A growing number of extremely large cities are located in coastal areas, which means that large amounts of infrastructure may be affected. For some island nations, the high cost of providing storm-surge protection would make it essentially infeasible, especially given the limited availability of capital for investment. It also may be possible to rebuild or relocate capital assets at the end of their design life. Factors that limit the implementation of these options include inadequate financial resources, limited institutional and technological capability, and shortages of trained personnel. In most regions, current coastal management and planning frameworks do not take account of the vulnerability of key systems to changes in climate and sea level or long lead times for implementation of many adaptation measures.
Inappropriate policies encourage development in impact-prone areas.
Against this positive backdrop, however, there appears to be a widespread increase in new and resurgent vector-borne and infectious diseases, such as dengue, malaria, hantavirus, and cholera. Compared with the total burden of ill health, these problems are not likely to be large.