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The health and well-being of human populations - and the very existence of low-lying island states - depend on an ambitious outcome at the 21st Conference of the Parties to the United Nations Framework Convention on Climate Change, (Paris, 30 November to 11 December 2015). Unless the world dramatically reduces emissions of greenhouse gases, especially carbon dioxide from burning of fossil fuels, it is estimated that global average temperature will increase by 2.6-4.8 °C and sea level will rise by up to a metre around the end of this century.1 These changes would have major health impacts.
By the 2030s - now less than 15 years away - approximately 250 000 additional deaths are projected to occur every year from malnutrition, malaria, diarrhoea and heat stress attributable to climate change.2 Climate change will disproportionally affect small island states, because of their relatively small land area, high population density and dependence on local ecosystems for subsistence. Rising sea levels threaten to make low-lying island nations such as Kiribati, the Marshall Islands and Tuvalu uninhabitable. Understandably, Pacific island leaders have called for increases in global average temperatures to be limited to less than 1.5 °C.3
Pacific island countries are confronted with a triple burden of noncommunicable diseases, infectious diseases and climate change impacts. In some Pacific island states, mortality rates from noncommunicable diseases are already among the highest in the world. Since 2012, there have been over 40 large infectious disease...