turn that leadership into lasting resilience.”
The report urges governments to immediately translate commitments, including financial, into action for SIDS.