Background
Country Profile
Kiribati is an island nation situated in the central Pacific Ocean, consisting of 33 atolls2 and reef islands spread out over an area roughly the size of India (see Figure 1).i Yet, Kiribati is also one of the world’s smallest and most isolated country. A summary of Kiribati’s key statistics are provided in Table 1.
Capital: Tarawa
Population (2023): 133,828
Official Languages: Gilbertese, English (less spoken outside the capital)
Religion: Predominantly Roman Catholic (56%) and Protestants (34%)
Currency: Australian Dollar, Kiribati Dollar
Figure 1. Kiribati on the map. Image courtesy of Thaman & Tye, 2015ii
Table 1: Key Country Figuresiiiivvvi
Demographics
Urban population
57.8%
Life expectancy
68.2
Fertility rate (births per woman)
3.3
Economy
GDP per capita
US$ 1702.0
Unemployment rate
11%
Education expenditures
19.3%
Healthcare expenditures
11.6%
Health
Adolescent birth rate (aged 10-19 years) per 1,000 women
40%
Infant mortality rate (per 1,000 live births)
33
2 An atoll is a ring-shaped coral reef, island or series of islets.
The current document has been created using pages 6-12 from the reference below:
AlMekhled, D., Garcia, A., Zufan, S., Zhang, Y., & Lim, J. (2023). 2023 Indo Pacific Global Health Competition. Sowing Seeds in Rising Tides:
Addressing Childhood Nutrition in Kiribat. 2023-Indo-Pacific-Case-Competition-Case-Release.pdf
Under 5 years mortality rate (per 1,000 live births)
52
Neonatal mortality rate (per 1,000 live births)
21
Physicians (per 1,000 people)
0.2
Education
Primary completion ratea
94%
Junior secondary completion ratea
78%
Senior secondary completion ratea
20%
a Per centage of a cohort of children or young people 3–5 years older than the intended age for each level education and completed that level of education.
Background: Climate Change
In 2015, Ioane Teiota, a Kiribatian, made the headlines for applying to be the world’s first climate refugee by claiming asylum in New Zealand vii. With an average elevation of less than six feet above sea levelviii, this Pacific Island nation is one of the most susceptible to the imminent effects of climate change.
Rising Sea Levels, Extreme Weather Events, and Coastal Erosion.
One of the most pressing concerns for Kiribati is the rising sea levels attributed to global warming. It is estimated that sea levels have risen an average of 3.2 mm per year since 1993, making Kiribati at the perils of being the first country to be swallowed up by the effects of climate changeix. King tides3 further aggravate the sea levels rising impact on Kiribati that could elevate the sea levels by additional 30cm in the Central pacific. Kiribati is also vulnerable to an increased frequency and intensity of extreme weather events, including cyclones and storm surges. In addition, coastal erosions have occurred rendering certain atolls uninhabitable. Many communities are being forced to relocate due to the coastal erosion, and some islands (e.g. Abanuea and Tebua Tarawa) have been completely flooded and no longer existx.
These extreme conditions contribute to further issues affecting drinking water and food availability. As seawater intrudes into freshwater sources, this threatens the availability of clean drinking water for the population. As seawater infiltrates the soil, agricultural lands are becoming increasingly salinized, jeopardizing food security and increasing the incidence of water and vector borne diseasesxi. Coupled with inadequate access to basic sanitation (see Figure 2), the effects of climate change are compounding and posing a serious public health threat.
3 King tides is a non-scientific term used to describe exceptionally hide tides, influenced by the El Nino-Southern Oscillation.
Figure 2. Kiribati’s Poor Access to Basic Sanitation. Image courtesy of World Bank (2015)xii
Adaptation and Resilience Strategies
In the face of these challenges, Kiribati has been working to develop and implement adaptation and resilience strategies including the construction of sea walls, the elevation of infrastructure, and the development of climate-resilient agriculture practices. These programmes are heavily funded by foreign aid with Australia being a key figure in pledging spending towards climate-resilient programmes in the Pacificxiii. Australia’s investment in Kiribati includexiv: •The Kiribati Education Improvement Program ($9.8 million 2016-20 in climate and disasterfinance of $96 million 2010-22 project total) which ensures schools have raised floors andprotective seawalls to reduce coastal flooding, that school facilities are built usingsustainable materials with integrated water and energy systems, and that children learnabout climate change at school.•The Pacific Technical Assistance Mechanism (PACTAM) is supporting the Director of theMinistry of Finance’s Climate Finance Division to increase Kiribati’s access to internationalclimate finance. Through this support, Kiribati has secured over USD150 million in supportfor priority climate change projects.•The Kiribati Adaptation Project Phase 3 ($5.9 million, 2010-2018) built seawalls and othershoreline protection systems around South Tarawa to help protect roads, homes andbusinesses during storm surges and sea flooding.
Additionally, the government is exploring innovative solutions, such as floating islands, to ensure the survival of its citizens in the face of rising sea levels. In 2014, then President Anote Tong, authorised the purchase of 20 sq km of land in Vanua Levu, Fiji, as a contingency plan for relocationxv.
Background: Food Insecurity
According to the Food and Agriculture Organization of the United Nationsxvi, around 8% of Kiribatians are undernourished, 22% live below the basic needs poverty line, and 41% experience moderate or
severe levels of food insecurity4. In addition, Kiribati has the Pacific Islands’ lowest childhood survival rate, with 15% of children under the age of five suffering from stunting5, and 6.3% of children dying before the age of fivexvii.
Multiplier Effects of Climate Change
Traditional food harvesting practices, which are central to the nation’s food security, have been compromised due to the impacts of climate change. Overfishing, coral reef degradation, and changing ocean patterns have led to declines in fish stocks, a significant protein source for the population. The productivity of coastal fisheries (e.g. fishes and invertebrates) is projected to decline by 20% by 2050 in part due to the effects of rising sea surface temperaturexviii. With 31.9% of Kiribatians employed in the agriculture, forestry and fishery sector, livelihoods are increasingly made precarious by effects of climate change leading to further food insecurityxix.
High Dependency on Imported Food
Climate change has resulted in significant declines in local food production, increasing reliance on nutrient-deficient imported foods and raising the prevalence of noncommunicable diseases. There is now a higher dependency on imports with 43.69% of food importedxx, leaving the nation exposed to supply chain disruptions and price fluctuations. From Jan-May 2023, 22 children were admitted to hospitals for malnutrition, with 6 deaths subsequently recordedxxi. According to latest UNICEF data, child malnutrition is on the rise with 1.3% of children suffering from severe acute malnutrition and 2.2% suffering from moderate acute malnutritionxxii.
With limited arable land and freshwater resources, Kiribati’s capacity to produce food is greatly restricted. As such, there has been a significant shift from a diet of traditional foods characterised by legumes, tubers, fresh fish, seafood and green leafy vegetables to one heavily dependent on non-nutritious, cheap, imported food consisting of oils, fatty and processed meats, confectionary and dominated by rice as a staple foodxxiii.
Consequently, diabetes and cardiovascular disease are now the primary causes of premature death in the countryxxiv. Vitamin and mineral deficiencies continue to be public health threats in Kiribatixxv. With an increasingly sedentary lifestyle over 41% of adults aged 18 years and over were characterised as insufficiently physically active in 2010xxvi. According to WHO estimates, 46% of Kiribati’s population aged 18 and above is obese or overweightxxvii. In 2015, 49.7% of all presentations to health facilities were of people with confirmed or suspected diabetes, and the figure was 46.9% for hypertension, confirming a picture of a country with pressing NCD-related problemsxxviii.
Adaptation and Resilience Strategies
The Kiribati government has developed a comprehensive nine-year strategy to promote climate change adaptation and skill up the country’s emergency preparedness. The main goal is to foster healthy and resilient ecosystems while also improving water and food security through integrated and sector-specific initiatives. To achieve this goal, the government intends to strengthen communities’ ability to take practical and long-term measures to address food security, increase understanding of food and nutrition practices, and improve food preservation and storage techniques to avoid food shortagesxxix. Some of these initiatives include: 4 A person is food insecure when they lack regular access to enough safe and nutritious food for normal growth and development and an active and healthy life. 5 Child stunting refers to a child who is too short for his or her age and is the result of chronic or recurrent malnutrition.

• Collaborative Sustainable Fisheries Projectxxx:
  Kiribati has partnered with the Australian Centre for International Agricultural Research on a sustainable fisheries initiative. The goal is to implement community-based fisheries management and establish Marine Protected Areas. This approach involves local communities in managing fisheries resources and creating protected zones to conserve marine habitats and enhance resource sustainability.
• Integrated Coastal Management Projectxxxi:
  The Ministry of Environment, Lands and Agricultural Development (MELAD) and the Ministry of Fisheries and Marine Resources Development are jointly leading an initiative that focuses on sustainable management of both land and coastal fisheries. Its objectives include boosting food production, safeguarding natural resources, and improving the well-being of island communities.
• Livelihood and Cultural Promotion by Tourism Authorityxxxii:
  The Tourism Authority organises workshops that cover fishing guides, home gardening practices, and the promotion of local culture. These efforts contribute to improved livelihoods and self-sufficiency in food production.
  Despite these efforts, there are doubts as to whether any of these initiatives will be sustainable and sufficient to stem the tide from the effects of climate change.
  Appendices
  i The World Factbook: Kiribati. Retrieved August 21, 2023 from: https://www.cia.gov/the-world-factbook/countries/kiribati/#environment
  ii Thaman, R.R. and Tye, A. (2015) ‘Flora of Kiritimati (Christmas) atoll, Northern Lines Islands, Republic of Kiribati’, Atoll Research Bulletin, (608). Retrieved August 21, 2023 from: https://www.researchgate.net/publication/285362928_Flora_of_Kiritimati_Christmas_Atoll_Northern_Line_Islands_Republic_of_Kiribati
  iii Kiribati National Statistics Census Report. Retrieved August 21, 2023 from: https://nso.gov.ki/
  iv The World Bank: Kiribati. Retrieved August 21, 2023 from https://data.worldbank.org/country/kiribati
  v UNICEF 2021 MICS-EAGLE Kiribati Education Fact Sheets. Retrieved August 21 from https://www.unicef.org/pacificislands/reports/2021-mics-eagle-kiribati-education-fact-sheets
  vi Final Report for Kiribati Education Improvement Program (KEIP) Independent Evaluation 2018. Retrieved from https://www.dfat.gov.au/sites/default/files/kiribati-education-improvement-program-2018-independent-evaluation-report.pdf
  vii UN landmark case for people displaced by climate change. Retrieved August 21, 2023 from: https://www.amnesty.org/en/latest/news/2020/01/un-landmark-case-for-people-displaced-by-climate-change/
  viii Kiribati Development Plan 2020-2023. Retrieved August 21, 2023 from: https://policy.asiapacificenergy.org/sites/default/files/Kiribati%20Development%20Plan%202020-2023.pdf
  ix Kiribati, the first country rising sea levels will swallow up as a result of climate change. Retrieved August 22,2023 from: https://www.iberdrola.com/sustainability/kiribati-climate-change
  x Climate Change in Kiribati. How will rising sea levels effect Kiribati? Retrieved 22 August, 2023 from: https://storymaps.arcgis.com/stories/7f455136b85f4edd8655d15a89b5039f
  xi Water, water, everywhere, but not a drop to drink: Adapting to life in climate change-hit Kiribati. Retrieved August 22, 2023 from: https://www.worldbank.org/en/news/feature/2017/03/21/adapting-to-life-in-climate-change-hit-kiribati#:~:text=King%20tides%20can%20wash%20over,agriculture%20and%20peoples’%20general%20wellbeing.
  xii Thaman, R.R. and Tye, A. (2015) ‘Flora of Kiritimati (Christmas) atoll, Northern Lines Islands, Republic of Kiribati’, Atoll Research Bulletin, (608). Retrieved August 21, 2023 from: https://www.researchgate.net/publication/285362928_Flora_of_Kiritimati_Christmas_Atoll_Northern_Line_Islands_Republic_of_Kiribati
  xiii Kiribati – Australia’s commitment to strengthening climate and disaster resilence in the Pacific. Retrieved 22 August, 2023 from: https://www.dfat.gov.au/about-us/publications/kiribati-australias-commitment-to-strengthening-climate-and-disaster-resilience-in-the-pacific
  xiv ibid
  xv Besieged by the resing tides of climate change, Kiribati buys land in Fiji. Retrieved August 22, 2023 from: https://www.theguardian.com/environment/2014/jul/01/kiribati-climate-change-fiji-vanua-levu
  xvi Kiribati Food Security Profile. Retrieved August 22,2023 from: https://www.fao.org/3/cb3786en/cb3786en.pdf
  xvii Food Consumption in Kiribati. Based on Analysis of the 2019/20 Household Income and Expenditure Survey. Retrieved 23 August, 2023 from: https://www.fao.org/3/cb6579en/cb6579en.pdf
  xviii Priority adaptations to climate change for the fisheries and aquaculture. Retrieved August 22, 2023 from: https://spccfpstore1.blob.core.windows.net
  xix Labour in Kiribati. Retrieved August 22, 2023 from: https://spccfpstore1.blob.core.windows.net
  xx Kiribati – Food Imports (% of Merchandise Imports). Retrieved August 22,2023 from: https://tradingeconomics.com/kiribati/food-imports-percent-of-merchandise-imports-wb-data.html
  xxi Malnutrition in Kiribati. Retrieved August 23,2023 from: https://msf.org.au/article/project-news/malnutrition-kiribati#:~:text=Kiribati%20is%20estimated%20to%20need,pneumonia%20and%20bronchiolitis%20are%20common.
  xxii ibid
  xxiii ChildFund Kiribati: Positive Places to Live Project. Nutritional Status and Household Water Quality Report. Retrieved August 22,2023 from: https://www.sciencedirect.com/science/article/pii/S030691922100052X
  xxiv Institute for Health Metrics and Evaluation (IHME), 2019. Kiribati Country Profile. Retrieved August 22, 2023 from: http://www.healthdata.org/kiribati.
  xxv ibid
  xxvi ibid
  xxvii Food Consumption in Kiribati. Based on Analysis of the 2019/20 Household Income and Expenditure Survey. Retrieved 23 August, 2023 from: https://www.fao.org/3/cb6579en/cb6579en.pdf
  xxviii Global status report on noncommunicable diseases in 2014. Retrieved August 22, 2023 from: https://www.sciencedirect.com/science/article/pii/S030691922100052X
  xxix Kiribati Joint Implementation Plan. Retrieved 23 August, 2023 from: https://unfccc.int/sites/default/files/resource/Kiribati-NAP.pdf
  xxx Locally-sourced. How Kiribati is shoring up food security and community resilience in the face of global climate change. Retrieved 23 August, 2023 from: https://undp-climate.exposure.co/locallysourced
  xxxi ibid
  xxxii Fishing For Food And Resilience, Sowing Seeds For People and The Planet. Retrieved 23 August, 2023 from: https://undp-climate.exposure.co/kiribati-sowing-seeds-for-food-security