The island communities in the Pacifc contribute very little to global carbon emissions, yet they are among the most vulnerable to the effects of climate change. Dr Colin Tukuitonga, a general practitioner by training, was born and raised on Niue Island in the Pacifc. He has held senior public health roles in the New Zealand Government and, since 2014, has served as Pacifc Community Director-General. He spoke to us about how climate change is affecting the health of people living in Pacifc Island countries and the relevance of Australia’s climate change policy responses to these neighbouring countries.