Fiji is prone to climate change hazards including sea-level rise, cyclones and floods, with increases in extreme weather events, such as shifting wet/dry seasons and extreme rainfall days, likely in the coming decades. These changes are expected to influence disease patterns, community resilience and health systems. Fiji is already experiencing a rapidly growing health burden due to the increased incidence and prevalence of non-communicable and communicable diseases, combined with increasing climate change-related health impacts. In the absence of appropriate and rapid health-focused adaptation strategies, climate change has the potential to cause a range of significant negative health impacts. In Fiji climate change affects human health through multiple pathways, including increased risk of waterborne diseases (such as diarrheal diseases) and vector-borne diseases (such as dengue), increased food and water insecurity leading to nutritional issues, and disruption of health systems due to climate-induced extreme weather events and sea-level rise. The combination of exposure to climatic hazards with limited capacity of the health system, including inadequate infrastructure, human resources and supplies, as well as communities that are remote and hard to reach, provide significant challenges in reducing climate change-related morbidity and mortality.

The Fiji Ministry of Health and Medical Services (MOHMS) has a close working relationship with Fiji Meteorological Services (FMS), starting in 2010 through the Climate Change and Health Steering Committee and various projects. Previously, climate information was accessed through “request for data” applications, particularly for large data sets, and was more project-focused and ad hoc. In 2020, MOHMS and FMS signed a Memorandum of Agreement for collaboration to improve meteorological observation network coverage in data-sparse areas; to facilitate data sharing between the Parties, including meteorological data and health-related data on climatesensitive diseases; and to enhance the capacity of health sector institutions to respond to climate-sensitive health risks, based on early warning information provided by FMS and development of early warning systems for climate-sensitive diseases. The plan was also to improve information systems supporting integrated assessment of climate-sensitive health risks in management and long-term planning, and to build capacity of health sector and key multisectoral partners in strengthening data management across sectors. MOHMS is now working to develop its climate-based early warning system through the Korea International Cooperation Agency (KOICA)-funded project, Strengthening Health Adaptation Project: Responding to Climate Change in Fiji (SHAPE).

An outcome of this collaboration has been the identification of the four climate-sensitive diseases (leptospirosis, typhoid, dengue and diarrheal disease) for Fiji, with the ambition to explore climate change linkages with non-communicable disease underway. Statistical and spatial analysis training has also been integrated into existing divisional and sub-divisional outbreak response activities, focusing on identifying relationships between disease outbreaks and climate variables (for example, rainfall and vector surveillance). With this training, the sub-divisional outbreak response teams can correlate the relationship between disease outbreaks and climate patterns to map out “highly vulnerable” areas. This has assisted the teams to better prepare and respond to climatic changes in Fiji, including on seasonal timescales, which has helped reduce morbidity and mortality from climate-sensitive diseases in their sub-divisions.

Communication is vital for information sharing and it is also a key limitation. The warnings/forecasts can be delayed, and at times irregular or inconsistent. The language used is also sometimes too technical for the health workers and is not well interpreted for prompt response. Additionally, the modality for requesting data still suffers from delays, sometimes slowing implementation of projects and/or research. However, there is continued consultation with FMS to improve on these challenges.

The collaboration has helped the teams to better prepare and respond to climatic changes in Fiji, including on seasonal timescales.