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Between 2020 and 2024, climate change increased the number of 'pregnancy heat-risk days'—days exceeding the 95th percentile of local temperatures—in every analyzed country. In 90% of countries and 63% of cities, these risk days at least doubled compared to a world without climate change. The most significant increases occurred in developing regions, particularly the Caribbean, where 15 countries saw an average of at least 60 additional risk days annually, representing roughly one-fifth of a typical pregnancy. Beyond heat, the report notes that climate-driven air pollution, flooding, and infrastructure damage further threaten maternal health and birth outcomes.

Montserrat has reached 50 percent renewable energy installed capacity through the installation of a 750 kW solar system and 1 MWh battery storage, which powers 300 households. The project, supported by RMI, focused on hurricane resilience—designing for 180 mph wind speeds—and equity, as the utility-owned facility allows diesel savings to be shared among all customers via reduced fuel surcharges. While the island aims for 100 percent renewable electricity by 2030, further progress is constrained by the size of the economy and requires continued grant funding.

The report details how developing countries approach investment treaty negotiations, highlighting a trend toward renegotiating outdated agreements and the use of model treaties. It identifies the Ministry of Foreign Affairs and investment authorities as the primary leads in negotiations and provides a detailed mapping of ratification processes across various nations.

The 2018 Eastern Caribbean Green Economy Barometer evaluates the transition to a green economy (GE) in the OECS, concluding that progress is "below average." While member governments generally acknowledge the GE concept, the report finds that definitions remain narrow, often lacking focus on equity and inclusion. Key barriers include a lack of structured fiscal policies, the absence of finance ministries in GE dialogues, and a failure to integrate natural capital valuation into national policies. Despite these gaps, the report identifies "green shoots" such as renewable energy commitments in Dominica, Antigua and Barbuda, and Saint Lucia, as well as the Caribbean Regional Oceanscape Project (CROP).

The document analyzes climate finance commitments to OECS Member States between 2010 and 2015, finding that while US$ 101 million was committed, actual disbursement rates were extremely low (under 10% for most countries). The funding was dominated by multilateral sources and focused heavily on disaster-related adaptation, primarily delivered through short-term projects.

The report examines flood risk in Jamaica, noting that while tropical cyclones cause the largest losses, flooding is not strictly related to storm intensity but often to preceding rainfall. It highlights that public infrastructure, particularly roads and bridges, suffers the most damage. Despite repeated recommendations for hazard mapping and watershed management, the report finds a persistent lack of enforcement regarding 'no build zones' and a critical shortage of digital spatial data for planners.

The Green Climate Fund (GCF) Accreditation Panel recommends the Caribbean Development Bank (CDB) for accreditation as a regional entity for 'small' projects (up to USD 50 million) with a high environmental and social risk category (Category A/I-1). The CDB demonstrated strong fiduciary standards, a track record of mobilizing approximately USD 200 million for climate action, and a robust gender equality policy. However, accreditation is conditional upon the CDB establishing a public system for reporting the progress of grant-funded projects and finalizing a permanent external communications mechanism for environmental and social complaints.