On January 30-31, 2020, Pacific RISA and NOAA International Research and Applications Project Principal Investigator Laura Brewington of the East-West Center led the first national Republic of the Marshall Islands (RMI) Climate Change and Health Dialog in Majuro. NOAA’s Regional Climate Services Director, John Marra, facilitated the Dialog. According to RMI Secretary of Health Jack Niedenthal, climate impacts on health are not merely something the country needs to prepare for in the future – they are happening right now.

In the weeks prior to the Climate Change and Health Dialog, confirmed cases of dengue fever in RMI rose from around 60 new cases a week to more than 120 a week, with an estimated 8,000 of the country’s 53,000 citizens infected (Figure 1). Persistent dry, warm weather punctuated by short periods of intense rain have exacerbated the problem since the Christmas holiday season. This record-breaking epidemic has occurred in tandem with other, smaller outbreaks related to a lack of clean water: typhoid fever, diarrheal disease, and conjunctivitis.

Around 100 participants attended the Opening Ceremony of the Dialog (Figure 2), including His Excellency, RMI President David Kabua, former President Hilda Heine, the Honorable Ministers of Health and the Environment, the Secretary and Deputy Secretary of Health, Senators and Mayors representing many of the islands and atolls, the World Health Organization Liaison for Micronesia, and high school and college students from Majuro and Ebeye.

Speaking to all those gathered, Secretary of Health Jack Niedenthal explained, “The reason why climate change impacts the RMI and other nations of Micronesia so severely is that we have one of the highest rates of diabetes, tuberculosis in the world, so our health system is already overtaxed.”

The dialog process first asked participants to break into small groups and describe health outbreaks in the form of a timeline, then link them with climate and weather events that occurred at similar times, such as king tides, drought, and heat waves. Matthew Widlansky from the University of Hawaiʻi Sea Level Center and Reginald White from the National Weather Service Majuro office then described existing products and tools for the RMI region that have good predictive capacity for these key events.

On the second day of the workshop, small groups focused on identifying the types of products that would aid health officials in assessing early warning for the health impacts of climate variability and change, particularly vector-borne and waterborne diseases. The workshop concluded with a set of next steps for generating an early warning system for the health sector using the relevant forecast products in tandem with NOAA, the University of Hawaiʻi, and the National Weather Service Majuro office.