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One of the world’s smallest nations is leading the fight against the biggest global challenge of our time — climate change. It’s doing this to secure its future and to protect its health today.

The Marshall Islands — an archipelago of 29 atolls in the Pacific Ocean — just became the first nation to sign onto the Kigali pact, a major international agreement aimed at limiting the emission of an extremely potent class of greenhouse gases called hydrofluorocarbons.

The country certainly has a stake in the success of the pact. Rising sea levels threaten to someday submerge the islands, which rise only a few feet above sea level. But the effects of climate change are putting the lives of its residents in danger today. A years-long drought — together with frequent ocean floods — have compromised the nation’s drinking water and made it increasingly difficult to grow food.


The Marshall Islands’s story is hardly unique. The complex effects of climate change are threatening the health — and the very existence — of small island states around the globe. And those threats aren’t looming in the distance. They’re destroying people’s lives and livelihoods right now.

Small island nations account for a minuscule share of the world’s greenhouse gas emissions. Fiji, for instance, generates only 0.04 percent of global emissions. Grenada, meanwhile, is responsible for a mere 0.0005 percent.


Yet small island nations suffer some of the worst consequences of climate change. They bear the brunt of increasingly common heat waves, cyclones, floods, and droughts. These extreme weather events threaten the health of their residents in several ways, including by creating ideal conditions for the proliferation of water and animal-borne diseases.

Climate change, for instance, compounds the existing risk of mosquito-borne infections, particularly dengue fever and malaria. The number of dengue fever cases in the Caribbean has jumped fivefold in just a decade. Or take the Solomon Islands, where 99 percent of residents now live in areas where they’re at risk of contracting malaria. The share of the global population at risk of contracting malaria is less than half.

In Fiji, the number of dengue outbreaks over the past 15 years was double the number in the previous 40 years. A 2014 dengue outbreak infected 20,000 Fiji islanders — more than 2 percent of the population.

These problems will only get worse as heavy rainfall caused by climate change creates new pockets of standing water, which provide fertile breeding grounds for mosquitoes. Warmer temperatures, meanwhile, let viruses replicate more quickly and be transmitted almost immediately after they infect a mosquito. And as temperatures increase, mosquitoes mature faster and bite more frequently. That increases disease transmission rates.

Climate change also threatens the water supplies of small island nations. Increased flooding, for instance, can introduce contaminants into the drinking water of an entire region. In 2016, for example, the Dominican Republic reported a record number of deaths caused by a waterborne disease called leptospirosis. The incidence of this bacterial disease, which is transmitted through contact with animal urine, skyrocketed shortly after Hurricane Matthew caused rivers throughout the country to overflow. That introduced the Leptospira bacteria into the water supply. Over one four-week period, leptospirosis took 19 lives.

Some diseases plaguing small island nations are linked to both droughts and flooding. Take diarrheal diseases, which kill more 200 children every day in Latin America and the Caribbean. During floods, these diseases can be spread through contaminated food or drinking water. During droughts, lack of water for proper hygiene is to blame.

Last year, flooding caused an outbreak of 6,000 diarrheal disease cases in the Solomon Islands. In 2011, a La Niña — a period of unusually cold ocean water — led to droughts in the Pacific island nation of Tuvalu. That, in turn, yielded a surge in diarrheal illnesses.

While climate change is often thought of as a long-term existential threat, for residents of small island nations it’s an immediate public health challenge. Forcing the people of these countries to sacrifice their health because of an environmental crisis they played little role in creating is simply unjust.

Hugh Sealy is a professor in the Department of Public Health and Preventive Medicine at St. George’s University in Grenada. He helped negotiate the Paris climate agreement in 2015 and participated in the 2016 round of international climate negotiations in Morocco.