How the accumulating damage of climate change could worsen the undue burden of tuberculosis across the Pacific.
We know that the Pacific Islands have been forced to deal with an untenable burden of tuberculosis since its introduction, likely by traders in the 19th century. Yet publicly available data on disease prevalence before the 21st century is scarce. Recent public estimates put the average burden at 10 to 50 fold that of the OECD, a club of mostly rich countries. With current data, it is difficult to estimate how many lives have been claimed or worsened by the “White Death.”
Both in relative and absolute terms, tuberculosis disease prevalence is high in the Pacific Islands. Papua New Guinea deserves special mention, as the people of this island suffer from an extraordinary burden. But even without this one country’s extraordinary disease prevalence, the Pacific Islands experience an order of magnitude more disease than the OECD.
Concurrently, the continued wear of typhoon seasons has brought billions of dollars (USD) in infrastructure damage. The intensity of these storms seems to be increasing with higher ocean temperatures. As such, we expect the effects of climate change to layer on top of decades of accumulated storm damage.
Between 1997 and 2024 there were — recorded storms. — reached Category 4 or 5. Those closest to the equator are protected by the spin of the Earth, while some suffer repeat insults year after year.
High-intensity storms may worsen the tuberculosis burden.
In 2025, the WHO released a report detailing how tuberculosis could be a climate-modified disease. High-intensity storms would be expected to displace families, require crowding for shelter, and damage healthcare infrastructure. When we look at the aftermath of storm seasons, we see a strong increase in tuberculosis cases in the following two years. High-intensity seasons show a +15% increased risk of tuberculosis cases in the following two years.
The sharpest rises after severe seasons in our dataset are the N. Mariana Islands in 2015 and Fiji in 2016. The following two years demonstrated dramatic increases in tuberculosis estimates. Over almost 25 years, increased storm intensity was associated with roughly 23,000 extra cases of tuberculosis for the Pacific Islands.
The analysis here looks at annual reports of cases because monthly data is unavailable publicly. Yet if storms precipitate the spread of tuberculosis, we could expect to find increased disease burden within months, not years. This analysis does not demonstrate a causal relationship. We cannot say from this retrospective data that increased storm intensity is responsible for more cases of tuberculosis. Dedicated research is needed to define the spread of tuberculosis after high-intensity storms. With research and targeted support, we could remove a curable illness from the seemingly endless burden of climate change.
Spencer Millen is a doctor of pediatrics and neonatology. He lives in Japan with his family. He has a passion for health analytics and data visualization.
Anthropic’s Claude (a Large Language Model) was used in this work product to write the code for the figures above. All figures started from hand drawings/sketches, and were slowly built out over weeks to their final product. This product’s ideas, analyses, conclusions, and prose were created solely by Spencer Millen.
Data sets employed: WHO tuberculosis estimates via the Pacific Data Hub .Stat (DF_SDG_03, CC BY 4.0); Pacific Data Hub climate series (DF_CLIMATE_CHANGE, CC BY 4.0); NOAA IBTrACS v04r01 cyclone best tracks (public domain); Natural Earth 10m & 50m (public domain); island coastlines © OpenStreetMap contributors (ODbL). Storm swaths are drawn at each storm’s R34 gale radius; reporting gaps are filled by within-storm interpolation, then wind-band medians. A data story for the Pacific Dataviz Challenge 2026.