Climate Change 2001: Impacts, Adaptation and Vulnerability

18.7. Sectoral and Regional Findings

Insights gained about adaptation and adaptive capacity from the sector chapters and the regional chapters are summarized in Tables 18-6 and 18-7, respectively.

Table 18-6: Adaptation and adaptive capacity in sectors (key findings from Chapters 4 through 9).

Sector

Key Findings

Water Resources

Water managers have experience adapting to change. Many techniques exist to assess and implement adaptive options. However, the pervasiveness of climate change may preclude some traditional adaptive strategies, and available adaptations often are not used.
Adaptation can involve management on the supply side (e.g., altering infrastructure or institutional arrangements) and on the demand side (changing demand or risk reduction). Numerous no-regret policies exist that will generate net social benefits regardless of climate change.
Climate change is just one of numerous pressures facing water managers. Nowhere are water management decisions taken solely to cope with climate change, although it is increasingly considered for future resource management. Some vulnerabilities are outside the conventional responsibility of water managers.
Estimates of the economic costs of climate change impacts on water resources depend strongly on assumptions made about adaptation. Economically optimum adaptation may be prevented by constraints associated with uncertainty, institutions, and equity.
Extreme events often are catalysts for changes in water management, by exposing vulnerabilities and raising awareness of climate risks. Climate change modifies indicators of extremes and variability, complicating adaptation decisions.
Ability to adapt is affected by institutional capacity, wealth, management philosophy, planning time scale, organizational and legal framework, technology, and population mobility.
Water managers need research and management tools aimed at adapting to uncertainty and change, rather than improving climate scenarios.

Ecosystems and Their Services

Adaptation to loss of some ecosystem services may be possible, especially in managed ecosystems. However, adaptation to losses in wild ecosystems and biodiversity may be difficult or impossible.
There is considerable capacity for adaptation in agriculture, including crop changes and resource substitutions, but adaptation to evolving climate change and interannual variability is uncertain.
Adaptations in agriculture are possible, but they will not happen without considerable transition costs and equilibrium (or residual) costs.
Greater adverse impacts are expected in areas where resource endowments are poorest and the ability of farmers to adapt is most limited.
In many countries where rangelands are important, lack of infrastructure and investment in resource management limit options for adaptation.
Commercial forestry is adaptable, reflecting a history of long-term management decisions under uncertainty. Adaptations are expected in both land-use management (species-selection silviculture) and product management (processing-marketing).
Adaptation in developed countries will fare better, while developing countries and countries in transition, especially in the tropics and subtropics, will fare worse

Coastal Zones

Without adaptations, the consequences of global warming and sea-level rise would be disastrous.
Coastal adaptation entails more than just selecting one of the technical options to respond to sea-level rise (strategies can aim to protect, accommodate, or retreat). It is a complex and iterative process rather than a simple choice.
Adaptation options are more acceptable and effective when they are incorporated into coastal zone management, disaster mitigation programs, land-use planning, and sustainable development strategies.
Adaptation choices will be conditioned by existing policies and development objectives, requiring researchers and policymakers to work toward a commonly acceptable framework for adaptation.
The adaptive capacity of coastal systems to perturbations is related to coastal resilience, which has morphological, ecological, and socioeconomic components. Enhancing resilience—including the technical, institutional, economic, and cultural capability to cope with impacts—is a particularly appropriate adaptive strategy given future uncertainties and the desire to maintain development opportunities.
Coastal communities and marine-based economic sectors with either low exposure or high adaptive capacity will be least affected. Communities with less economic resources, poorer infrastructure, less developed communications and transportation systems, and weak social support systems have less access to adaptation options and are more vulnerable.

Human Settlements, Energy, and Industry

The larger and more costly impacts of climate change occur through changed probability of extreme weather events that overwhelm the design resiliency of human systems.
There are many adaptation options available to reduce the vulnerability of settlements. However, urban managers, especially in developing countries, have so little capacity to deal with current problems (housing, sanitation, water, and power) that dealing with climate change risks is beyond their means.
Lack of financial resources, weak institutions, and inadequate or inappropriate planning are major barriers to adaptation in human settlements.
Successful environmental adaptation cannot occur without locally based, technically competent, and politically supported leadership.
Uncertainty with respect to capacity and the will to respond hinder the assessment of adaptations and vulnerability.

Insurance and Other Financial Services

Adaptation in financial and insurance services in the short term is likely to be to changing frequencies and intensities of extreme weather events.
Increasing risk could lead to a greater volume of traditional business and the development of new financial risk management products, but increased variability of loss events would heighten actuarial uncertainty.
Financial services firms have adaptability to external shocks, but there is little evidence that climate change has been incorporated into investment decisions.
The adaptive capacity of the financial sector is influenced by regulatory involvement, the ability of firms to withdraw from at-risk markets, and fiscal policy regarding catastrophe reserves.
Adaptation will involve changes in the roles of private and public insurance. Changes in the timing, intensity, frequency, and/or spatial distribution of climate-related losses will generate increased demand on already overburdened government insurance and disaster assistance programs.
Developing countries seeking to adapt in a timely manner face particular difficulties, including limited availability of capital, poor access to technology, and absence of government programs.
Insurers' adaptations include raising prices, nonrenewal of policies, cessation of new policies, limiting maximum claims, and raising deductibles—actions that can seriously affect investment in developing countries.
Developed countries generally have greater adaptive capacity, including technology and economic means to bear the costs.

Human Health

Adaptation involves changes in society, institutions, technology, or behavior to reduce potential negative impacts or to increase positive ones. There are numerous adaptation options, which may occur at the population, community, or personal levels.
The most important and cost-effective adaptation measure is to rebuild public health infrastructure—which, in much of the world, has declined in recent years. Many diseases and health problems that may be exacerbated by climate change can be effectively prevented with adequate financial and human public health resources, including training, surveillance and emergency response, and prevention and control programs.
Adaptation effectiveness will depend on timing. "Primary" prevention aims to reduce risks before cases occur, whereas "secondary" interventions are designed to prevent further cases.
Determinants of adaptive capacity to climate-related threats to health include the level of material resources, the effectiveness of governance and civil institutions, the quality of public health infrastructure, and the preexisting burden of disease.
Capacity to adapt also will depend on research to understand associations between climate, weather, extreme events, and vector-borne diseases.

Table 18-7: Adaptation and capacity in regions (key findings from Chapters 10 through 17).

Sector

Key Findings

Africa

Adaptive measures would enhance flexibility and have net benefits in water resources (irrigation and water reuse, aquifer and groundwater management, desalinization), agriculture (crop changes, technology, irrigation, husbandry), and forestry (regeneration of local species, energy-efficient cook stoves, sustainable community management).
Without adaptation, climate change will reduce the wildlife reserve network significantly by altering ecosystems and causing species emigration and extinctions. This represents an important ecological and economic vulnerability in Africa.
A risk-sharing approach between countries will strengthen adaptation strategies, including disaster
management, risk communication, emergency evacuation, and cooperative water resource management.
Most countries in Africa are particularly vulnerable to climate change because of limited adaptive capacity, as a result of widespread poverty, recurrent droughts, inequitable land distribution, and dependence on rainfed agriculture.
Enhancement of adaptive capacity requires local empowerment in decisionmaking and incorporation of climate adaptation within broader sustainable development strategies.

Asia

Priority areas for adaptation are land and water resources, food productivity, and disaster preparedness and planning—particularly for poorer, resource-dependent countries.
Adaptations already are required to deal with vulnerabilities associated with climate variability, in human health, coastal settlements, infrastructure, and food security. The resilience of most sectors in Asia to climate change is very poor. Expansion of irrigation will be difficult and costly in many countries.
For many developing countries in Asia, climate change is only one of a host of problems to deal with, including nearer term needs such as hunger, water supply and pollution, and energy. Resources available for adaptation to climate are limited. Adaptation responses are closely linked to development activities, which should be considered in evaluating adaptation options.
Early signs of climate change already are observed and may become more prominent over 1 or 2 decades. If this time is not used to design and implement adaptations, it may be too late to avoid upheavals. Long-term adaptation requires anticipatory actions.
A wide range of precautionary measures are available at the regional and national level to reduce
economic and social impacts of disasters. These measures include awareness building and expansion of the insurance industry.
Development of effective adaptation strategies requires local involvement, inclusion of community
perceptions, and recognition of multiple stresses on sustainable management of resources.
Adaptive capacities vary between countries, depending on social structure, culture, economic capacity, and level of environmental disruptions. Limiting factors include poor resource and infrastructure bases, poverty and disparities in income, weak institutions, and limited technology.
The challenge in Asia lies in identifying opportunities to facilitate sustainable development with strategies that make climate-sensitive sectors resilient to climate variability.
Adaptation strategies would benefit from taking a more systems-oriented approach, emphasizing multiple interactive stresses, with less dependence on climate scenarios.

Australia and
New Zealand

daptations are needed to manage risks from climatic variability and extremes. Pastoral economies and communities have considerable adaptability but are vulnerable to any increase in the frequency or duration of droughts.
Adaptation options include water management, land-use practices and policies, engineering standards for infrastructure, and health services.
Adaptations will be viable only if they are compatible with the broader ecological and socioeconomic environment, have net social and economic benefits, and are taken up by stakeholders.
Adaptation responses may be constrained by conflicting short- and long-term planning horizons.
Poorer communities, including many indigenous settlements, are particularly vulnerable to climate-related hazards and stresses on health because they often are in exposed areas and have less adequate housing, health care, and other resources for adaptation.

Europe

Adaptation potential in socioeconomic systems is relatively high as a result of strong economic conditions; stable population (with capacity to migrate); and well-developed political, institutional, and technological support systems.
The response of human activities and the natural environment to current weather perturbations provides a guide to critical sensitivities under future climate change.
Adaptation in forests requires long-term planning; it is unlikely that adaptation measures will be put in place in a timely manner.
Farm-level analyses show that if adaptation is fully implemented large reductions in adverse impacts are possible.
Adaptation for natural systems generally is low.
More marginal and less wealthy areas will be less able to adapt, so without appropriate policies of response climate change may lead to greater inequities.

Latin America

Adaptation measures have potential to reduce climate-related losses in agriculture and forestry.
There are opportunities for adapting to water shortages and flooding through water resource management.
Adaptation measures in the fishery sector include changing species captured and increasing prices to reduce losses.

North America

Strain on social and economic systems from rapid climate and sea-level changes will increase the need for explicit adaptation strategies. In some cases, adaptation may yield net benefits, especially if climate change is slow.
Stakeholders in most sectors believe that technology is available to adapt, although at some social and economic cost.
Adaptation is expected to be more successful in agriculture and forestry. However, adaptations for the water, health, food, and energy sectors and the cities are likely to require substantial institutional and infrastructure changes.
In the water sector, adaptations to seasonal runoff changes include storage, conjunctive supply management, and transfer. It may not be possible to continue current high levels of reliability of water supply, especially with transfers to high-valued uses. Adaptive measures such as "water markets" may lead to concerns about accessibility and conflicts over allocation priorities.
Adaptations such as levees and dams often are successful in managing most variations in the weather but can increase vulnerability to the most extreme events.
There is moderate potential for adaptation through conservation programs that protect particularly threatened ecosystems, such as high alpines and wetlands. It may be difficult or impossible to offset adverse impacts on aquatic systems.

Polar Regions

Adaptation will occur in natural polar ecosystems through migration and changing mixes of species. Species such as walrus, seals, and polar bears will be threatened, although others (such as fish) may flourish.
Potential for adaptation is limited in indigenous communities that follow traditional lifestyles.
Technologically developed communities are likely to adapt quite readily, although the high capital investment required may result in costs in maintaining lifestyles.
Adaptation depends on technological advances, institutional arrangements, availability of financing, and information exchange.

Small Island
States

The need for adaptation has become increasingly urgent, even if swift implementation of global agreements to reduce future emissions occurs.
Most adaptation will be carried out by people and communities who inhabit island countries; support from governments is essential for implementing adaptive measures.
Progress will require integration of appropriate risk-reduction strategies with other sectoral policy initiatives in areas such as sustainable development planning, disaster prevention and management, integrated coastal zone management, and health care planning.
Strategies for adaptation to sea-level rise are retreat, accommodate, and protect. Measures such as retreat to higher ground, raising of the land, and use of building set-backs appear to have little practical utility, especially when hindered by limited physical size.
Measures for reducing the severity of health threats include health education programs, improved health care facilities, sewerage and solid waste management, and disaster preparedness plans.
Islanders have developed some capacity to adapt by application of traditional knowledge, locally appropriate technology, and customary practice. Overall, however, adaptive capacity is low because of the physical size of nations, limited access to capital and technology, shortage of human resource skills, lack of tenure security, overcrowding, and limited access to resources for construction.
Many small islands require external financial, technical, and other assistance to adapt. Adaptive capacity may be enhanced by regional cooperation and pooling of limited resources.

Increasingly, adaptation and adaptive capacity are explicitly considered in impact and vulnerability assessments, and there are some consistent findings across sectors and regions (see Section 18.8). However, there is insufficient basis to rank systematically countries according to their adaptive capacity or to list the "most vulnerable" overall. Analyses to date indicate that adaptive capacity and vulnerability are multidimensional, so that one country (or, more often, a group within a country) may be extremely vulnerable economically whereas another country (or community) is extremely vulnerable in terms of life and livelihood. These different types of vulnerability reflect different types of exposures and adaptive capacities.


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Table 18-6: Adaptation and adaptive capacity in sectors (key findings from Chapters 4 through 9).

Sector	Key Findings

Water Resources	Water managers have experience adapting to change. Many techniques exist to assess and implement adaptive options. However, the pervasiveness of climate change may preclude some traditional adaptive strategies, and available adaptations often are not used. Adaptation can involve management on the supply side (e.g., altering infrastructure or institutional arrangements) and on the demand side (changing demand or risk reduction). Numerous no-regret policies exist that will generate net social benefits regardless of climate change. Climate change is just one of numerous pressures facing water managers. Nowhere are water management decisions taken solely to cope with climate change, although it is increasingly considered for future resource management. Some vulnerabilities are outside the conventional responsibility of water managers. Estimates of the economic costs of climate change impacts on water resources depend strongly on assumptions made about adaptation. Economically optimum adaptation may be prevented by constraints associated with uncertainty, institutions, and equity. Extreme events often are catalysts for changes in water management, by exposing vulnerabilities and raising awareness of climate risks. Climate change modifies indicators of extremes and variability, complicating adaptation decisions. Ability to adapt is affected by institutional capacity, wealth, management philosophy, planning time scale, organizational and legal framework, technology, and population mobility. Water managers need research and management tools aimed at adapting to uncertainty and change, rather than improving climate scenarios.
Ecosystems and Their Services	Adaptation to loss of some ecosystem services may be possible, especially in managed ecosystems. However, adaptation to losses in wild ecosystems and biodiversity may be difficult or impossible. There is considerable capacity for adaptation in agriculture, including crop changes and resource substitutions, but adaptation to evolving climate change and interannual variability is uncertain. Adaptations in agriculture are possible, but they will not happen without considerable transition costs and equilibrium (or residual) costs. Greater adverse impacts are expected in areas where resource endowments are poorest and the ability of farmers to adapt is most limited. In many countries where rangelands are important, lack of infrastructure and investment in resource management limit options for adaptation. Commercial forestry is adaptable, reflecting a history of long-term management decisions under uncertainty. Adaptations are expected in both land-use management (species-selection silviculture) and product management (processing-marketing). Adaptation in developed countries will fare better, while developing countries and countries in transition, especially in the tropics and subtropics, will fare worse
Coastal Zones	Without adaptations, the consequences of global warming and sea-level rise would be disastrous. Coastal adaptation entails more than just selecting one of the technical options to respond to sea-level rise (strategies can aim to protect, accommodate, or retreat). It is a complex and iterative process rather than a simple choice. Adaptation options are more acceptable and effective when they are incorporated into coastal zone management, disaster mitigation programs, land-use planning, and sustainable development strategies. Adaptation choices will be conditioned by existing policies and development objectives, requiring researchers and policymakers to work toward a commonly acceptable framework for adaptation. The adaptive capacity of coastal systems to perturbations is related to coastal resilience, which has morphological, ecological, and socioeconomic components. Enhancing resilience—including the technical, institutional, economic, and cultural capability to cope with impacts—is a particularly appropriate adaptive strategy given future uncertainties and the desire to maintain development opportunities. Coastal communities and marine-based economic sectors with either low exposure or high adaptive capacity will be least affected. Communities with less economic resources, poorer infrastructure, less developed communications and transportation systems, and weak social support systems have less access to adaptation options and are more vulnerable.
Human Settlements, Energy, and Industry	The larger and more costly impacts of climate change occur through changed probability of extreme weather events that overwhelm the design resiliency of human systems. There are many adaptation options available to reduce the vulnerability of settlements. However, urban managers, especially in developing countries, have so little capacity to deal with current problems (housing, sanitation, water, and power) that dealing with climate change risks is beyond their means. Lack of financial resources, weak institutions, and inadequate or inappropriate planning are major barriers to adaptation in human settlements. Successful environmental adaptation cannot occur without locally based, technically competent, and politically supported leadership. Uncertainty with respect to capacity and the will to respond hinder the assessment of adaptations and vulnerability.
Insurance and Other Financial Services	Adaptation in financial and insurance services in the short term is likely to be to changing frequencies and intensities of extreme weather events. Increasing risk could lead to a greater volume of traditional business and the development of new financial risk management products, but increased variability of loss events would heighten actuarial uncertainty. Financial services firms have adaptability to external shocks, but there is little evidence that climate change has been incorporated into investment decisions. The adaptive capacity of the financial sector is influenced by regulatory involvement, the ability of firms to withdraw from at-risk markets, and fiscal policy regarding catastrophe reserves. Adaptation will involve changes in the roles of private and public insurance. Changes in the timing, intensity, frequency, and/or spatial distribution of climate-related losses will generate increased demand on already overburdened government insurance and disaster assistance programs. Developing countries seeking to adapt in a timely manner face particular difficulties, including limited availability of capital, poor access to technology, and absence of government programs. Insurers' adaptations include raising prices, nonrenewal of policies, cessation of new policies, limiting maximum claims, and raising deductibles—actions that can seriously affect investment in developing countries. Developed countries generally have greater adaptive capacity, including technology and economic means to bear the costs.
Human Health	Adaptation involves changes in society, institutions, technology, or behavior to reduce potential negative impacts or to increase positive ones. There are numerous adaptation options, which may occur at the population, community, or personal levels. The most important and cost-effective adaptation measure is to rebuild public health infrastructure—which, in much of the world, has declined in recent years. Many diseases and health problems that may be exacerbated by climate change can be effectively prevented with adequate financial and human public health resources, including training, surveillance and emergency response, and prevention and control programs. Adaptation effectiveness will depend on timing. "Primary" prevention aims to reduce risks before cases occur, whereas "secondary" interventions are designed to prevent further cases. Determinants of adaptive capacity to climate-related threats to health include the level of material resources, the effectiveness of governance and civil institutions, the quality of public health infrastructure, and the preexisting burden of disease. Capacity to adapt also will depend on research to understand associations between climate, weather, extreme events, and vector-borne diseases.

Table 18-7: Adaptation and capacity in regions (key findings from Chapters 10 through 17).

Sector	Key Findings

Africa	Adaptive measures would enhance flexibility and have net benefits in water resources (irrigation and water reuse, aquifer and groundwater management, desalinization), agriculture (crop changes, technology, irrigation, husbandry), and forestry (regeneration of local species, energy-efficient cook stoves, sustainable community management). Without adaptation, climate change will reduce the wildlife reserve network significantly by altering ecosystems and causing species emigration and extinctions. This represents an important ecological and economic vulnerability in Africa. A risk-sharing approach between countries will strengthen adaptation strategies, including disaster management, risk communication, emergency evacuation, and cooperative water resource management. Most countries in Africa are particularly vulnerable to climate change because of limited adaptive capacity, as a result of widespread poverty, recurrent droughts, inequitable land distribution, and dependence on rainfed agriculture. Enhancement of adaptive capacity requires local empowerment in decisionmaking and incorporation of climate adaptation within broader sustainable development strategies.
Asia	Priority areas for adaptation are land and water resources, food productivity, and disaster preparedness and planning—particularly for poorer, resource-dependent countries. Adaptations already are required to deal with vulnerabilities associated with climate variability, in human health, coastal settlements, infrastructure, and food security. The resilience of most sectors in Asia to climate change is very poor. Expansion of irrigation will be difficult and costly in many countries. For many developing countries in Asia, climate change is only one of a host of problems to deal with, including nearer term needs such as hunger, water supply and pollution, and energy. Resources available for adaptation to climate are limited. Adaptation responses are closely linked to development activities, which should be considered in evaluating adaptation options. Early signs of climate change already are observed and may become more prominent over 1 or 2 decades. If this time is not used to design and implement adaptations, it may be too late to avoid upheavals. Long-term adaptation requires anticipatory actions. A wide range of precautionary measures are available at the regional and national level to reduce economic and social impacts of disasters. These measures include awareness building and expansion of the insurance industry. Development of effective adaptation strategies requires local involvement, inclusion of community perceptions, and recognition of multiple stresses on sustainable management of resources. Adaptive capacities vary between countries, depending on social structure, culture, economic capacity, and level of environmental disruptions. Limiting factors include poor resource and infrastructure bases, poverty and disparities in income, weak institutions, and limited technology. The challenge in Asia lies in identifying opportunities to facilitate sustainable development with strategies that make climate-sensitive sectors resilient to climate variability. Adaptation strategies would benefit from taking a more systems-oriented approach, emphasizing multiple interactive stresses, with less dependence on climate scenarios.
Australia and New Zealand	daptations are needed to manage risks from climatic variability and extremes. Pastoral economies and communities have considerable adaptability but are vulnerable to any increase in the frequency or duration of droughts. Adaptation options include water management, land-use practices and policies, engineering standards for infrastructure, and health services. Adaptations will be viable only if they are compatible with the broader ecological and socioeconomic environment, have net social and economic benefits, and are taken up by stakeholders. Adaptation responses may be constrained by conflicting short- and long-term planning horizons. Poorer communities, including many indigenous settlements, are particularly vulnerable to climate-related hazards and stresses on health because they often are in exposed areas and have less adequate housing, health care, and other resources for adaptation.
Europe	Adaptation potential in socioeconomic systems is relatively high as a result of strong economic conditions; stable population (with capacity to migrate); and well-developed political, institutional, and technological support systems. The response of human activities and the natural environment to current weather perturbations provides a guide to critical sensitivities under future climate change. Adaptation in forests requires long-term planning; it is unlikely that adaptation measures will be put in place in a timely manner. Farm-level analyses show that if adaptation is fully implemented large reductions in adverse impacts are possible. Adaptation for natural systems generally is low. More marginal and less wealthy areas will be less able to adapt, so without appropriate policies of response climate change may lead to greater inequities.
Latin America	Adaptation measures have potential to reduce climate-related losses in agriculture and forestry. There are opportunities for adapting to water shortages and flooding through water resource management. Adaptation measures in the fishery sector include changing species captured and increasing prices to reduce losses.
North America	Strain on social and economic systems from rapid climate and sea-level changes will increase the need for explicit adaptation strategies. In some cases, adaptation may yield net benefits, especially if climate change is slow. Stakeholders in most sectors believe that technology is available to adapt, although at some social and economic cost. Adaptation is expected to be more successful in agriculture and forestry. However, adaptations for the water, health, food, and energy sectors and the cities are likely to require substantial institutional and infrastructure changes. In the water sector, adaptations to seasonal runoff changes include storage, conjunctive supply management, and transfer. It may not be possible to continue current high levels of reliability of water supply, especially with transfers to high-valued uses. Adaptive measures such as "water markets" may lead to concerns about accessibility and conflicts over allocation priorities. Adaptations such as levees and dams often are successful in managing most variations in the weather but can increase vulnerability to the most extreme events. There is moderate potential for adaptation through conservation programs that protect particularly threatened ecosystems, such as high alpines and wetlands. It may be difficult or impossible to offset adverse impacts on aquatic systems.
Polar Regions	Adaptation will occur in natural polar ecosystems through migration and changing mixes of species. Species such as walrus, seals, and polar bears will be threatened, although others (such as fish) may flourish. Potential for adaptation is limited in indigenous communities that follow traditional lifestyles. Technologically developed communities are likely to adapt quite readily, although the high capital investment required may result in costs in maintaining lifestyles. Adaptation depends on technological advances, institutional arrangements, availability of financing, and information exchange.
Small Island States	The need for adaptation has become increasingly urgent, even if swift implementation of global agreements to reduce future emissions occurs. Most adaptation will be carried out by people and communities who inhabit island countries; support from governments is essential for implementing adaptive measures. Progress will require integration of appropriate risk-reduction strategies with other sectoral policy initiatives in areas such as sustainable development planning, disaster prevention and management, integrated coastal zone management, and health care planning. Strategies for adaptation to sea-level rise are retreat, accommodate, and protect. Measures such as retreat to higher ground, raising of the land, and use of building set-backs appear to have little practical utility, especially when hindered by limited physical size. Measures for reducing the severity of health threats include health education programs, improved health care facilities, sewerage and solid waste management, and disaster preparedness plans. Islanders have developed some capacity to adapt by application of traditional knowledge, locally appropriate technology, and customary practice. Overall, however, adaptive capacity is low because of the physical size of nations, limited access to capital and technology, shortage of human resource skills, lack of tenure security, overcrowding, and limited access to resources for construction. Many small islands require external financial, technical, and other assistance to adapt. Adaptive capacity may be enhanced by regional cooperation and pooling of limited resources.