Challenges and strategies for climate change adaptation among Pacific Island nations. 
Few regions of the world are at higher risk for environmental disasters than the Pacific Island countries and territories.  During 2004 and 2005, the top public health leadership from 19 of 22 Pacific Island countries and territories convened 2 health summits with the goal of developing the world's first comprehensive regional strategy for sustainable disaster risk management as applied to public health emergencies.  These summits followed on the objectives of the 1994 Barbados Plan of Action for the Sustainable Development of Small Island Developing States and those of the subsequent Yokohama Strategy and Plan of Action for a Safer World.  The outputs of the 2004 and 2005 Pacific Health Summits for Sustainable Disaster Risk Management provide a detailed description of challenges and accomplishments of the Pacific Island health ministries, establish a Pacific plan of action based upon the principles of disaster risk management, and provide a locally derived, evidence-based approach for many climate change adaptation measures related to extreme weather events in the Pacific region.  The declaration and outputs from these summits are offered here as a guide for developmental and humanitarian assistance in the region (and for other small-island developing states) and as a means for reducing the risk of adverse health effects resulting from climate change.