Developed a better understanding of the relationship between local level climate variability and refined a set of analytical techniques for assessing the impact of seasonal to inter-annual climate variability on important diseases in the Pacific Islands region. This project also demonstrated how these techniques can be used to allow climate forecasts to be used to reduce the risk of these diseases and provided an understanding of the impact of seasonal to inter-annual climate variability that can be applied to the impact of longer-term climate change to the Pacific Islands and other parts of the world.