Adaptation to the climate crisis: opportunities for food and nutrition security and health in a Pacific small island state

Climate change, malnutrition, and noncommunicable diseases (NCDs) are three of the most significant health challenges of this century, and they share fundamental underlying drivers. Pacific Island countries (PICs) are at the forefront of the impacts of climate change, which is likely to affect food and nutrition security (FNS) directly and indirectly, and many countries have existing high NCD burdens. This paper surveys the climate change adaptation (CCA) landscape in one PIC, Vanuatu. It explores the extent to which FNS and diet-related NCDs are considered and addressed within CCA initiatives. A comprehensive review of the literature related to CCA, FNS, and NCDs in Vanuatu was combined with 32 semistructured interviews with key experts and stakeholders. This study found that some promising groundwork has been laid for tackling the effects of climate change on FNS in policy and governance, agriculture, coastal management, and nutrition. However, several opportunities for strengthening CCA were identified: targeting urban populations; complementary integration of disaster risk reduction and CCA; incorporating local knowledge; applying a systems-based framing of NCDs as climate-sensitive health risks; and emphasizing humancentered, community-led CCA. Vanuatu will continue to be affected by accelerating climate change. A strong foundation for CCA presents clear opportunities for further development. As food and nutrition insecurity and diet-related NCD risk factors are increasingly exacerbated by climate change, alongside other socioeconomic drivers, it is crucial to find new and innovative ways to increase transformational resilience and adaptive capacity that also improve nutrition and health outcomes